The most important factor isn't really the type of facility — it's the qualifications of the person actually holding the needle. Whether it's a derm's office or a med spa, you want to confirm that a licensed medical professional is performing the injections, not just overseeing them from another room. Reputable med spas operate under medical supervision and use FDA-approved products. Ask directly: who performs the injections, what are their credentials, and who is the medical director? If they can't answer that clearly, move on.