Safe to Have Nurse Inject Restylane?

There are some nurses that have focused so much on injecting fillers, under the supervision of a doctor, that they develop better technique than the supervising doctor. These days, more doctors tend to do the injections. Fillers are not a cookie cutter treatment. There is an art and science to injecting fillers, and the technique improves with experience. Some injectors have a forceful hand and bruising and pain increase. Others are very gentle and give slow injections which can make it less painful and there might be less bruising as a result. These techniques can be learned by a nurse as readily as a doctor. Extremely reputable cosmetically-minded plastic surgeons have nurses performing these injections in their office and would not have them do it on their facelift patients if they were concerned that there would be a bad result.
One disadvantage of having a nurse do the fillers is that if you really like his or her treatment, they might change jobs to a different office and you would have to look for a new injector if you can't find them. If you have a doctor do your injections and you like their treatment, then you could follow them to any practice to which they transfer. Theoretically, if there is a complication, which is extraordinarily rare, the physician might be more readily able to deal with and treat the unexpected problem.

Hi Abby.  The answer to the question is certainly a personal preference.  In our practice we can only say that of all the injection patients that have come from other practices (because they were unhappy), there are as many that were injected by physicians as nurses.

Mastering injection techniques takes time and effort and whether the injector is a nurse, PA or physician, they need to dedicate the time and effort necessary to master these skills.  We would seek out a word of mouth referral for an injector that one of your friends or family trusts, regardless of the title.

Some practices have nurses inject Restylane and Botox. I think it is important that the nurse have adequate training and has on site physician supervision. If the plastic surgeon or dermatologist doesn't perform any injections, chances are he/she didn't train the nurse nor can they effectively supervise that nurse. This is in contrast to a busy plastic surgeon who has patient overflow and has a nurse inject patients that would otherwise have to wait weeks to be seen. A busy injector probably has good results and would be the right person to train their own nurse in the same techniques that they use. I think that the physician should remain on site when the nurse is injecting.
Laws regarding nurse injectors also vary from state to state.
Good luck!

While many surgeons do their own injections of botulinum toxins and filler products, there are many very experienced nurse injectors. Laws vary by the state on who is qualified to inject these products. The requirements for supervision also vary.

As you can see there is a range of opinions on the subject of whether a nurse or a physician should do Restylane injections, and no single correct answer. If you go to a clinic where the nurse injectors specialize in that, then they may very well be more experienced than the supervising physician, and other MD's for that matter. It should always be clear who the delegating physician is, and what their qualifications are.

While it is difficult to say what the skill of that particular nurse is, it is my feeling that most dermatologists do their own injections (as is the case in my office). Because I do my own, I feel that my patients are getting the absolute best that I have to offer. Also, if a nurse is doing it, there is always the chance that they haven't worked for that practice all that long and might not be all that good.
In general, plastic surgeons tend to delegate these procedures to other people in order to generate more revenue, while dermatologists tend to take more of a role in doing their own procedures, believing that it is important to do it themselves and offer the best 'injector' to the patient. Hope that helps!

There are several issues here:
qualifications
experience
aesthetic eye
regulations
Depending on your state, certain regulations are in place that ultimately guide whether treatment can be delivered by an allied health professional (other than a physician).
Without denegrating the skills of nurse injectors, ultimately most conservative states require that treatment be delivered under the immediate supervision of a physician. Does that tell you anything?

I personally like to inject the fillers for my patients.   There certainly are alot of nurse practitioners out there that can do a good job, but I think my patients would prefer that I do it for them.

There certainly are nurse injectors out there who can safely administer restylane and other fillers. Many states, however, require direct supervision of such activity by a physician. I am somewhat surprised that you have not been able to find an experienced physician (plastic surgeon or dermatologist) to administer your filler, as all of my colleagues generally perform filler injections themselves.
Good luck, and be safe.

There are nurses who are great at doing Restylane injections, however, you are probably more likely to get a better result with an experienced physician. Remember there are four specialties that specialize in facial treatments: facial plastic surgery, plastic surgery, dermatology, and oculoplastic surgery. They can offer you options and alternatives which is just as important as having a good hand at injections. It is important that your injector is well well trained and experienced. Review their before and after photos if necessary. If the physician does not do is or her own injections, you probably don't want to be their first patient.