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Botox, Fillers & The Right to Inject

A few months ago, I was attending a function in NJ where some physicians were in attendance. Through the course of discussion, some of us became involved in a discussion about NJ State law which prohibits nurses from injecting Botox or dermal fillers. While many of us sat there with our jaws dropped in disbelief of what we were witnessing, a plastic surgeon went into a soliloquy about why nurses shouldn’t be injectors.

There he stood on his soap box declaring his supremacy over all that was injectable as highly experienced nurses began interjecting some factoids about how nurses are specialized in IV therapies, take more time to attend training courses, and overall exhibit better patient care. It went on and on with no outcome other than shattered egos.

The truth is, many States permit nurses and PAs to inject Botox and dermal fillers as well. While many physicians may hold true to their stance that a skilled board certified dermatologist or plastic surgeon should be doing the injections, what truly matters is the skill, experience and knowledge of the injector. My point is, there are as many physicians out there who should not be doing injectables as there are nurses.

While Botox has had as many horror stories as, say, laser hair removal or lipodissolve, the truth is (if you care to do some research) that the majority of the issues with Botox were due to the fact that they were administered by either non-licensed or untrained personnel such as estheticians. In regards to nurse injectors, many of the State laws declare they can perform the injections under the direct supervision of a physician who has performed the initial examination of the patient and has written orders for it.

The initials after a person’s name should not be the deciding factor when clients choose a practitioner to inject their Botox or fillers. What is important is excellent knowledge of facial muscle anatomy, training, certification, education in the latest techniques, and hands-on experience.

Author: Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

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Reader Comments (3)

This plastic surgeon agrees with you. I think selected nurses can make wonderful injectors, given appropriate training, supervision and experience.

03.6 | Unregistered CommenterTF

Yet another nurse facing charges for injecting Botox:

Laws governing medspas are definitely vague.

08.14 | Unregistered Commenterjudy823

I would have to agree with you on this. Having trained hundred of physicians as well as nurses over the last several years, I have seen expertise on both sides. Simply having a degree does not qualify someone as a "good" injector.

That being said, there also needs to be a baseline level of certification required before a medical professional is able to perform these injections. In my opinion, a nurse or PA is qualified but an aesthetician is not. Another baseline requirement should be level of experience before performing more complicated treatment procedures. I am also shocked when I train a novice injector and they want to learn how to inject the tear trough first day out. Are you kidding me with this? That is a complex and complicated area that should be never be addressed by someone who is just starting out.

So...the next time you seek an injector, check out not only their credentials but also their degree of experience.

Gregory A. Buford, MD FACS
Board Certified Plastic Surgeon

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