“Med spa” is an unregulated term, which is why choosing one is harder than it should be. This is the guide we would want a friend to read — who can legally inject in Texas, what the letters after a name actually mean, the six questions to ask, the red flags, what things really cost here, and who we are not the right practice for.
What a med spa actually is
The term is unregulated, which is the root of most of the confusion. “Med spa” is applied to everything from a physician-owned clinic with a full medical director to a salon that added injectables last spring. The sign on the door tells you almost nothing.
What a med spa should be is a practice performing medical aesthetic treatment under genuine physician oversight, with real consultations, real charting, and a real answer when something goes wrong. Everything in this guide is about telling those apart from the rest.
Who can legally inject in Texas
Injecting botulinum toxin or dermal filler is the practice of medicine in Texas. It can be delegated — a physician may delegate it in writing to a properly trained physician assistant, advanced practice nurse, or other properly trained person, with supervision.
So a registered nurse injecting you is normal and lawful. The question was never whether your injector is a nurse. The question is whether there is a real physician behind them, and whether that physician is actually involved rather than a name on a filing.
That distinction is not theoretical. The Texas Medical Board has publicly flagged med spas and IV clinics as a source of complaints about improper supervision and delegation — including patients being treated without the physician evaluating them or reviewing records first. The Board can investigate the supervising physician, and where no physician is involved at all, it has cease-and-desist authority.
The credentials, decoded
- RN — registered nurse. Can inject under physician delegation.
- BSN — bachelor of science in nursing. A degree, not a licence.
- NP / APRN — nurse practitioner. Broader scope, can prescribe.
- PA — physician assistant. Practises under physician supervision.
- MD / DO — physician. DO and MD are equivalent licences.
- CANS — Certified Aesthetic Nurse Specialist. A specialty certification requiring an active RN licence, documented hours in aesthetic practice under a core-specialty physician, and a proctored exam.
What none of these tell you is how many times the person has treated the specific thing you are asking about. Ask that separately, and ask it plainly.
What “physician supervised” should mean
It is the most-used phrase in aesthetics and the least examined. At minimum it should mean a named physician, a written delegation, a standing relationship with the injectors, and a route to that physician when something is not right.
At Privé the Medical Director is Dr. Gregory Gardner, DO. If a practice will not name theirs on their own website, that is information.
Six questions to ask before you book
- Who performs the treatment, and what is their licence?
- Who is the supervising physician? Are they on site, or reachable, and how?
- How many times have you done this specific treatment?
- What product, and what does it cost per unit or syringe? Per-area pricing without explanation hides the unit count.
- What happens if I have a problem at 9pm on a Saturday? There should be an immediate, unhesitating answer.
- Is there anyone you would decline to treat? A practice that has never declined anyone is telling you something.
Red flags
- No named supervising physician anywhere on the site.
- Pressure to buy a package at a first consultation.
- No medical history taken before injection.
- Prices only available “on consultation” for standard treatments.
- Before-and-afters with inconsistent lighting, angle or makeup — or obvious stock imagery.
- Injectables at a party or pop-up with no private consult and no charting.
- A yes to absolutely everything.
What things actually cost in Dallas
Botox runs roughly $10 to $18 per unit across the Dallas market, with the middle sitting around $12 to $14. Hyaluronic acid filler is usually $650 to $900 per syringe. Those ranges are wide because they include everything from high-volume injectable bars to physician-owned practices.
Meaningfully below the range is a question rather than a bargain: over-dilution, very short appointments, or an injector early in training. Any of those can be acceptable if disclosed. None should be a surprise. Meaningfully above it should buy you something identifiable — time, credential, or technique — and if nobody can tell you what, it is just a higher price.
Privé publishes every price on one page rather than quoting on request.
Med spa vs dermatologist vs plastic surgeon
They are not competitors so much as different tools.
A dermatologist is a physician trained in skin medicine. Anything that might be disease — a changing mole, persistent rash, severe or scarring acne — belongs there first. A plastic surgeon handles what surgery handles: significant skin laxity, structural change, anything a needle cannot do. A med spa performs non-surgical aesthetic treatment under delegation.
