Can I trust a PA for restylane injections?

I have heard recently that it is risky to have a PA do injections. But the two top rated plastic surgeons in my area have a physicians assistant doing the injections and they make it seem as if that is common practice. Please tell me if I can trust a recommended PA or if I should only seek out a plastic surgeon. Thanks!!!!

Doctor Answers 8

Training and experience are key.

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It may surprise a lot of people to know, but almost every type of provider (MD/DO/PA/NP), regardless of specialty, gets most of their training on Botox and dermal fillers AFTER all their formal training. For example, as plastic surgeons, we spend a lot of time learning and practicing the intricacies of delicate surgery; for dermatologists, they are learning to identify the many subtle differences of what may look like just a brown spot to a lay person. While we do all get at least some training on Botox and fillers, I have known many senior residents that weren't completely confident doing these procedures on their own upon graduation. And while many here strongly advocate for board-certified plastic surgeons or dermatologists performing these procedures, I can tell you, as a board-certified plastic surgeon, that I wasn't ever scrutinized or asked about my botox techniques as much as I was my surgical skill set. 

So, the answer is that you want to go to a highly trained, experienced provider of any type that has good reviews and has performed many procedures. 

I have worked with a PA who, by himself and only doing injectables, achieved Diamond status (top 3% in the country) with Allergan, the manufacturer of Botox and Juvederm. That meant he injects more, by himself, than 97% of any practice that offers those services in the entire country. And he has 4.9+/5 stars on every review site he can be found on. 

So I can assure you, when given the choice to see him or me, for example, you most certainly should prefer me doing any of your surgical procedures, but you ought to very well prefer him to do your botox or fillers. 

Lastly, an artistic eye matters. While any contributor here may be able to learn the techniques - how to inject a filler, for example - not everyone will necessarily have an eye for it, nor may the provider's style always suit your desires. Ask to see before and after pictures and you'll quickly see if this is a provider you can trust.

Hope that helps!

Tampa Plastic Surgeon
5.0 out of 5 stars 3 reviews

PAs injecting filler

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Hello, and thanks for your question. The bottom line is you want someone with appropriate training and a good eye, regardless of the letters after their name. While there are some PAs who meet these criteria, it is harder to assess their credentials than it is for physicians, who need to undergo rigorous training and examination in order to be board-certified in their specialty. Short answer: some PAs are every bit as good as physician injectors, but it is harder to know which ones are adequately trained. In order to determine the best treatment plan for you, I recommend an in-person consultation with a well-trained dermatologist or plastic surgeon. Best of luck, Dr. Frucht.   

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Who should do the injections

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Traditionally it was common for nurses and PA's to do injections in surgeons offices.  The surgeons preferred to be in the operating room.  Now there are PAs and nurses doing injections in some dermatologists offices also.  I have no doubt that there are likely some PAs and nurses who inject better than the physicians in those offices.  The question whether you see a doctor or his staff is whether that person is truly an expert in the procedure you want.  How was she trained? How much experience does she have?  Does she attend academic meetings, or in an ideal world, teach at these meetings?In my office, I am the only one doing injections.  It is something I truly love doing and I teach other cosmetic physicians around the world.  It is also a procedure that requires a combination of good eyes to see the places to inject to have the best effect, good hands to do the injections with minimal pain and maximal results,  a solid foundation of anatomy to provide safe care, and a clear understanding of how to handle any emergency that might arise.I hope this answer was helpful. Best wishes.

Heidi A. Waldorf, MD
New York Dermatologist
5.0 out of 5 stars 10 reviews

Injections by a PA

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It is not unusual to have a PA inject in a physicians office and many are well skilled in the procedures. As long as the doctor is present in the office there is no issue. as a matter of fact I have been associated with many types of injectors and one of the best I have seen is a PA

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 7 reviews

Facial Sculpting Using Fillers Like Voluma, Radiesse, Lyft, Juvederm and Sculptra and Fat

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I suggest going to an expert for fillers and ensuring you get the most comprehensive workup for your face.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Can I trust a PA for Restylane injection?

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You ask a good question.  Quality of outcome will vary based on experience so you need to do your research and not simply be swayed by the office recommendation.  In my practice I do all of the filler and botox/xeomin injections and feel that my patients get the best outcome as a result.  Other offices have a different approach.  In the end if you're confident than a PA should be fine.  If not, find a Bd Cetified derm or plastic surgeon with a good reputation who will care for you.Regards,Jon A Perlman MD FACS  Certified, American Board of Plastic Surgery  Extreme Makeover Surgeon ABC TV Best of Los Angeles Award 2015, 2016  Beverly Hills, Ca 

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 32 reviews

Whether or not to trust a PA depends on the PA's training

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Many board certified plastic surgeons will have physician extenders (PA/NP or RN with supervision) do injectables for them as they focus on surgical procedures. Whether or not you can trust these physician extenders really depends on the individual's experience and how much training they have had. There are many PA/NP's that I would frankly trust over MD's simply because they have been well trained and inject fillers/Botox everyday. It also depends on what it is you want done. If you are interested in having Restylane injected to off label places, you may want to at least interview the supervising MD.

Lily Lee, MD
Pasadena Plastic Surgeon
5.0 out of 5 stars 29 reviews

Can you trust a PA

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Physician Assistants, PAs, are what are known as "mid-level providers". They, as well as RNs, are qualified to perform cosmetic injectables. Many plastic surgery practices employ PAs or RNs to do injectables, thus freeing up the surgeon to do surgeries. On the other hand, many surgeons do their own injectables. Ultimately, the training and experience of the individual are what count. Ask your PA how many injections he or she has performed, and how good are they at correcting any problems that arise. I wish you all the best!

Arnold Almonte, DO
Roseville Plastic Surgeon
4.9 out of 5 stars 35 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.