Can Nurses Inject Botox?

Physicians Coalition for Injectable Safety offers clarity on the role of nurse injectors

New York, NY - June 30, 2008 - The Physicians Coalition for Injectable Safety (http://www.injectablesafety.org) today advises patients that all nurse and physician assistant injectors may not be qualified to perform cosmetic injections such a Botox, Restylane or other dermal fillers. Patients should be aware that the most important factor to any nurse or physician assistant injector is their relationship with an appropriately trained, supervising physician, and how closely the nurse and physician work together. The Coalition offers these guidelines to consumers who have questions about the safety or appropriateness of cosmetic nurse injectors:

  • Nurses and physician assistants performing injectable treatments should only treat under the following conditions:
  • The nurse or PA is under the supervision of a board certified plastic surgeon, facial plastic surgeon, ophthalmic plastic surgeon or dermatologist who has prescribed the injectable treatment appropriate for the patient
  • The nurse or PA can demonstrate appropriate medical education, licensure and training specific to the delivery of cosmetic injections
  • The nurse or PA only performs injections in a medical setting supervised by the prescribing physician
  • The nurse or PA follows all of the appropriate steps in performing cosmetic injections, and that all patients are given informed consent documents that clearly define the risks and benefits of the procedure.
  • The patient has the option to request the doctor perform cosmetic injections

Patients should not accept treatment from nurses or any other clinician in private homes, hair salons, hotels, bars or any other non-medical setting. "It is generally safe for nurses to perform injectable treatments under the appropriate circumstances: proper training specific to cosmetic injectables, proper supervision by a qualified physician, and within the supervising physician's office," says Jeffrey Kenkel, MD of Dallas, TX. "I have personally trained my nurses in performing injectables. They present an option to patients who understand that regardless of who delivers the injection, I prescribe treatment and inevitably patient outcome is my responsibility. However, if a patient of mine prefers that I treat them, that is entirely the patient's right."

"Physicians have differing in-office philosophies. I prefer to perform cosmetic injections personally, to evaluate a patient's goals and physical condition before prescribing treatment and to also administer that treatment." says Roger Dailey, MD, of Portland, OR. "Like many physicians who perform their own injections, I enjoy spending time with patients whether the injection is a first-time treatment, or a treatment to refresh appearance." A survey conducted by the Coalition in July 2007 reports that while 94.6% of physicians personally perform cosmetic injections, only 24.4% of Coalition member practices include nurse or physicians' assistant injectors. In addition, 45.3% of complications resulting from cosmetic injections are reported to result from unqualified providers, and that 35.2% result from injections administered in a non-medical setting, such as a spa, hair salon or private home.

Whether the patient opts for cosmetic injections performed by the physician or accepts injection by a registered nurse (R.N.) or licensed physician's assistant (P.A. or P.A.-C), it is important to make sure the patient follows the safety guidelines of DOCTOR. BRAND. SAFETY:

  • Doctor: Is the injectable recommended by a qualified doctor who regularly treats similar conditions, in an appropriately licensed and equipped medical facility? Has the doctor examined the prospective patient before recommending treatment?
  • Brand: Is the injectable recommended approved by the U.S. FDA, in the U.S. (and by equivalent agencies in the country of origin) for cosmetic indications and is it appropriately labeled and packaged to reflect its authenticity and approval?
  • Safety: Is the setting a proper medically-equipped office, with safety and sterilization procedures? Has the physician evaluated conditions, recommended treatment, offered alternatives and clearly defined the potential outcomes including any complications?

To learn more about nurse injectors, FDA approved brands of cosmetic injectables and their benefits, and to see video of live, appropriately administered injectables as well as real patient stories and more visit http://www.injectablesafety.org and. http://www.realself.com/injectable-safety-campaign.

About Us
The Physicians Coalition for Injectable Safety is an alliance of specialty physician organizations including the American Society for Aesthetic Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, and the American Society of Ophthalmic Plastic and Reconstructive Surgery. The mission of the Coalition is to provide the public with unbiased and necessary information on injectable cosmetic treatments, appropriate injectors and where to safely access cosmetic medical procedures. Our goal is to promote treatment supervised by properly qualified and trained, board-certified doctors and to promote only the use of U.S. FDA-approved, appropriately administered product. More information can be found at http://www.injectablesafety.org.

About ASAPS
The 2400-member American Society for Aesthetic Plastic Surgery (ASAPS), founded in 1967, is the leading professional organization of plastic surgeons certified by the American Board of Plastic Surgery who specialize in cosmetic plastic surgery. With 2,100 members in the U.S., Canada, and many other countries, ASAPS is at the forefront of innovation in aesthetic plastic surgery around the world.

About AAFPRS
The American Academy of Facial Plastic and Reconstructive Surgery is the world's largest specialty association that represents over 2,700 facial plastic and reconstructive surgeons throughout the world. The AAFPRS is a National Medical Specialty Society of the American Medical Association (AMA), and holds an official seat in both the AMA House of Delegates and the American College of Surgeons board of governors. AAFPRS members are board certified surgeons whose focus is surgery of the face, head, and neck.

About ASOPRS
The American Society of Ophthalmic Plastic and Reconstructive Surgery represent surgeons qualified in plastic surgery of the eyelids and surrounding facial structures. Fellows of the Society are board certified in ophthalmology, have completed fellowships in ocular surgery (currently two years), and perform aesthetic, plastic, and reconstructive surgery of the face, orbits, eyelids, and lacrimal system.

About ISAPS
Founded in 1970 at the United Nations in New York, ISAPS represents 1650 members in 85 countries and is the leading authority in international aesthetic plastic surgery. Members must pass stringent admission criteria and are all board certified or the equivalent in their home country. More information can be found at http://www.isaps.org.

Manager of Media Relations Adeena Babbit

Contact email: media@surgery.org
tel: 212.921.0500
fax: 212.921.0011

Please Credit the American Society for Aesthetic Plastic Surgery.