What medical history matters most?

Blood thinners come first, whether a physician ordered them or the reader picked them up at a pharmacy. Warfarin, the newer anticoagulants, aspirin, ibuprofen and naproxen all raise bruising, and so do fish oil, vitamin E, ginkgo and high-dose garlic.

The injector needs the full list to plan around it. A medicine a physician has ordered is never stopped on an injector's word; the physician who ordered it is asked. Some antibiotics and muscle relaxants can strengthen a botulinum toxin's effect and should be named.

Isotretinoin, the oral acne medicine, delays many skin treatments for months after the last dose. A current or recent steroid course changes healing. Bring the bottles or a photo of them if the names are hard to remember.

Conditions that change the plan

For toxin treatments, any condition at the junction of nerve and muscle, such as myasthenia gravis, is a listed contraindication.

For filler, autoimmune disease is the gray area; many physicians treat controlled disease and hold off during a flare, and some decline certain products altogether because of delayed nodules.

Bleeding disorders, diabetes that is not well controlled, and a suppressed immune system all raise infection or healing risk. A history of keloid or thick scars matters for threads and devices more than for injectables, but it belongs on the form regardless.

Cold sores matter because a lip treatment can trigger one, and a physician can plan ahead for that.

Pregnancy and breastfeeding are firm holds for toxin and filler. Not because of proven harm, but because the products have not been studied in those groups.

The recent-events section

Dental work, including a routine cleaning, within the last two weeks is a common reason to delay filler, since bacteria from the mouth can travel to fresh product. Surgery or a significant illness in the last few months changes healing and bruising.

A vaccination in the last two weeks is on some practices' delay lists for filler. Travel plans matter too: an injector will want to know if the reader is flying tomorrow, since swelling and any complication are harder to manage from a hotel.

Everything already in the face

Previous filler, with product name, area and approximate date. Previous threads. Previous energy-device treatments.

Any permanent or unknown product, including anything injected abroad or at a party. This section is often the least complete on a form and the one injectors care about most.

Old product changes how new product behaves, and unknown product can be a reason to decline an area. If the earlier practice kept records, ask them for a copy; California practices are required to keep patient records and to release them on request.

In field terms, the answer turns on whether the injector can see the whole picture.

A reader who tracks consumer product recalls through the CPSC knows that a recall notice is useless without the lot number; the same applies to a filler chart, which is why product and lot belong in the reader's own records too.

How to present it

Write it down before the visit, in four short blocks: medicines and supplements, conditions and allergies, recent events, and past treatments. Hand it over rather than reciting it. A practice that photographs or scans the list into the record is doing it properly.

A practice that does not ask for any of it is telling the reader something.

Plan the day around it as well. If the list includes a sedative or a strong painkiller, driving home is a question; the transit maps from the city's transportation department make a car-free trip to most Los Angeles practices possible.

If bruising is likely, a quiet evening indoors, at an LA Phil concert rather than a bright restaurant, is easier on the reader's self-consciousness.

And if the reader lives outside the city proper, in a place like the one served by the City of Pasadena, the drive time back matters if a complication needs a same-day return.

How the desk checked this answer

The answer desk compiled this from the intake questionnaires Los Angeles practices publish, the contraindication sections of the product information for the main toxin and filler brands, and the American Society of Plastic Surgeons' patient guidance on preparing for injectables.

The items above appear on nearly every form. The desk cannot weigh the reader's own history and does not try to. The physician's good-faith examination, which California expects before a first treatment, is where the history is interpreted.