The non-medical day spa I usually visit every month or two for services like massage, pedicures and facials is offering cosmetic injectables for a limited time. The promotional material I received indicates that the procedure will be performed by a registered nurse under the direction of a physician. Does this sound like a reasonable, safe way to undergo this procedure?
The anesthesia for laser skin resurfacing depends on the depth of the laser skin resurfacing and the area being treated. Most Fractionated CO2 laser or FRAXEL type laser resurfacing can be tolerated with topical numbing creams. Deeper treatments can be done with numbing blocks or injections of lidocaine if the area is limited such as the eyelids, crows feet or lips smokers lines. If the full face is being treated with CO2 laser to a deep degree then general anesthesia is required. Its not that painful afterwards but the actual treatments would hurt. Many people these days do obtain their Botox, Dysport or fillers from spas, whether medi-spas or day-spas. These spas usually have a “travelling doctor” come in once a week or once a month and do the Botox, Dysport or filler injections. Some of these spas have nurses or other technicians doing the Botox, Dysport or filler injections “under the supervision of a physician” however unless the physician is actually standing there and watching the nurse do the injection, it’s not truly “direct supervision.” Furthermore, many of the physicians that either do the actual Botox, Dysport or filler injections in these spas or supervise the nurses are not actual Plastic Surgeons / Facial Plastic Surgeons but many are simply family doctors, internists, OBGYNs or other kind of doctors who themselves may not be fully trained in the Botox, Dysport or filler injections. Many spas simply use the MD (medical license) of these physicians in order to be able to offer such services under state medical board regulations. While you may have a very skilled person injecting you as a spa or medi-spa, the odds are that a Plastic Surgeon or Facial Plastic Surgeon or Dermatologist in the proper setting would be safer. But then again, I have many colleagues who do not do the Botox, Dysport or filler injections themselves even in their own offices and have nurses or techs do the injections. This past week, I trained the nurses and PA (Physician Assistant) at Georgetown University Hospital Medical Center Department of Plastic Surgery because the Plastic Surgeons there do not usually do the Botox, Dysport or filler injections. Just make sure you do more research and know what you are having injected and by who!