Is it ok to have an RN do dermal injections?

Question

Is it ok if an RN with 8-9 yrs working with plastic surgeons and voted top 100 qualified? I've been reading that it should be a plastic surgeon to do this but can't find one that actually does smaller tasks like this one. I have an appointment in a couple days wondering if I should cancel?! Thanks in advance

James Bonaparte, MD, MSc, FRCSC · Answer

This is a common question we get asked. In our clinic, both the physicians and nurses do the injections. I worked in a previous clinics and everyone is different. However, in some clinics the nurses spend the majority of their day doing fillers and become very good at it. Personally, I have had family members and friends treated by nurses and it is nothing something that worries me at all. However, my advice is to make sure they are experienced, there is a physician on site and the clinic is reputable. James P. Bonaparte

Michael J. Weinberg, MD · Answer

Thanks for this question.There are many Plastic Surgeons who do injections in their offices. In my office I do most of the injections but I also have a nurse who does some of the injections. All of the patients that the nurse injects are seen by me first and no injections are done without my supervision. I am also available to see the patients if any issues arise. I think that those are the key elements to insist upon if a nurse is going to do any injecting

Rodger Shortt, FRCSC · Answer

Injectables can be very safe when done properly.  A nurse in a clinic with lots of experience and consistently good results can be an excellent choice.  I would still advise to choose the location wisely.  There are many clinics where a ghost-doctor signs off on the procedure but never is available to see patients or deal with complications.  Make sure that the location has a plastic surgeon or dermatologist that oversees the procedures.  Do not go cheap as this is your face. Lots of "discount" places seem cheap on a per unit bases only to recoup their costs by over injecting too much product.Dr Rodger ShorttPlastic SurgeonMD, FRCS(C)Ass't Clinical ProfessorDirector of Cosmetic Surgery Training,McMaster University

Hratch Karamanoukian, MD, FACS · Answer

Thank you for your question.Not quite sure what the laws are in Canada but this depends on where the RN works in the U.S. Some States allow nurses to inject and others don't.If you are paying the $ amount, perhaps it is best to ask the physician to do something like this.In our offices, trained Physician Assistants and the Physician do injectable fillers.There is a difference between NP and RN's in the U.S.

Robert S. Bader, MD, FAAD · Answer

Who "can" perform filler injections is a legal question that, in the United States, is governed by the Board of Medicine from State to State. In Florida, it is my understanding that a filler is considered to be an implant and only a FL licensed MD, DO, PA, or ARNP can perform this. That being said, are there RNs performing such in Florida--absolutely. Is it legal--absolutely not. There have been "TOP" plastic surgeons and Dermatologists in our area utilizing RNs to perform injections that they are not permitted to do, to the best of my knowledge. I am not an attorney and this is the information that has been relayed to me from our local board of Medicine. I do recommend that you ask your local regulatory agency.Regarding who "should" perform the filler injections is a totally different question. Of course, at the bare minimum, they should be legally qualified to do so. That is the bare minimum. Whomever performs the injections should be adequately trained and also be able to handle any potential complications that arise. In most cases, a Dermatologist, Plastic Surgeon, Facial Plastic Surgeon, Ophthalmologist, and ENT are usually capable of such. Some fillers have a higher risk of problems than others. Hyaluronic acid fillers is the safest and can be reversed in the event of a bad result--which may cost more than the treatment. Longer lasting fillers and permanent fillers should ONLY be performed by qualified and highly experienced licensed providers as if the results are not optimal, you will be stuck with such a result.In short, the longer lasting the procedure and the more risk for complications, the more the reason to have someone who is extremely experienced and extremely qualified to handle any potential problems that could arise.

R. Stephen Mulholland, MD (retired) · Answer

Dear Sweetie_1986,

The use of soft tissue and dermal fillers is an art as well
as a skill.  This art and skill can be
learned by skilled injectors from many professional backgrounds.  I have been performing soft tissue filler
injections for over 20 years.  I have
evolved my technique in to volume shaping of the face, a procedure called the
VolumaLift whereas I specialize in volume and shaping, I have also employed
highly skilled registered nurses who are employed by me and inject as
well.  Generally, the nurse injectors
focus on specialized and somewhat smaller areas than my global facial shaping
paradigm and are excellent.

All the registered nurses in my SpaMedica clinic are
personally trained by me, overseen by me and have ongoing quality assurance
updates by myself.  In the Province of
Ontario you must be seen by a physician prior to being delegated to a nurse
injector and simply doing some research on both the clinic, the physician/owner
and the nurse injector can tell a lot. 
Look for online reviews such as RealSelf and perhaps even speak to
patients that have been injected by the registered nurse you are considering.

My team of five injector nurses are excellent and do high
quality injections and generally at a lower price than a certified plastic
surgeon would.  Being concerned about
outgoing procedure and doing your research so that you are very attentive to
detail and quality I’m sure your results will be excellent.  There are many nurse injectors whose
injection technique far exceeds some of the physicians I have trained in the
hundreds of injection workshops I have performed in the United States and I
would never hesitate recommending a high quality, highly trained, skilled and
artistic registered nurse. Ensure that
there’s a medical director and that there is protocols in place for rare but
significant complications such as intra-arterial injection or immunologic
responses to the injection and hard lumpiness. 
As long as you have access to a certified injection specialist,
preferably a plastic surgeon, dermatologist or facial plastic surgeon, I think
your experience should be excellent.

I hope this information has been of some assistance and best
of luck.

For more information, please review the link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto

Is it ok to have an RN do dermal injections?

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