Botox, Filler and Chemical Peel Regulations in Texas?

Question

Who is allowed to do Botox injections, injectable fillers and chemical peels in Texas? Is it legal for a nurse to do Botox in Texas?

John LoMonaco, MD, FACS · Answer

Some doctors offering Botox and other injectables have a non-physician, and in some cases a non-nurse do the actual injections. 
The law in Texas does allow non-physician designees to perform supervised treatments.  The key is what is meant by supervision, and you will see some clinics with no doctor in the building offering injectables.  I am not sure, but I believe that advanced nurse practitioners can perform unsupervised treatments.
My personal preference is to perform all the injections myself.  It is facial sculpting and artistry in my opinion, and I personally enjoy seeing the imemdiate results from the fillers and alos interacting with patients.

Harold J. Kaplan, MD · Answer

Hi Tansy0175. Although we are not in Texas, we'd like to comment on the use of non-physicians (and non-medical professionals) for injecting Botox. 
We are big proponents of training and not title (providing that a nursing or physician's license is the baseline minimum). For example, in our practice, we have two excellent nurse injectors. They have been trained by myself, Allergan trainers (the makers of Botox) and attend seminars quarterly to keep up with changes in best practices. They are both consummate professionals and have an eye for cosmetic "artistry" as Dr. Lomonaco points out.  Our patients love them and they do an excellent job. 
But passing off these procedures to someone without any medical license is crossing the line in our opinion. The reason why injection procedures should be limited to those with a medical license (nurse, PAs and physicians) is that their livelihood depends on the license. 
This means that it is in that practitioners best interest to know and understand very well the procedures that they offer. Not knowing them well could lead to malpractice, revocation of their license, and loss of their livelihood. 
If non-nurses, non-PAs and non-physicians are allowed to perform injection procedures in states such as Texas, what's the incentive to protect themselves by getting the correct training?  If there's no license to lose, there's no incentive to train. 
This is the same reason all consumers should seek out a practitioner that has "something to lose" by not performing these procedures correctly.  Find a licensed practitioner or "buyer beware".

Michael Coverman, MD · Answer

A staff member with proper training and physician supervision. It is best done under sterile conditions in a physicians office with written policies and procedures in place.

Botox, Filler and Chemical Peel Regulations in Texas?

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Botox, Filler and Chemical Peel Regulations in Texas?

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