Is It Ok for Someone Other Than a Doctor to Do Injectable Fillers?

Of course injectable fillers are available from a lot of unqualified/under-trained providers, so a dermatologist or facial plastic surgeon would be the way to go. However,  getting the impression that some of them have Physician Assistants, maybe even nurses, doing the injections. That seems to be putting one at the same risk by having an inexperienced injector.

Doctor Answers 6

The MOST IMPORTANT thing about Restrylane, Botox and Juvederminjectables

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The most important thing about receiving any cosmetic treatments utilizing injectableagents is who is at the other end of the needle.

Botox, Dysport, Restylane and Juvederm are our FDA regulated treatments and are only available to licensed  physicians. Different states will have different regulations as to what tasks a physician may delegate to his staff.

A board certified dermatologist/ENT/Plastic Surgeon has had  extensive training in the anatomy physiology, and repair of skin. When you receive the treatment your goal should be to receive the highest quality treatment from a doctor with the most knowledge and experience.

You may be offered lower prices from a strip mall medi-spas who have no actual medical director on-site. In cases like this you really have no idea of the experience or training of the person offering the treatment.

When it comes to your face demand only the best.  When I was in medical school I remember a plaque on the wall of a shoe repair business I frequented the plaque said the bitterness of poor quality lasts much longer than the sweetness of low price.

Not only should you insist and expect that the physician perform your treatment you should ask three basic questions 1.  what is the medical name of what you're injecting into my face?  2.  how does it work? 3. what are the anatomical sites  of where you're injecting it?

If the person doing the injections can't tell you what the scientific name of what they're using is, the mechanism of action of how it works,  and 3.  where they're injecting it,, thenthey shouldn't be doing it.

Minneapolis Dermatologic Surgeon

Core physicians are Superior

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Frankly, it seems to me that there is a public perception that Botox is dangerous, but fillers are safe. It does not take long to peruse this site, or listen in on dermatologists and plastic surgeons discussing cosmetic procedures, to learn that fillers are far more laden with potential for disaster than Botox. 

While I personally have not heard of any Botox disasters, I DO know of three incidences in which large areas of a woman's face ended up gangrenous and black due to poorly injected fillers. In two of these cases, the injections were done by a non-physician and the third by a dentist, dipping his feet into the field of cosmetic dermatology. 

When you have your fillers injected by a dermatologist or plastic surgeon you are assured that your injector has a   deep familiarity and knowledge of the skin, its layers, where the blood vessels and nerves lie. Experienced practitioners of both specialities have performed hundreds, if not thousands of procedures on the tissues they will be working on. This knowledge was not gained in a one day course given by a nurse aesthetician but by years of training and experience.

It is my opinion, that plastic surgeons and dermatologists who employ nurses or aestheticians to perform these injections are abnegating their responsibility to their patients. My impression is that these physicians are doing this to improve their bottom line rather than to enhance the beauty of their patients. 

Certainly, it is better to have injections done "under the medical supervision" of a dermatologist or plastic surgeon who is on site rather than at a medi-spa where who knows where and what kind of physician is involved. But I feel that if you are paying good money for a filler, this should be done by those who are best qualified, a dermatologist or plastic surgeon.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Injectable Filler procedures are best performed by qualified physicians.

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This is another great question. Dr. Oppenheim hit the nail right on the head with his thoughtful response below. Skin necrosis does happen with HA and other gel-fillers, and in my opinion, this disfiguring complication is at least somewhat technique-dependent. If signs of ischemic skin changes are noted at the time of treatment, there is a protocol involving immediate hyaluronidase and nitroglycerine paste to improve outcomes. Examples of disfiguring HA complications were presented at 7th annual multi-specialty symposium. Las Vegas, 6/24/2011 515pm.

In my view, Injectable Filler procedures are best performed by qualified physicians.

Hope this helps.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 429 reviews

Injectables and injectors

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I do all my own injecting because I feel that the patients want me to do it for them, and I was trained in aesthetic procedures and have an "eye" for it.  Yes there are some good non physician injectors like nurses and PA's.  I believe in NY state( my home state) these two individuals are allowed to inject under the supervision of a physician but I am not sure in other states.

Who Should be injecting Wrinkle Fillers and Botox?

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Opinions re divided on WHO is best qualified to inject filles and Botox. If done efficiently and in large numbers fillers and Botox can be very profitable. Understandably, Family Practicea and Ob-Gyn  as well as salons and "spas" jumped into he fray. In addition a lot of Plastic Surgery | Dermatology practices are very profitable bt delegating these procedures to "injectors".  Are their results better than those of inexperienced injectors? yes. Are their results better nd more customized than the results produced by Doctor-administered fillers and Botox? Hardlly. When you get an interested Plastic surgeon to do your fillers and Botox you WILL get a much better and customized  result.  You AKWAYS get what you pay for. Look for a Plastic  surgeon who does his/her own fillers and Botox.

Peter A. Aldea, MD
Memphis Plastic Surgeon


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While you may be able to get injectables by someone other than a doctor, I would highly recommend finding someone who is at least licensed and well trained on how to properly inject fillers. Definitely do some research before hand.

Harold A. Lancer, MD
Beverly Hills Dermatologic Surgeon

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.