Short answer
It depends on your state. In Georgia, the medical board treats Botox and filler injections as the practice of medicine: physicians, physician assistants and advanced practice nurses can inject under board rules, and registered nurses can with a physician's written order. Dentists follow a separate board rule. Estheticians and other unlicensed people may not. Check your state board and your provider's license before you book.
Who is legally allowed to give Botox and fillers?
It varies by state, so your state board has the final word. In Georgia, the Georgia Composite Medical Board says these injections are the practice of medicine and lists who may perform them: physicians, physician assistants and advanced practice nurses under board-approved arrangements, and registered nurses with training and a written physician order. Other unlicensed people may not.
The board's answer starts from how the products are classified. It calls botulinum toxin a dangerous drug and soft tissue fillers medical device implants approved by the FDA, and the FDA's own filler page describes fillers the same way. Other states set their own rules, so a rule you read online for one state may not apply in yours. This is a summary of what the Georgia boards published when this article was written in October 2026, not legal advice. Nurses are also regulated by a nursing board, and this article did not review its guidance.
The same answer adds details that matter to patients. The physician should examine and prescribe, but does not have to stay on site while a physician assistant, advanced practice nurse or registered nurse injects under a written order. A physician may not delegate the injection to a medical assistant, which the board defines as unprofessional conduct. So the useful checks are who examined you, who wrote the order and who is holding the syringe.
| Who | Georgia Composite Medical Board answer |
|---|---|
| Physician | May inject |
| Physician assistant | With a Board-approved job description and Additional Duty Request |
| Advanced practice nurse | With a Board-approved protocol agreement and Form C |
| Registered nurse | With appropriate training and a written physician order |
| Medical assistant | Physician may not delegate this injection |
| Esthetician or other unlicensed person | Not permitted |
Can I inject Botox if I'm not a nurse?
Being a nurse is not the test. What matters is whether your license carries authority to inject, and under what arrangement. In Georgia, the medical board lists physicians, physician assistants and advanced practice nurses, and the Board of Dentistry lets dentists administer injectables for the mouth and nearby tissues after a Board-approved course. Physicians may not delegate the injection to medical assistants, and estheticians and other unlicensed people may not inject.
Dentists are regulated separately. The Georgia Board of Dentistry's 2012 notice says a dentist may administer injectable pharmacologics, which include hyaluronic acid, fillers and botulinum toxin, only after completing a Board-approved post-doctoral course. The rule text, as published by the Georgia Secretary of State, requires approved courses to run at least 21 hours and cover topics that include head and neck anatomy, patient selection and management of complications. It describes the permitted use as cosmetic or functional enhancement of the gums, cheeks, jaws, lips, oral cavity and associated tissues in connection with a dental procedure in a dental treatment setting, and it bars a dentist from delegating the injection.
A training course can teach technique, but the medical board's answer is organized by license type and by the written order or board-approved paperwork, and it asks only for 'appropriate training' for nurses. If you are a clinician asking how to get qualified, the starting point is a license that carries injecting authority in your state. Ask your state board before you pay for any course.
What qualifications do you need to give Botox?
A valid license that allows injecting in your state, plus training for the area being treated. The CDC says to ask whether your provider has a valid healthcare license and is trained to give botulinum toxin injections. The FDA tells filler injectors to know the anatomy, recognize the signs of injection into a blood vessel and have a plan if it happens. A 2026 review noted that inexperience contributes substantially to complications.
The stakes are clearest with fillers. The most concerning risk the FDA names is unintentional injection into a blood vessel. It says the chances are low, but complications can be serious and may be lasting, including tissue death, vision abnormalities including blindness, and stroke. A 2024 review in Aesthetic Surgery Journal found 365 newly published cases of partial or complete vision loss after filler injection between September 2018 and March 2023. Of the 318 cases that reported outcomes, 68.2% had no vision recovery. The authors call it a rare but disastrous complication and say injectors should have thorough knowledge of prevention and management.
