Ten Questions to Ask Your Practitioner

Ten questions to ask your aesthetics practitioner before agreeing to a Botox or dermal filler treatment.

Skin Beautiful Medical and Cosmetic Clinic provides expert advanced dermal filler treatments at clinics in Exeter Milton Keynes Bristol Coventry Swansea Warwick Daventry Evesham Carmarthen Llanelli and Neath.

Botox & dermal fillers treatments are expensive and can be highly problematic, even dangerous if not administered correctly.

 On the one hand Botox & dermal fillers treatments can be personally uplifting and a lasting, worthwhile investment. However, many clients don't know what to ask their practitioner before agreeing to expensive treatments.
 

This short guide will help clients seeking treatments to ask the right questions and find the right 'suitably qualified' practitioner.

 

1. What aesthetics training/assessment/qualifications have you taken?

Perhaps the single most important question to ask your practitioner. After all, why are you paying so much money for your treatment(s)?

Firstly, just to dispel any confusion over training and qualifications...

A qualified doctor, dentist or nurse is NOT a qualified medical aesthetics practitioner.
Any suggestion to the contrary is entirely misleading. Please take this into account.


However, a qualified medical aesthetics practitioner must not only be a qualified doctor, dentist or nurse but, in addition, he/she must also carry additional certificates for professional independent medical aesthetics training and qualification. Otherwise who do you think trained your practitioner to inject Botox? Well, it certainly wasn't the university they attended. Nor was it the house doctor or ward sister who mentored them during undergraduate training.

There are so many practitioners practising aesthetics in the UK who have had no formal aesthetics training or qualifications at all. To say to a client "I'm a fully qualified doctor/dentist/nurse" is not good enough. Many doctors and nurses don't routinely use needles, and even then they would know nothing about placement or injection technique with something as specialised as Botox or dermal fillers.

 

2. How much post qualification experience do you have?

Again, a similarly important question and one I would urge you to ask before booking an appointment. Many practitioners promote themselves as "highly experienced" or "best placed" to carry out treatments. If they haven't had formal medical aesthetics training then they are neither highly experienced nor best placed in the true sense of the meaning. Of course, experience is all very well, but not if it isn't accompanied by medical aesthetics knowledge.

As an example of this I recently visited a client whom had been treated with Botox by a "highly experienced" doctor. Unfortunately, the doctor had no aesthetics qualifications which became all the more apparent when the client told me about the treatment. The doctor had not only misplaced the injection(s) but didn't give enough injections either. Had she taken proper medical aesthetics certificates then she would have known not to make these mistakes.

So, do ask not about experience, but post medical aesthetics qualification experience, and, if necessary ask to see certificates too.

 

3. What cosmetic insurance do you carry?

It is absolutely essential that your practitioner has not only insurance, but the right professional cosmetic insurance and enough of it too. A practising doctor with medical practise insurance or a nurse with RCN insurance will not be insured in the £millions for mishaps of the non surgical cosmetic type. So how do I know if my practitioner has the right type of insurance?

A separate professional cosmetic insurance policy should be in place and visible to all clients prior to treatment. Aside from the name and formal qualifications of the practitioner, date and indemnity it should also list the products that the practitioner is insured to use (e.g. Botulinum toxin type A: Botox, Vistabel, Xeomin, and dermal fillers Juvederm, Restylane, Teosyal, Belotero, etc).

 

4. Have you been independently trained and assessed in the treatment I require?

Let's suppose you are seeking a lip augmentation treatment and your chosen practitioner is a 'qualified medical aesthetics practitioner.' A lip augmentation is an advanced aesthetics treatment that requires skill and advanced knowledge, none of which are covered by a basic Botox or dermal fillers training and assessment course. Advanced treatments require advanced independent medical training and assessment.

In some cases practitioners (e.g doctors, dentists or nurses) may have been trained by a pharmaceuticals company to use certain products. One particular problem with this is that there are many dermal fillers on the market whose physical properties are very different from the one they trained with. For example, a practitioner that trained with a non cross-linked filler such as Belotero would not have been trained or assessed to work with a cross-linked dermal filler such as Teosyal.

Some aesthetics companies manufacturing dermal fillers offer free training courses for doctors and nurses working in aesthetics clinics and in return expect the clinic to use only their product. This leaves the practitioner with no knowledge of other products, and unable to offer impartial advice to clients seeking treatment. As for the treatment itself, where an unfamiliar filler is used there may be a certain amount of guess work involved if the practitioner has no qualified knowledge of the filler's physical properties.

 

5. Can I see some examples of your own work?

I cannot stress enough how important this is. You need to see before and after images of the very treatment you are seeking where the treatment was recently carried out by the practitioner. Generic images (widely available across the internet) are not sufficient. Authentic before and after images not only prove the practitioner has experience of the treatment you require but also his/her relative skill/competency level.

