Are Nurse Injectors the New Norm?
- First Online:
- 363 Downloads
As Botox®/filler use has increased in recent years, a growing number of nonaesthetic health professionals have emerged to perform these procedures. Since studies have shown that patients identify training as the most important factor in considering these procedures, this study seeks to summarize the perspective of plastic surgeons regarding these paradigm shifts.
In the summer of 2013, an eight-question survey was sent to members of ISAPS, ASAPS, and ASPS (approximately 26,113 plastic surgeons globally). Two questions assessed practice location and membership affiliation and six questions assessed various healthcare practitioners’ capability to administer Botox, fillers, and vaccines (control). Healthcare practitioners included plastic surgeons and dermatologists, gynecologists, dentists, nurses in plastic surgery and dermatology, or nurses in other fields.
On three e-mail notifications, 14,184 plastic surgeons opened the survey and 882 responded: 36.6 % from North America, 29.1 % from Europe, 12.9 % from South America, 10.1 % from Asia, 4.5 % from the Middle East, 3.4 % from Australia, 1.9 % from Africa, and 1.6 % from Central America. Seventy-seven percent believed nurses were not as capable as plastic surgeons in administering Botox; 81 % felt the same for fillers. Conversely, 84 % agreed that nurses were as capable as plastic surgeons in administering vaccines. Plastic surgeons ranked nurses in other fields (48 %) as most capable in administering vaccines, then plastic surgeons (42 %), nurses of plastic surgeons (9 %), gynecologists (1 %), and dentists (<1 %). When asked about Botox/fillers, responders ranked plastic surgeons (98 %) most capable, then nurses in plastic surgery (2 %), gynecologists (<1 %), dentists (<1 %), and nurses in other fields (<1 %). When asked to rank according to patient perception, the order remained the same.
Based on responses from over 880 plastic surgeons from around the world, plastic surgeons consider themselves and dermatologists the most capable injectors. However, they still believe nurses in other fields to be the most capable of administering vaccines. This dichotomy may define the role of various practitioners in an increasingly more competitive injectable environment to improve patient satisfaction and outcomes. Given that the majority of growth in cosmetic injectables is being driven by providers other than plastic surgeons and dermatologists, further clarification on training requirements and practice guidelines may be necessary to ensure a consistent, reproducible experience for the patient.
Level of Evidence V
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
KeywordsInjectable Botox® Dermal filler Survey Plastic surgeon perception Patient perception
- 2.Neuber F (1893) Fettransplantation. Chir Kongr Verhandl Dsch Gesselch Chir 22:66–68Google Scholar
- 3.Gersuny R (1900) Ueber eine subcutane prothese. Ztschr Heilkunde 6:199–204Google Scholar
- 18.Lowe NJ, Ascher B, Heckmann M, Kumar C, Fraczek S, Eadie N, Botox Facial Aesthetics Study Team (2005) Double-blind, randomized, placebo-controlled, dose-response study of the safety and efficacy of botulinum toxin type A in subjects with crow’s feet. Dermatol Surg 31:257–262PubMedCrossRefGoogle Scholar
- 20.American Society of Plastic Surgeons (2013) 2012 plastic surgery statistics report, pp 1–23. http://www.plasticsurgery.org/Documents/news-resources/statistics/2012-Plastic-Surgery-Statistics/full-plastic-surgery-statistics-report.pdf
- 25.American Academy of Physician Assistants (2011) Summary of state laws, regulations, and policies affecting physician assistant practice in the area of aesthetics/plastic surgery. AAPA advocacy and government relations. American Academy of Physician Assistants, Alexandria, VA, p 63Google Scholar
- 26.Soderlund K (2013) Massachusetts approves Botox policy for dentists. In: Judy Jakush (ed) ADA news, vol 44, no 7. American Dental Association, Chicago, ILGoogle Scholar
- 30.Anyone can give Botox jabs in Sweden (2014) Report in the local, 2014. http://www.thelocal.se/20110525/33978. Accessed 15 April 2014
- 31.Review of the Regulation of Cosmetic Interventions, 2014. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212859/Call-for-evidence-cosmetic-procedures.pdf. Accessed 11 April 2014
- 32.BBC News, new cosmetic rules ‘are appalling’, 2014. http://www.bbc.com/news/health-26151061. Accessed 11 April 2014
- 33.Daily Mail UK (2013) Beauticians and hairdressers to be banned from giving Botox jabs in bid to cut botched procedures, Mail Online, 30 March 2013. http://www.dailymail.co.uk/news/article-2301761/Beauticians-hairdressers-banned-giving-Botox-jabs-bid-cut-botched-procedures.html. Accessed 11 April 2014
- 34.Australasian Academy of Cosmetic Dermal Science (2014) Cosmetic medicine education for nurses and beauty therapists, frequently asked questions. http://www.aacds.com.au/faq/. Accessed 11 April 2014
- 35.EU New Cosmetic Law to Take Effect in July 2013. 2014. http://www.reach24h.com/en/component/k2/item/581-eu-new-cosmetic-law-to-take-effect-in-july-2013.html. Accessed 16 April 2014