Preparedness is part of training. The 2026 review of filler-related vascular occlusion in the skin identified hyaluronidase, the enzyme that breaks down hyaluronic acid filler, as the established treatment, while noting that high-quality evidence is limited, and urged injectors to train in recognizing and managing emergencies early. It is reasonable to ask whether an office keeps it on hand. It is not a promise of rescue: in the 2024 review, no treatment was significantly associated with vision improvement. The FDA's patient advice is to seek a licensed provider with experience in dermatology or plastic surgery who is trained in filler injection.
Is it risky to get Botox or fillers from someone unlicensed?
It can be. A 2024 CDC report describes seven women who became ill after cosmetic botulinum toxin injections in nonmedical settings; four were hospitalized and two were monitored in intensive care. The FDA determined the product given to four of them was counterfeit. The report also says these products are considered safe for cosmetic use in clinical settings, though the toxin can spread and cause temporary local effects.
Six of the seven received injections at a residence and one at a cosmetic spa. The four Tennessee and Kentucky patients were injected by a relative of one of them who was not licensed. All seven had drooping eyelids, dry mouth, trouble swallowing, shortness of breath and weakness. For those four, the packaging claimed a vial size the real manufacturer does not make, and the batch number belonged to a genuine batch that expired in 2017. The CDC says symptoms can start hours to weeks after injections, and weakness, double vision or trouble swallowing or breathing is a reason to seek emergency care.
A license alone does not remove the risk. The FDA's 2024 alert says the counterfeit Botox was injected by licensed and unlicensed individuals and/or in non-medical or unlicensed settings, and that the products appear to have been bought from unlicensed sources. The FDA's filler guidance adds that injectable silicone is not approved for any aesthetic use and that you should not purchase filler products online. So ask about the product's source as well as the person's license.
Can an oral and maxillofacial surgeon do cosmetic surgery?
Yes, within their state's rules. The American Association of Oral and Maxillofacial Surgeons (AAOMS) says oral and maxillofacial surgeons are well qualified to perform cosmetic procedures of the face, and lists wrinkle-relaxing injections and injectable fillers among the procedures they commonly perform. State rules and each surgeon's own training decide what any one surgeon offers.
AAOMS describes its specialty as surgical training in a hospital-based residency of a minimum of four years, alongside medical residents in fields that include plastic surgery and anesthesiology, focused on the bone, skin and muscle of the face, mouth and jaws. That is a society describing its own members, so treat it as context, not a promise about any one surgeon. For how that training compares with a general dentist's, see our oral surgeon vs dentist guide.
In Georgia, the Board of Dentistry's rule exempts a dentist who completed an ADA accredited oral and maxillofacial surgery program from the Board-approved injectable course, but it still describes the permitted use in terms of the mouth and nearby tissues, so the scope question is worth asking directly. At ANEWU, the practice's pages describe Dr. Abtin Shahriari as an oral and maxillofacial surgeon and say facial aesthetics, including Botox and fillers, is led and performed by Dr. Arshia Payman, MD.
How do you check a provider's license?
Use your state board's public lookup, and ask the provider for the license type and number. Georgia's medical board says its online verification shows license number, status, issue and expiration dates, and any public board orders. For physician assistants it also lists the job description and approved supervising physician.
A license check answers one question: is this person licensed, and what does the board's public record show. It does not tell you how many times they have treated a given area or how they handle complications, so you ask those directly. Other license types, such as dentists, are checked with their own boards, and the CDC notes that your state may have a lookup tool to verify provider or facility licensing.
Who is in the room is a separate question. As noted above, Georgia's medical board does not require the physician to stay on site while a physician assistant, advanced practice nurse or registered nurse injects under a written order. So ask who examined you and wrote the order, who is injecting today, and how you reach a clinician if a problem starts after you leave. For Botox, the CDC adds a simple check: ask the provider to draw the product from the labeled vial into the syringe while you watch.
What should you ask before getting Botox or fillers?