 

6. Which product(s) do you use and why?

This question is a good way to determine whether the practitioner was independently trained in the medical aesthetics industry. I know of many doctors in the industry that use only Restylane dermal fillers and only Botox or Vistabel botulinum toxin type A. These are all quality, licensed products, but there are others on the market that may in be better suited to individual clients.

It is also a good way to test the practitioner's knowledge of not only his/her products but also the field of aesthetics too. Some practitioners may use only one type of dermal filler because they don't know anything about other types.

 

7. How much product will you use?

This question really must be asked every time you have a treatment. Not only do you want to know that you will receive the right amount of product as per prescription (if applicable), but also as a way to evaluate total cost of the treatment. A cheap initial treatment can quickly become a very expensive overall treatment if the practitioner charges you for additional product or "top up treatments."

Professionally, I would advise that clients should receive either a full syringe of product in one treatment, or, at the advice of the practitioner should receive a lesser amount with the option of a fortnightly review and free top up from the original syringe.

 

8. How long will the treatment(s) last?

For your investment you are going to want to know that the treatment will last a reasonable duration. This is another way to judge your practitioner's knowledge of aesthetics products.
Generally speaking a botulinum toxin type A treatment (Botox, Vistabel, BoCouture, Azzalure) administered as a wrinkle reducing treatment should last beyond three months. However, any practitioner giving guarantees of longer durations may not understand the scientific nature of Botox in the body. Shortly after three months neuromuscular function is restored and muscles are again contracting. It is only a matter of time before the lines and wrinkles reappear. No guarantees over this should be given as it is a matter not determined by the action of Botox on the neuromuscular system.

Some practitioner may tell you that the effects of Botox injections can last for up to 6 months. I believe this advice to be accurate as the operative word here is "can" and not "will." Perhaps the best guide to longevity is 3-6 months.

With dermal fillers clients should expect a minimum of 6 months and possibly longer. Some dermal fillers can last for as long as 18 months, but these are normally of the semi-permanent type, and are more costly to have treatment for. Professionally I advise 6-9 months for most dermal fillers.

 

9. What happens if I need more product?

...or, you could just ask: "Do you offer free top up treatments?" However if the answer is "No" then you need to know what the alternative is. It's about evaluating the total cost of treatment. Whilst I would advise caution where practitioners charge high prices and offer free top up treatments (especially where a top up is not required) I would equally advise caution against cheap treatments where no free top up treatment is offered. Clients should by paying only for the product they need and not paying for what they don't need (expensive treatments with optional free top up).

Of course, clients would expect to pay additional money where they decide to have fuller cheeks of lips. No practitioner is going to offer a free syringe of dermal fillers. However, it is the duty of practitioners to make clients aware of exactly what they are being charges for.

Ask your practitioner to advise you on the overall cost of treatment including a top up where it is necessary.

 

10. What is your medical background?

By asking this question one can determine whether the practitioner is actually a beautician or therapist administering Botox or dermal fillers as opposed to a doctor, dentist or nurse. Beauticians will not be medically insured and will not be able to obtain medical supplies legitimately from pharmacies or pharmaceutical suppliers.

Go one stage further and ask not only about training, but also about academic qualifications. Many older and highly experienced nurses in the UK have no university degrees or diplomas even. This does not necessarily detract from their ability to deliver aesthetics treatments, but it may be worth noting that some independent medical aesthetics training companies will not accept nurses without a formal academic nursing qualification. Furthermore, there are many qualified nurses that have little if any exposure to dealing with complications in daily practice. Botulinum toxin type A injections can lead to complications. It is important that your practitioner knows how to deal with any that arise quickly and competently.

Useful links for Botox (botulinum toxin type A) & dermal fillers:

Skin Beautiful Medical & Cosmetic Skin Clinic
Information about Botox
Information about dermal fillers
Botox & dermal fillers treatments
Botox & dermal fillers FAQ
Botox & Dermal Fillers Myths

Before and after images
About Skin Beautiful & Helen Bowes RGN BSc (hons)
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Botox - How Qualified is Your Practitioner?

Is your medical aesthetics practitioner suitably qualified to administer your Botox or dermal filler treatment? Many aren't. This article explains why.

Skin Beautiful Medical and Cosmetic Clinic provides expert advanced dermal filler treatments at clinics in Exeter Milton Keynes Bristol Coventry Swansea Warwick Daventry Evesham Carmarthen Llanelli and Neath.

Experienced doctor, qualified GP, registered dentist or trained nurse. Which one is qualified to administer Botox or dermal fillers?

The answer is none of them! It may come as a surprise, given the way in which many doctors, GPs and nurses advertise their aesthetics services that many have no independent training or qualifications in administering injectable Botox or dermal fillers.

