Ask a doctor

Who Can Inject Botox?

i would imagine botox injections need to be done by doctors, but i keep hearing about nurses and others doing it...isn't botox a medical treatment that requires a doctor to administer it? who is best qualified to do botox shots?

Doctor Answers (39)

Who SHOULD inject Botox?

+3

The question really ought to be who should inject Botox.  The laws vary from state to state as to who is allowed to inject and with what amount of supervision, but Botox is a powerful neurotoxin that can cause significant problems that don't readily resolve. As a controlled substance, injectors should be physicians or under the direct supervision of physicians when injecting.  Beware of places where an MD has put their name on a medical spa, but is never seen in person.  These places often are operating under his/her name only, not his/her supervision.


Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

Who can inject Botox

+3

Botox can be injected by a licensed physician, nurse practitioner, physician assistant, or registered nurse depending on what state you reside in. Different states have different regulations in regards to that state's medical board. Just make sure to whomever you choose for Botox injections that they have been properly trained, licensed, and advanced certified with a lot of experience in Botox.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 10 reviews

Botox or Dysport should be performed by trained aesthetic physicians

+3

The most important criteria in selecting a physician or any professional for cosmetic procedures is does the person have the expertise to minimize complications and if a complication were to happen, does the person know how to treat it. You are better off getting consultation from a board-certified dermatologist or plastic surgeon.

William Ting, MD
Bay Area Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

You might also like...

Botox Injections Qualifications

+2
Healthcare professionals who are qualified to inject Botox include Physicians, Physicians Assistants, Nurse Practitioners, and Registered Nurse Injectors.  Physicians Assistants and Registered Nurse Injectors must be under the supervision of a Doctor or Nurse Practitioner to inject Botox.  The person who is best qualified to inject you with Botox would be an injector that has had proper training and has experience with injecting Botox. 

Peter J. Capizzi, MD
Charlotte Plastic Surgeon
5.0 out of 5 stars 22 reviews

Botox is a purified protein and it is incredibly safe...

+2

Botox is a purified protein and it is incredibly safe with a 20-year track record. Getting the best results from Botox requires enough of the agent in just the right places. So Botox injections are highly technique dependent.

Does this mean you should avoid your family doctor who recently started offering Botox treatments and only go to a general plastic surgeon, otolaryngologist, dermatologist, or fellowship-trained eye plastic surgeon? The answer is maybe.

These are the subspecialists with the most experience with Botox. An intimate surgical knowledge of the muscle groups to be treated is very helpful. This does not mean that the person doing the treatment in a particular office is the doctor. I personally do all the treatments in my office, but this is not always the case in other offices. So ask: Will the doctor be performing my treatment?I strongly recommend staying away from bogus situations like estheticians injecting Botox in non-medical settings.

Botox should only be injected by a licensed physician, or a registered nurse under the direct supervision of a physician who has examined you personally. Contact the medical board in your particular state to learn what training and supervision is required to perform Botox injections. Often, this information is posted on the medical board website. Medical boards are there to protect you.

If a setting does not feel right, don’t get treated. Is it really worth saving a few bucks? And don’t get me started on Botox parties. They still go on, but they are unethical. Don’t insult your intelligence and accept treatment at a Botox party.

Botox is a very expensive medication. Human nature being what it is, some offices may fudge on what they’re giving you. Ask how much Botox you will receive.

Don’t accept the statement that you are getting a syringe or one cc. Botox is not measured by volume. It comes from Allergan, Inc. in a small vial that contains 100 units of Botox. The “unit” refers to a measure of activity. Units are how doctors think about and use Botox. The vial comes with no fluid in it, just dried powder.

The doctor’s office injects the vial with a certain volume of saline to reconstitute the Botox and draws up the amount to be injected into a syringe. Offices use between one and four milliliters of saline for this purpose. So, a one-milliliter syringe might contain between 25 to 100 units of Botox. However, some offices dilute their Botox much more. I am familiar with one doctor who boasts of diluting a vial of Botox with 20 milliliters of saline, so each one-milliliter syringe contains 5 units of Botox.

Trust me, there is a big treatment difference between 100 units of Botox and 5 units of Botox. So pin the office down. Ethical offices will have no hesitation telling you how many units of Botox you are receiving.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 17 reviews

Licensed & Board-Certified Plastic Surgeons for Botox Injections

+1

In our changing healthcare system the question of who’s qualified to inject botox is going to be asked more and more frequently. The answer is dependent upon how you define qualified.  Does qualified mean licensed, or does that mean something more?

If qualified means licensed in a broad spectrum of individuals should be able to inject botox. These may include registered nurses, licensed practical nurses, medical doctors, physician’s assistants, nurse practitioners ,and a variety of technicians. Unfortunately, within this group many individuals including physicians may not have adequate training or in the case of non- physicians adequate supervision. This is especially true in some medical spas where non-M. D. injectors are supervised in name only.

For these reasons it's extremely important to understand your provider’s qualifications. Licensure is only a starting point. Providers of this service need to have an understanding of facial anatomy and facial aesthetics to properly perform these maneuvers.

In most cases this requires a background in plastic surgery, facial plastic surgery, cosmetic surgery, occulo plastic surgery, or dermatology. Even within these groups it's important to check experience, qualifications, and certification. It's important to remember that not everyone who injects botox is equally qualified.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 86 reviews

Who Can Inject Botox?

+1
In Australia, Botox along with Juvederm, Restylane and other fillers are Schedule Drugs ( in the same category
as Narcotic medications such as Morphine and Pethidine.))
Schedule drugs need to be stored securely, must always be prescribed by a Doctor and administered by a Doctor or a Nurse under Supervision. The Doctor and the Nurse should be appropriately trained and should have attended a training course. 

Naveen Somia, MBBS, PhD, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 29 reviews

Who can inject Botox?

+1
Physicians,  Physician assistants , RNs, and Nurse Practitioners can in all inject Botox. It's very important to find an  experienced injector for best results. 

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Botox and credentials

+1
In seeking to get a medical procedure performed it is always best to consult a board certified physician/dermatologist who understands facial anatomy and has experience doing the procedure.  You should use the same standards you would use with any other medical procedure to get the best care.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 33 reviews

Legality of Botox injectors

+1

The laws determining who is allowed to inject neurotoxins and fillers varies from state to state.

In Florida, where I practice, the law states:

  • Botox must be performed by a Physician, a Physician Assistant under supervision, or an Advanced Registered Nurse Practitioner working under a protocol signed by a Physician.

 

In the state of Florida, it is forbidden for an RN to inject Botox or fillers.

 

What is much more important is that the individual responsible for performing the injections is capable of dealing with any adverse results which may possibly occur.  

In my opinion, this is becoming a significant problem as many current "MedSpa" type injectors have no real knowledge of the anatomy of the mimetic facial musculature or vascular structures, nor would they know how to correct a complication resulting from a poorly placed injection .  

You will be best served seeing a board certified specialist for safe and effective treatments.

Best Regards,

Dr. LeBeau

 

Jacque P. LeBeau, MD
Pensacola Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.