Visit any esthetics medi-spa and chances are Botox will be front and center on the menu of services.
Botox injections have become the number one most common minimally invasive cosmetic procedure performed in the world today. In fact, in 2017 alone there were 7.2 million Botox procedures performed in the United States.
What is Botox and How Does it Work?
Botox is an FDA-approved drug made from a neurotoxin produced by the bacterium clostridium botulinum—or Botulinum toxin. Although it sounds a little intimidating, Botox is inactive (found in the natural environment) and non-toxic (not to be confused with the active and highly deadly neurotoxin responsible for botulism).
In medical and dental settings, it is used to treat certain medical conditions, such as excessive sweating, migraines, muscular disorders, and even bowel and bladder disorders. In medi-spa settings, it is used cosmetically to treat wrinkles by essentially paralyzing the muscles.
When injected in extremely small concentrations, Botox works by preventing signals from the nerve cells from reaching the muscles, which leaves the muscles unable to contract.
Botox is generally applied to the folds/wrinkles of the forehead and cheeks and the areas around the eyes and mouth. When injected, the skin plumps up, thus removing the folds and wrinkles.
Botox is administered by diluting the powder in saline and injecting it into the neuromuscular tissue, directly under the skin’s surface. The procedure takes between 5 and 15 minutes to perform. Botox and other dermal fillers are temporary, typically lasting a few months.
Risks and Potential Side Effects
Most patients tolerate Botox injections, with just a few side effects reported that include:
- Mild pain and swelling at the injection site
- Mild nausea
- Temporary weakness/paralysis of the nearby muscles
Job Duties of Estheticians Before, During, and After a Botox Procedure
If you are employed in a medical office or esthetics medi-spa, you will likely work alongside medical professionals performing this service. Estheticians are not allowed to administer Botox injections, although they can assist the doctor, nurse, or physician assistant by providing pre- and post-procedure care. To be clear, this is considered a cosmetic procedure and can only be performed by a licensed medical professional.
Job duties of an esthetician before, during, and after a Botox procedure often include:
- Prepping the face by wiping it down with a non-alcohol cleanser
- Applying a topical anesthetic
- Applying pressure or gold gel packs if bleeding occurs after the injection
- Applying moisturizer and/or sunscreen after the procedure
- Providing client with pre- and post-treatment instructions
Botox Certification and Licensing Requirements: What it Takes to Offer Botox in Medi-Spa Settings
In the United States, Botox can only be legally administered by licensed medical professionals. In most states, this includes nurses, physician assistants, dentists, and doctors; however, some states require physician oversight if it is administered by nurses or physician assistants, while in other states, nurses are strictly forbidden from administering Botox.
For example, in California, nurses and physician assistants may administer Botox injections, but a physician must first examine the patient and prescribe the procedure.
However, in Florida, only physicians, nurse practitioners, and physician assistants are allowed to perform Botox injections. The injection of Botox is deemed the practice of medicine and registered nurses are not allowed to perform injections, even when the physician is present. Nurse practitioners and physician assistants are allowed to perform Botox injections under protocols that are written and reviewed by the supervising physician.
Medical professionals must take and pass a Botox certification course to perform this procedure. For example, in Texas, medical professionals must receive Botox training that includes clinical, hands-on training before performing Botox treatments. Botox training certification must be kept in the place of practice.
Botox certification programs include both theory and hands-on training. Many are taught by industry experts, including plastic surgeons and dermatologists. Medical professionals may be able to earn CME/CE credits by completing a Botox course.
Botox certification programs are generally one to two days long, and training often encompasses similar dermal fillers, such as Juvederm, Restalyne, Perlane, Radiesse, and Sculptra.
Program objectives of a Botox training program include:
- Categories and types of dermal filler products
- Cosmetic indications and contraindications of Botox
- Facial anatomy and physiology as it applies to facial esthetics
- History, safety, mechanism of action and preparation of Botox
- Proficiency in conducting an esthetic patient consultation
- Proper injection techniques using Botox and dermal fillers
- Techniques for dermal filler injections to correct folds, wrinkles, and lip augmentation