Cosmetic Procedures Done In Non-Clinical Settings by Unlicensed Personnel Can Pose Serious Dangers

Recent cases of patients receiving BOTOX(R) and tissue fillers at beauty salons, shopping malls, or in their homes by people without licensure or adequate medical or professional training are causing great concern within the medical community.

In response to the rise in unqualified individuals performing non-surgical cosmetic procedures, the American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons (ASPS) are trying to raise awareness about the dangers inherent in this risky practice.

Only properly credentialed and trained medical professionals should perform procedures such as tissue filler injections, laser therapies, skin resurfacing, and chemical peels. In addition, the work should use only products approved by the Food and Drug Administration (FDA).

According to Dr. Mark Jewell, MD, president of the Aesthetic Society: "There are some misconceptions among patients about the true nature of non-surgical cosmetic procedures. Non-surgical does not mean non-medical. Patients deserve to know who is treating them, what their qualifications are, who the supervising physician is, and where the product is coming from. These are questions patients should ask."

In recent years, there has been an explosion in the number of non-surgical cosmetic procedures which often take place in retail or spa-like settings. Unlike proper doctors’ offices, where clinicians oversee the treatment and maintain medical records, these spa-type centers may have limited or no full-time trained medical staff and may lack the experience to handle services other than routine spa and beauty treatments.

There is also the fact that unlicensed  personnel working in non-clinical settings may not be able to respond appropriately and promptly to medical emergencies that sometimes occur during even the simplest procedure.

Patients need to make sure that a properly trained and qualified practitioner will perform their procedure appropriately, under the right conditions, with the correct (and properly sterilized) instruments, and using FDA-approved products.

According to Dr. Bruce Cunningham, president of ASPS: "In many situations, physicians appropriately provide oversight for patient care in a variety of medical settings. Our concern here is that physician supervision in non-surgical cosmetic procedures may be inadequate or non-existent and that the individuals performing the treatments lack adequate training to safely perform the procedures. Our purpose in convening a patient safety group on this issue is to ensure that patients have the information they need to make the right decision. While spas and salons are convenient for cosmetic medical treatments, this should not be at the expense of safety and expertise."

A Joint ASPS and ASAPS Advisory on Injectables and Fillers: Legal and Regulatory Risk Management Issues, released in 2005, underscores the two societies’ position: "The administration of injectables and fillers is a medical procedure and is subject to the same precautions of any medical procedure. It is the physician’s responsibility to ensure that the non-physician administering the injectables or fillers possesses the proper education and training."

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