Ask who is injecting and what license they hold, what training they have in the area being treated, where the product came from, and what happens if something goes wrong. CDC and FDA both advise asking about license, training and product source. If you are in doubt, CDC's advice is to skip the injections.
Tell the provider about your medical history, medicines and allergies. The FDA lists conditions to tell your provider about before filler, including inflamed or infected skin, a bleeding disorder and allergies to some filler ingredients. Two of the questions above are tied directly to documented harm: the product's source and the injector's training. Write the answers down, and compare more than one provider if you can.
Also ask how complications are handled in practice. The FDA tells filler providers to have an updated plan for treating injection into a blood vessel and to prepare staff to help patients who call with signs of a filler complication. Seek immediate medical attention for unusual pain, vision changes, or skin that looks white, gray or blue near the injection site.
- What is your license type and number?
- What training have you had in facial anatomy and in managing complications?
- How often do you treat this area?
- Which product will you use, and where was it bought?
- Can I read the patient labeling for this filler?
- Will you draw the botulinum toxin from the labeled vial while I watch?
- What is your plan if filler blocks a blood vessel, and is hyaluronidase in the office?
- Who do I call if I have symptoms after I leave?
Who performs Botox and fillers at ANEWU?
ANEWU's website says facial aesthetics is led by Dr. Arshia Payman, MD, and that she performs the Botox and dermal filler treatments at the practice. Her page describes her as a board-certified physician specializing in aesthetic medicine who trained at George Washington University and at four Washington D.C. hospitals, including the National Institutes of Health.
The site says she reviews your health history before treating you, and that the first consultation is free with no pressure to book. It also says she works directly with Dr. Abtin Shahriari so surgical and aesthetic plans can be made together. Those are the practice's own statements, and this article has not verified them. Apply the questions in this article to ANEWU as you would to any provider, including which board certified her, and check any license on your state board's lookup.
If you are weighing Botox or fillers, you can book a free consultation at the Buckhead, Cumming or Dawsonville office (her page suggests calling to ask which office she is at on your day) and bring your list of questions, your medical history and the names of any medicines you take. The Botox page and dermal fillers page explain how each treatment is used at the practice, and results vary from patient to patient.
Sources and further reading
- Who can inject botulinum toxin and soft tissue fillers in Georgia? (FAQs) Georgia Composite Medical Board
- Verify a Licensee Georgia Composite Medical Board
- Notice of New Board Rule on Administration of Injectable Pharmacologics Georgia Board of Dentistry, June 15, 2012
- Ga. Comp. R. & Regs. R. 150-14-.04, Administration of Injectable Pharmacologics Georgia Secretary of State, Rules and Regulations of the State of Georgia (text of the Georgia Board of Dentistry rule)
- Dermal Fillers (Soft Tissue Fillers) U.S. Food and Drug Administration, content current as of July 2023
- Counterfeit Version of Botox Found in Multiple States U.S. Food and Drug Administration, 2024 (content current as of May 2, 2024)
- Notes from the Field: Illnesses After Administration of Presumed Counterfeit Botulinum Toxin in Nonmedical Settings, Tennessee and New York City, March 2024 Morbidity and Mortality Weekly Report, CDC, 2024
- How to Stay Safe When Getting Botulinum Toxin Injections Centers for Disease Control and Prevention, page dated April 22, 2026
- Facial Cosmetic Surgery MyOMS.org, American Association of Oral and Maxillofacial Surgeons
- OMS are the Experts in Face, Mouth and Jaw Surgery MyOMS.org, American Association of Oral and Maxillofacial Surgeons
- Update on Blindness From Filler: Review of Prognostic Factors, Management Approaches, and a Century of Published Cases Aesthetic Surgery Journal, 2024
- Hyaluronic Acid Dermal Filler-Associated Vascular Occlusion: A Review of Prevention and Management Strategies Journal of Cosmetic Dermatology, 2026
This article is general information about dental and facial procedures, not a diagnosis or medical advice. Every jaw and every health history is different, so the right plan for you can only be set after an exam and imaging with a surgeon.