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What you never knew about botox

Thinking of getting cosmetic injectables such as botox or fillers? Read this first! 

At Accuratus we work with health providers and businesses to become licensed to Drugs and Poisons and/or achieve registration as a day-surgery, hospital or non-emergency patient transport. Unfortunately, there is an alarming lack of consumer awareness when researching cosmetic fillers and botox. Most consumers are unaware of specific questions to ask and how to verify their answers.

Most studies show cosmetic injectable poisons to be safe, although they have only been in use since 1988. Botox was first released to the market by a company called Allergan. Research indicates that Schedule 4 poisons used for cosmetic purposes, if administered correctly can have risk minimised to an acceptable level. This is when the procedure is completed by a suitably trained professional and regulated by Drugs, Poisons and Controlled Substances Act 1981 and Regulations 2017. These controls ensure ongoing audit and verification of qualifications, drugs used and administered, sterility of equipment and facilities are equipped to handle the procedure. This includes managing emergency escalation if the procedure goes wrong.

Are cosmetic injectables considered to be a medical procedure?

Absolutely. You are considered to be a patient. This means your procedure should be treated and managed, with risk to safety mitigated to as low as possible, as any patient in any medical setting would expect. Patient care and safety include, but not limited to, qualified and registered medical professionals, sterile environment and handling, safe use of drugs, medicines and poisons.

Any procedure which involves the injecting of a prescribed Schedule 4, 8, 9 drug, medicine or poison is considered to be a medical procedure. Medical and nursing professionals are required to act in accordance with relevant Federal and State health Acts and Regulations. Contact us if you would like a list of those.

Does the provider have a current Drugs and Poisons license?

Schedule 4 poisons (may be used for botox and fillers cosmetic procedures) when prescribed and provided are controlled within the boundaries set out Drugs, Poisons and Controlled Substances Act 1981 and Regulations 2017. The Department of Health (DHHS) monitors all licensed providers to ensure that the poisons are correctly stored, administered and disposed of within a sterile environment. It is a preventative measure to considerably reduce the risk of a safety incident.

What are the names of some Schedule 4 medicines used for Botox or Dermal Fillers?

Botulinum toxin type A (Botox® and Dysport®) and dermal fillers (Zyderm®, Zyplast®, CosmoPlast®, Cosmoderm®, Restylane®, Perlane®, Dermalive®, Juvéderm®, Emervel®, Sub Q®, Esthelis® and Belotero®, Hylaform®, Newfill®, Nufill® and Sculptra®) are ‘prescription-only’ (Schedule 4) medicines. (DHHS)

How do I know if I will have the procedure completed under the right level of medical care?

All medical and nursing professionals have a scope of practice that defines what they can and can’t do and levels of supervision required.

Schedule 4 cosmetic injections can only be prescribed by a registered medical practitioner and be administered by a registered medical practitioner or a registered health practitioner (such as a nurse or midwife) under the instruction of a registered medical practitioner. (DHHS information available. PM for info).

A Registered Nurse can conduct the procedure without a registered medical professional (doctor) supervising. They must be acting on doctors instructions, have a medical management plan in place, and the doctor must be contactable at all times.

Is the nurse an Enrolled Nurse (EN) or a Registered Nurse (RN)?

An EN is NOT qualified to administer prescribed drugs for cosmetic purposes without direct or indirect supervision of a Registered Nurse (RN3 or above) or Registered Medical Practitioner and relevant training. Indirect means the RN is located in the business at the same time as the procedure is taking place and can assist in an emergency situation.

How can I check the practitioner’s qualifications?

All nurses and doctors hold AHPRA registration in order to practice nursing or medicine. AHPRA is available to anyone to check medical professionals qualifications through AHPRA number and/or name. The link is provided here.

Who prescribes the drugs? Where are they located?

Cosmetic drugs MUST be prescribed on an individual script by a registered medical professional (doctor). Ask who the doctor is and where they are located. Also, ask to book an appointment for a face to face consult and obtain an AHPRA registration number to verify current status. The doctor’s availability will inform on their level of direct involvement. There have been cases where doctors from other States are writing scripts and are rarely on-site.

The registered medical professional can complete procedures in the absence of a registered medical professional. In this scenario, at minimum, the doctor is required to provide a medical management plan and procedure instructions. This medical information is compiled based on the specific case history of the patient. The doctor must be available by phone, video link or other means of communication during the procedure for purpose of managing an emergency.

The Q&A’s above are only a snapshot of the article. Accuratus has chosen to share this information as injectables are a growing market. We work with Standards required to achieve registration and these Standards consider all risks, across many scenarios, to patients. There are suitably qualified beauty salons, dentists, optometrists and other businesses providing cosmetic procedures. Our position is not for or against cosmetic enhancements. The intent of this article is to help us ordinary people know what to ask, what to look for and most of all to ensure that our safety expectations will always be met.

Full reference list can be supplied upon request. Sources:
Medical Board of Australia
Nursing and Mid Wifery Board of Australia
Drugs, Poisons and Controlled Substances Regulations 2017
Supply and Administration of Injectable
Cosmetic Treatments (DHHS)

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