A practice worth trusting will route you out when you are in the wrong place. We do, regularly, and it is one of the more useful things we do.
On Highland Park and the Park Cities
An address signals rent, not skill. There are excellent injectors in strip centres and indifferent ones on the best streets in Dallas.
What a small practice can genuinely offer is time — longer appointments, the same person each visit, someone who remembers what was done last year without opening a file. That is a real difference and it is worth paying for. “Luxury” by itself is not.
Where Privé fits — and who we’re not for
Privé is a small practice in Highland Park, led by Elizabeth Hurley, RN, BSN, CANS, with medical oversight by Medical Director Dr. Gregory Gardner, DO. Conservative dosing is the house style: we would rather add at a two-week follow-up than overshoot on the day. Prices are published. Consultations end with a written plan.
We are not the right practice if you want a fully frozen result, the lowest price in Dallas, treatment the same day without a consultation, or a dramatic change in a single visit. None of those are unreasonable things to want. They are simply not what this practice does, and we would rather say so than take the booking and disappoint you.
If what you want is someone who will tell you no when no is the right answer, that is the thing we are actually offering.
Frequently asked
Who can legally inject Botox in Texas?
Injecting botulinum toxin and dermal filler is the practice of medicine in Texas. A physician may delegate it to a properly trained physician assistant, advanced practice nurse, or other properly trained person under written delegation and supervision. So a registered nurse injecting you is normal and legal — provided there is a real supervising physician behind them. The question is never 'is my injector a nurse', it is 'who is the physician, and are they actually involved'.
What does CANS mean?
Certified Aesthetic Nurse Specialist — a credential from the Plastic Surgical Nursing Certification Board. It requires an active RN licence, documented hours in aesthetic practice under a core-specialty physician, and a proctored exam. It is not a weekend course and relatively few nurses hold it. It tells you someone chose to be tested on this specifically.
Is a med spa the same as a dermatologist?
No. A dermatologist is a physician who completed residency in skin medicine and treats disease — skin cancer, severe acne, autoimmune skin conditions — as well as cosmetic concerns. A med spa performs cosmetic and aesthetic treatment under physician delegation. If you have a mole that has changed, a rash that will not resolve, or anything that might be disease, you want a dermatologist, and any decent med spa will tell you so.
What should I ask before booking?
Who will perform the treatment and what is their licence. Who is the supervising physician and are they on site or reachable. How many times have you done this specific treatment. What product are you using and what is the price per unit or syringe. What happens if I have a complication at 9pm on a Saturday. And: is there anyone you would decline to treat?
Is the cheapest Botox in Dallas a bad idea?
Not automatically, but treat it as a question rather than a bargain. Botox runs roughly $10 to $18 per unit across Dallas with the middle around $12 to $14. Meaningfully below that range, ask what is funding the discount — over-dilution, a volume model with very short appointments, or an injector early in their training. Any of those can be fine if disclosed and none of them should be a surprise.
What are the real red flags?
No named supervising physician anywhere on the website. Pressure to buy a package at a first consultation. Prices quoted per area rather than per unit with no explanation. No medical history taken. Before-and-after photos that are obviously stock. Nobody ever saying no to anything. And injectables offered at a party or a pop-up with no private consultation.
How do I judge before-and-after photos?
Look for consistent lighting, angle and expression between the two images, and no makeup in the after that was absent in the before. Look for results that are proportionate rather than dramatic. And look at whether the practice shows a range of faces and ages, or the same three flattering cases on rotation.
Does it matter where in Dallas the practice is?
Less than people think, and mostly for the wrong reason. A Highland Park address signals rent, not skill. What matters is who treats you, who supervises them, how long they spend, and whether they will tell you no. Those are available at every price point and absent at every price point.
How many times should my injector have done this?
Ask the question plainly and judge the answer by how comfortable it is. Someone experienced will give you a straight number and will often volunteer where their limits are. Hesitation or deflection is the signal, not the number itself.
Who is not a good fit for Privé?
Someone who wants a fully frozen result, someone who wants the lowest price in Dallas, someone who wants to be treated the same day without a consultation, and someone who wants a dramatic change in one visit. None of those are wrong things to want — they are simply not what this practice does, and we would rather say so than take the booking.