How can I make sure a cosmetic injection is safe?

DOCTOR

My injecting, prescribing and/or supervising DOCTOR is certified by one of these:

• American Board of Plastic Surgery
• American Board of Otolaryngology and American Board of Facial Plastic & Reconstructive Surgery
• American Board of Ophthalmology with specialization in Ophthalmic Plastic & Reconstructive Surgery
• American Board of Dermatology with specialization in Cosmetic or Dermatologic Surgery

My injecting, prescribing and/or supervising DOCTOR is a member of one or more of these groups:

• American Society for Aesthetic Plastic Surgery
• American Society of Facial Plastic and Reconstructive Surgeons
• American Society of Ophthalmic Plastic Surgeons
• American Society of Plastic Surgeons
• American Society for Dermatologic Surgery

If a nurse or physician’s assistant is injecting all of these things are true:

1. I have first seen a DOCTOR whose specialty is defined above
2. The laws regarding cosmetic injections in the state where I will be injected are defined to me by the DOCTOR
3. I know where the prescribing/supervising DOCTOR will be during my injections
4. The nurse has demonstrated competency in performing cosmetic injections with a certificate issued by the supervising DOCTOR’s professional specialty organization (one of the below)

• American Society for Aesthetic Plastic Surgery
• American Society of Facial Plastic and Reconstructive Surgeons
• American Society of Ophthalmic Plastic Surgeons
• American Society of Plastic Surgeons

BRAND

All of these statements are true:

• My injector has defined the FDA approved BRAND or BRANDs of cosmetic injectable recommended for me
• My injector has shown me the BRAND packaging identifying the cosmetic injectable that will be injected into me is a genuine product
• My injector has written on my informed consent documents and in my medical chart the FDA approved BRAND or BRANDs of cosmetic injectables injected into me

SAFETY

All of these statements are true:

• My injections are being performed in a medical office, or a medical spa whose medical director meets all of the statements above about my DOCTOR
• My injections are being performed at a time when I or my injector are not intoxicated or under the influence of a controlled substance
• I feel safe and at ease with my injector
• My injector has taken me through the informed consent process defining where I will be injected, with what, and what the potential risks or complications may be as well as defined alternative treatments that may meet my cosmetic goals
• I will follow all the post-treatment instructions I am given and follow-up with my doctor or injector as prescribed

BEAUTY

All of these statements are true:

• I can clearly define the areas of my facial appearance I hope to improve with cosmetic injectables
• My injector has analyzed the areas of my facial appearance I hope to improve with cosmetic injectables, and my facial appearance overall to recommend the options available to me to meet my goals
• I understand the expected duration of my results, and that if I do not repeat injections, my facial appearance will return to it’s prior condition
• I understand that minor swelling, bruising or redness for a few days after my injections is a normal occurrence that can be camouflaged with cosmetics

One suggestion for dermal filler procedures, such as Restylane and Juvederm, that I can give is this – be sure to ask your doctor to perform “nerve block” anesthesia at the start of your treatment.

Nerve blocks deaden the area and prevent the pain associated with this procedure. Many less-skilled physicians cannot or do not use nerve blocks. Local anesthetic injections and topical numbing cream are sometimes helpful, but nerve blocks should be performed or the treatment will be unnecessarily painful. So, do your research and insist on a nerve block which will make the treatment most comfortable.

Cosmetic injectable therapies are a rapidly growing segment of treatment that many people are quick to embrace but don’t yet fully understand. While Botox and dermal filler injections are not surgical, they are still wholly medical procedures that require the experience and oversight of a physician specifically trained in cosmetic procedures of the face. A qualified physician is key, not only to ensure safety, but also to ensure an aesthetically pleasing outcome.

The need to be educated about cosmetic injectables and standards to protect your safety is evident in the findings released by the Physicians Coalition for Injectable Safety.

An independent study conducted by Industry Insights, Inc. surveyed members of the Coalition about U.S. FDA-approved, brand name injectable therapies designed to treat facial wrinkles, improve the signs of aging, enhance facial appearance, and treat skin imperfections with Botulinum Toxin (Botox), dermal fillers, and fat injections.

Top Findings:

• Member physicians see an average of 2-3 patients each year with complications resulting from cosmetic injections that were either administered in a non-medical setting, by an unqualified provider, or with an unknown substance.
• 84% of physicians reported that they have seen at least one patient with complications from cosmetic injectables.
• 29% of member physicians see complications arising from cosmetic injections administered in a non-medical setting.
• 38% of physicians see complications arising from cosmetic injections administered by an unqualified or untrained provider.
• 32% of physicians see complications from an unknown, non-FDA approved injectable substance. 

Before you get a cosmetic injection, you must:

1. Know how to choose a qualified doctor/provider
2. Know what questions to ask your doctor/provider
3. Ask to see packaging
4. Know what authentic packaging looks like for any injectables you purchase

Patient education information is not only the responsibility of the doctor, but also the responsibility of the patient. By partnering with your physician and asking the right questions consumers have a better chance of achieving the desired results and averting complications with injectable therapies. Patients must understand that all medical treatments have risks, and cosmetic injectable treatments are no exceptions.

Reducing your risk of potential complications requires that you:

• Recognize that injectables are medical treatments and belong in the hands of a qualified doctor.
• Choose only U.S. FDA-approved injectables for a use that is specifically cosmetic and an application that is similar to your condition.
• Accept that there is no such thing as a “generic” or “substitute brand” for U.S. FDA-approved injectables.
• Do not accept bargain prices or deep discounts, as you may not be getting a U.S. FDA-approved injectable or an appropriate dosage.
• Do not accept treatment at a party, public gathering, spa, salon or other non-medical setting.
• Do not act on impulse when you choose injectables. Follow proper procedure by learning about your doctor and the treatment you will have.
• Understand that fat injections require a two-step surgical process; first your fat is extracted and processed, then it is reinjected into appropriate regions.

Consumers should be aware that almost anyone can perform a cosmetic procedure. As such, it is extremely important to know just who it is that will be performing yours.

For example, if you are interested in facial rejuvenation, you should look for a physician who is especially skilled in this area.

• Ask them about their experience with the various fillers and injectables and approximately how long they have been using them.
• Although before and after photos are generally essential, they unfortunately do not always adequately demonstrate end results of the injectables.