Choosing a Botox Doctor

Published on February 4th, 2011 by Pattana Thaivanich

The American Society for Aesthetic Plastic Surgery (ASAPS) offers these safety guidelines for anyone considering Botox doctor.

• Selected surgeons should be board certified by the American Board of Plastic Surgery (ABPS). Any doctor (even one from a nonsurgical specialty) can legally perform surgery. On the other hand, certification by the ABPS ensures at least five years of surgical training, including two years of training specifically in plastic surgery. Patients undergoing a BOTOX Cosmetic procedure should select a member of the American Society for Aesthetic Plastic Surgery (ASAPS) to help ensure that their surgeon has extensive cosmetic surgical experience and has met ASAPS requirements for continuing cosmetic surgery education.

Botox gone wrong

The MHRA, the UK government agency responsible for ensuring that medicines and medical devices work, and are acceptably safe provides following guidance on the Botox regulations in the UK:

• Who can administer Botox?
  They can be:
  a. self administered
  b. administered by an appropriate practitioner
  c. administered by anyone acting in accordance with  the  directions of an appropriate practitioner.

• Who is an appropriate practitioner?
  A doctor, a dentist or, subject to certain limitations, a nurse or pharmacist independent prescriber or supplementary prescriber.

• Does there have to be a face-to face consultation with the practitioner before the product can be administered?
  No. There is no legal requirement under the legislation for a face to face consultation with a practitioner. However, he or she should have sufficient information about the patient to give an appropriate direction.  It is not sufficient for a nurse or other person who is going to administer the prescription only medicine to have the option to contact the practitioner. In other words, the practitioner must be involved in the decision to administer the medicine to each individual patient. Also, as mentioned above, a general direction applying to any patient who is going to be seen by the nurse/therapist is not sufficient to comply with the law.

• Can a doctor supply advance stocks of Botox® etc to nurses and others?  That is, before patients have been seen or assessed by the practitioner?
  Yes. A practitioner can supply advance stocks of these medicines to nurses and others who are employed within the same legal entity, for example a hospital or clinic.  The medicines must not be administered until the practitioner has given the patient -specific directions for the patient.

• Can Nurse Independent Prescribers independently prescribe and administer injections for use in cosmetic procedures?
  Yes. A Nurse Independent Prescriber can legally prescribe and administer licensed parenteral medicines such as Botox® in cosmetic procedures on his/her own initiative. However, as mentioned above the use of Botox for cosmetic treatment is outside the product’s licensed indications.  Nurse Independent Prescribers may prescribe medicines independently for uses outside their licensed indications (so called ‘off-licence’ or ‘off-label’). They must however, accept professional, clinical and legal responsibility for that prescribing, and should only prescribe ‘off-label’ where it is accepted clinical practice.

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