Botox and dermal fillers: myths and important client information
Skin Beautiful Medical and Cosmetic Clinic provides expert advanced dermal filler treatments at clinics in Exeter Milton Bristol Coventry Swansea Warwick Daventry Evesham Carmarthen Llanelli and Neath.
From every corner of the non surgical aesthetics industry there exists a multitude of myths regarding the uses, properties, legalities and ethics of Botox & dermal fillers. Some are quite surprising and none are limited to any one particular group.
In an attempt to provide the discerning public with the most accurate information possible, this article aims to clear up many of the most common myths.
Who can administer Botox injections?
Although there is widespread disparity in answering this question, the answer is a very straightforward one. At the time of writing, and under current UK law, any person can administer Botox injections, so long as certain criteria have been met. Botox is a prescription only medicine (POM). This means it must be supplied by prescription. A prescription must be obtained following a face to face consultation with an appropriate person. Therefore, if a doctor is willing to give a direction to a beautician to administer Botox there is currently no UK law prohibiting this.Who can prescribe Botox?
I have seen several articles where doctors claim that nurses are not allowed to prescribe Botox or other botulinum toxin type-A drugs. This is quite simply a distortion of the facts. Any nurse holding a nurse independent and supplementary prescriber qualification (NISP) can prescribe Botox independently of a doctor or dentist. An NISP may also prescribe for others and give a direction for others to administer Botox too.Who is qualified to do what?
I have seen several doctors (general practitioners) claiming to be 'best placed' or 'most suitably qualified' to deliver non surgical facial aesthetics treatments. I am sceptical that this advice is not in the best interest of the general public for several reasons:- A doctor is highly knowledgeable in medicine and disease. However, no aspect of doctor training covers any part of facial aesthetics, nor does it cover the technique of injecting Botox or dermal fillers.
- Many doctors have absolutely no aesthetics training, qualifications or certification whatsoever. That's not to say that doctors don't make good aesthetics practitioners. There are many good aesthetics practitioners with medical backgrounds. However, to claim to be most suitably qualified on the basis of a medical degree, without having had any professional aesthetics training is perhaps misleading.
- Over 70% of all injections in the UK are administered by qualified RGN or RN nurses. Many doctors rarely inject patients in daily practice, but instead give the direction to practice nurses to administer injectable drugs.
- Specialist medical aesthetics training course for doctors, dentists and nurses are readily available, leading to certification in all manner of non surgical cosmetic and medical procedures. A medical aesthetics certificate is evidence that the practitioner can perform the given procedure safely and correctly, and, independently of any medical, nursing or dentist training and qualifications.
My advice to the client is: ask several questions of your practitioner. Find out exactly what training and qualifications they have, and ask whether they have evidence that they can perform the treatment you require effectively. Always ask to see professional cosmetic insurance, which is independent of any other medical practice insurance. The best cosmetic insurance available will only cover doctors, dentists and nurses who are also qualified aesthetics practitioners.
The Frozen Look!
It is not good practice to inject a client's face leaving a frozen look. Scientific literature from both independent studies and drug manufacturers state that Botox Cosmetic (and other botulinum toxin type-A drugs) should 'relax', 'reduce' or 'weaken' muscle contractions. Botox is not supposed to be administered to the extent that muscles become completely, albeit temporarily paralysed. In my own practice I refuse to attempt the 'frozen look' on the basis of such scientific evidence. Botox is supposed to achieve a reduction in the visibility of facial lines and wrinkles, not a visibly stiff face.What is the difference between Botox and dermal fillers?
I often get asked this question by clients. For many 'Botox' has become a generically used term to describe all facial aesthetics injectable treatments. In terms of the physical and pharmacological properties of the two Botox and dermal fillers are very different.Firstly, Botox is a prescription only medicine (POM) whereas dermal fillers are medical devices (non POM). Botox cosmetic is a drug that is injected beneath the skin to temporarily correct lines and wrinkles caused by the contraction of particular facial muscle groups. It does so by blocking the release of acetylcholine, a neurotransmitter. This in effect inhibits localised muscle contraction.
By contrast, dermal fillers have no effect on muscle contraction or in neuromuscular function. Instead they work by replacing lost volume in the skin's matrix. The active ingredient in most dermal fillers is hyaluronic acid, a substance that occurs naturally in the body. In the skin it aids hydration by holding water, which in turn gives volume to the skin. Through ageing, our skin loses its ability to hydrate itself and the resulting loss of volume yields characteristic deep lines and folds. Dermal fillers can replace the lost hyaluronic acid and allow the skin to rehydrate itself once more.
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