Five Questions to Ask Before Getting Fillers in Montreal

What every informed patient deserves to know before their first injectable appointment.

By Dr. Sonya Ghalehii, Medical Doctor · Medical Director, GhalMédica · Pointe-Claire, Montréal

Dermal fillers have become one of the most requested aesthetic treatments in Quebéc. They are also one of the most variable — in terms of technique, safety protocol, and clinical training of the person performing them. Before committing to an appointment, there are five questions worth asking out loud. The answers will tell you more than any before-and-after photo ever could.

"The decision to trust someone with your face is a clinical decision. It deserves the same due diligence you would apply to any other medical procedure."

THE REGULATORY REALITY IN QUEBEC

In Quebéc, dermal filler injections can be legally administered by individuals with varying levels of medical training. This is not a criticism of any particular profession — it is a description of the regulatory landscape patients are navigating, often without realizing it.

Understanding who is treating you, what their training includes, and what oversight structure is in place is not an act of distrust. It is the most fundamental question a patient can ask.

01. IS THE PERSON TREATING YOU A PHYSICIAN?

A licensed physician brings a full understanding of facial anatomy, vascular structures, and emergency medicine to every injection. This is not a credential advantage — it is a clinical one. Complications from filler, while rare, can be serious. Vascular occlusion, the most significant injectable complication, requires immediate recognition and intervention. The physician's training in this area is not comparable to that of a non-physician injector, regardless of experience level. Ask directly: what is your medical background and what emergency training do you hold?

02. DO THEY USE A VASCULAR SAFETY PROTOCOL FOR FILLER PLACEMENT?

Facial anatomy is not uniform. Vascular structures — the arteries and veins that supply blood to your face — vary meaningfully from person to person. Standard anatomical maps, however well-studied, describe averages. They do not describe you specifically. Ultrasound-guided injection allows a physician to visualize your individual vascular anatomy in real time before and during treatment. This means that needle or cannula placement is informed by what is actually present beneath the surface, not by what is statistically probable. Ask: do you use any real-time imaging or vascular verification during filler treatment?

03. WHAT IS THEIR EMERGENCY PROTOCOL FOR VASCULAR COMPLICATIONS?

A properly trained injector carries hyaluronidase — the enzyme that dissolves hyaluronic acid filler — and knows precisely when and how to use it. They have a documented protocol for managing a vascular occlusion event. They do not need to look it up. This is not a question designed to alarm you; the incidence of serious filler complications is low. It is a question designed to tell you whether the person in front of you has treated this as the medical procedure it is, rather than a cosmetic service. Ask: what is your protocol if a vascular event occurs during or after treatment?

04. WILL THEY TELL YOU NO WHEN TREATMENT IS NOT APPROPRIATE?

A clinician who declines to treat — because the anatomy is high-risk, because your expectations exceed what the treatment can safely deliver, or because a different approach would serve you better — is acting in your best interest. The willingness to say "not today" or "not this treatment" is one of the clearest indicators of clinical integrity in an aesthetic practice. A consultation that ends in a booking is not always the right outcome. Ask yourself, after the consultation: did this person make space for the possibility that treatment was not indicated?

05. ARE THEY TREATING YOUR FACE AS A WHOLE, OR FEATURE BY FEATURE?

Isolated volume replacement — adding filler to a single area without considering its relationship to surrounding anatomy — can produce results that look disproportionate over time, even when each individual treatment appears reasonable in isolation. Facial harmony depends on structural balance. A physician who understands craniofacial anatomy, facial thirds, and the relationship between volume, skin quality, and skeletal support is thinking about your face as an integrated system. Ask: how do you approach treatment planning across the face as a whole?

WHAT INFORMED CONSENT ACTUALLY MEANS

Informed consent in aesthetic medicine is more than a form you sign at the front desk. It is a conversation — one in which the risks, realistic outcomes, alternatives, and your individual anatomy are discussed before any product is opened. If you are not having that conversation before your treatment, the consent process is incomplete.

Results from dermal filler treatment vary. They depend on your anatomy, your skin quality, the product used, the technique applied, and the clinical judgment of the person treating you. No reputable clinician will guarantee a specific outcome. Be cautious of any practitioner who does.

"Aesthetic medicine, practiced well, is not about adding. It is about restoring proportion — with respect for what is already there."

These questions are not designed to generate anxiety about a treatment that, in qualified hands, is safe and effective. They are designed to help you identify those qualified hands — and to give you language for a conversation that you have every right to have.

MEDICAL DISCLAIMER: The information provided by GhalMédica is for educational purposes only and does not constitute individualized medical advice. Clinical oversight by Dr. Sonya Ghalehii, MD, ensures our treatments and product selections meet evidence-based standards for skin health. For personalized medical recommendations, please consult a licensed physician.

Dr. Sonya wrote this article because she believes every patient deserves to walk into a consultation already informed. At GhalMédica, our consultations are unhurried, and every question above has an answer we are prepared to give you directly.

If you are considering filler treatment in the West Island and want to understand what physician-led care looks like in practice, we invite you to start with a conversation. Book a Consultation