Whilst Botox (botulinum toxin type-A) is a prescription only medicine and is therefore prescribed by a doctor, dentist or nurse prescriber this tells us nothing about the actual process of injecting or administering the product. Ironically, a GP may promote Botox in such a way as "All injections by a fully qualified GP" and yet during a normal GP surgery he/she would delegate the task of routine injections to a practice nurse.

This scenario becomes all the more ironic when considering that Botox and dermal fillers require specialist knowledge regarding placement and injection technique and yet a doctor who doesn't even inject flu jabs is somehow able to offer Botox injections.

Fully Qualified!

What exactly does this mean? It would probably be better for your GP or nurse to answer this question, but I will attempt to interpret the hidden small print.

In most cases where a doctor or GP makes reference to qualification then it should be interpreted as being qualified as a medical doctor. The same applies to dentists and nurses whom claim to be either 'registered' or 'qualified.' For example, a registered nurse (without a nursing degree) or registered general nurse (having a BSc. degree in nursing).

In addition, some doctors, GPs, nurses and dentists also mention 'registered with GMC, NMC, GDC, etc.' This is in reference to the governing council of whichever field they practice in. For example, a GP would have to be registered with the General Medical Council to practice. Similarly a nurse would have to be registered with the Nursing & Midwifery Council to practice on a hospital ward, as a health visitor, etc.

Fully Unqualified Practitioner

I'm sure by now you will have noticed the absence of any suggestion of being a 'qualified aesthetics practitioner.' This is quite blatant. Many GPs will point to their medical qualifications to reassure the client. That is until the client asks what training and qualifications they have in aesthetics. This is a question I once posed to an anonymous GP run 'skin clinic.'

A lady client had approached me following a treatment at another clinic and complained about results from a recent cheek augmentation. She wanted to disclose the name of the clinic to me and I called to enquire about a treatment. When I asked about the practitioner I was told that a fully qualified GP would be performing the treatment. When I further asked about his aesthetics qualifications I was told that he was fully qualified in all non surgical procedures. However, when I asked which medical aesthetics company trained the GP I learned that he had received no training or qualifications in aesthetics whatsoever. I politely told the receptionist that I would not be wanting treatment from a practitioner that has never been trained with Botox or dermal fillers.

Questions to Ask Your Practitioner

If you are considering investing money in a non surgical treatment then you have every right to know about the training and ability of your practitioner. Firstly, ask how they learned to inject Botox & dermal fillers and ask who trained them. Then ask what qualifications they have in aesthetics.

You want to know for certain before any treatment commences that your chosen practitioner has received training and is qualified in the exact procedure being given. It is of little comfort to know that a practitioner has attended a short half day course and watched a demonstration of frown lines being treated when you are wanting an advanced procedure such as a jaw definition or cheek enhancement.

Recognised Qualifications

A practitioner that is properly qualified will have been trained and systematically examined by a trainer when performing a live, unassisted treatment. Only once the trainee has proven to be competent in all procedures then a certificate is awarded. It is evidence that a practitioner can perform a treatment safely and correctly.

There are several medical and aesthetics training companies in the UK. A respectable training company will require a minimum nursing, dentistry or medical degree and post qualification practice before enlisting applicants. They will also require trainees to prove their ability in injecting for every treatment that the training course requires before issuing a certificate.

On completion of the course(s) the certificate will provide evidence of a practitioner's ability to perform a treatment in a safe and professional manner. A certificate should also carry a practitioner number too.

**An important note about aesthetics certificates**

A certificate in administering Botox and/or dermal fillers is a document providing evidence that the practitioner has performed relevant treatments unassisted and satisfied the examiner(s) in his/her ability and competence in performing these treatments. This is not the same as a certificate of attendance on a training course where delegates sit and watch routine demonstrations by an demonstrator.

There are many different aesthetics training courses for Botox and dermal fillers throughout the UK, ranging from half day demonstration courses to full 3 or 4 day medical assessment courses. A certificate of attendance is not a certificate of examination and provides little, if anything in terms of evidence of the competency and suitability of the practitioner to administer Botox or dermal fillers.

In support of Safe and Ethical Treatments

There are many doctors, dentists and nurses whom deliver a very high standard of professionalism in aesthetics. This blog in no way constitutes an attempt to single out certain types of practitioner. It was written in an attempt to inform the general public seeking Botox or dermal fillers treatments as to the meaning of 'fully qualified' and how it should apply to aesthetics.

As a qualified advanced medical aesthetics practitioner I understand that when a client approaches me wanting a treatment that it is my professional obligation to ensure the client knows exactly who I am and how suitably qualified I am to perform the required treatment.



Useful links
Skin Beautiful homepage
About Helen Bowes RGN, BSc (hons)
Contact Skin Beautiful

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About Dermal Fillers
Botox & Dermal Fillers Treatments
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