Registered nurses' perspectives on medically safe practices and sound ethical standards in aesthetic nursing: An interview study.

AIMS AND OBJECTIVES: To explore the views of registered nurses experienced in aesthetic nursing regarding medically safe practices and sound ethical standards. BACKGROUND: Aesthetic nursing is an emerging field of modern-day healthcare encompassed within aesthetic medicine. There is a distinct lack of research regarding how registered nurses who specialise in this area of care view medically safe practices and sound ethical standards. This is important to explore, because, in the absence of mandatory regulations within the sector, and it is the aesthetic nurse's own obligation to uphold professional, medical and ethical standards. DESIGN: Qualitative study. METHODS: Individual semi-structured interviews were conducted with 13 registered nurses who had worked in aesthetic nursing for at least two years. The interview transcripts were categorised using qualitative content analysis. The COREQ checklist was used to report the study. RESULTS: A main theme was generated during the analysis: Considering my professional, the clinic's and the patient's needs. The participants described that they considered medical and ethical aspects pertinent to their professional roles as registered nurses but also undertook practices in addition to what they already did as registered nurses, such as creating professional networks using social media. They also described the importance of establishing local medical and ethical guidelines for their clinics, and that they considered patients' individual needs such as using individual information relating to their patients' previous experiences. CONCLUSIONS: The study points to the positive tendencies of registered nurses in aesthetics to develop their own professional networks and create local medical and ethical guidelines until more robust mandatory regulations are in place. RELEVANCE TO CLINICAL PRACTICE: Considering that aesthetic nursing is a young industry, registered nurses are in an excellent position to utilise their professional networks and work with professional bodies to develop standards of professional nursing practice and education for this field.

Lip Enhancement: Physical Assessment, Injection Techniques, and Potential Adverse Events.

Lip enhancement is a common injection treatment that may involve several different injection techniques based on the patient's goals, expectations, and facial anatomy. It is the aesthetic provider's professional judgment to determine which technique will provide the desired results. Taking the time to provide a thorough assessment, review the potential complications, and discuss expectations is an important step in building a patient-nurse therapeutic relationship. Understanding the anatomy and the supporting structures around the perioral area will improve the overall results of a lip enhancement treatment.

A Recipe for Improved Nonsurgical Cosmetic Outcomes: Know Your Herbs and Spices.

The nonsurgical cosmetic arena continues to grow, with more people consistently seeking minimally invasive procedures for facial rejuvenation. However, although these prospective patients are not seeking surgical correction to obtain their results, there is still the potential for nonsurgical procedures to yield adverse events posttreatment. Patients often do not realize that their dietary regimens may affect their nonsurgical cosmetic outcomes. For example, many patients desiring these types of treatments are often found to be taking prescription medications, herbs, and spices on a daily basis that may have the capacity to potentiate adverse outcomes such as bleeding and/or bruising. For these reasons, it is important for clinicians to be inclusive while taking health histories and to properly educate their patients so that administered treatments have the best chance of yielding the desired results. The focus of this article is to provide health care providers information on many of the herbs and spices that have the potential to negatively impact nonsurgical cosmetic outcomes.

Are nurse injectors the new norm?

PURPOSE: As Botox(®)/filler use has increased in recent years, a growing number of nonaesthetic health professionals have emerged to perform these procedures. Since studies have shown that patients identify training as the most important factor in considering these procedures, this study seeks to summarize the perspective of plastic surgeons regarding these paradigm shifts. METHODS: In the summer of 2013, an eight-question survey was sent to members of ISAPS, ASAPS, and ASPS (approximately 26,113 plastic surgeons globally). Two questions assessed practice location and membership affiliation and six questions assessed various healthcare practitioners' capability to administer Botox, fillers, and vaccines (control). Healthcare practitioners included plastic surgeons and dermatologists, gynecologists, dentists, nurses in plastic surgery and dermatology, or nurses in other fields. RESULTS: On three e-mail notifications, 14,184 plastic surgeons opened the survey and 882 responded: 36.6 % from North America, 29.1 % from Europe, 12.9 % from South America, 10.1 % from Asia, 4.5 % from the Middle East, 3.4 % from Australia, 1.9 % from Africa, and 1.6 % from Central America. Seventy-seven percent believed nurses were not as capable as plastic surgeons in administering Botox; 81 % felt the same for fillers. Conversely, 84 % agreed that nurses were as capable as plastic surgeons in administering vaccines. Plastic surgeons ranked nurses in other fields (48 %) as most capable in administering vaccines, then plastic surgeons (42 %), nurses of plastic surgeons (9 %), gynecologists (1 %), and dentists (<1 %). When asked about Botox/fillers, responders ranked plastic surgeons (98 %) most capable, then nurses in plastic surgery (2 %), gynecologists (<1 %), dentists (<1 %), and nurses in other fields (<1 %). When asked to rank according to patient perception, the order remained the same. CONCLUSION: Based on responses from over 880 plastic surgeons from around the world, plastic surgeons consider themselves and dermatologists the most capable injectors. However, they still believe nurses in other fields to be the most capable of administering vaccines. This dichotomy may define the role of various practitioners in an increasingly more competitive injectable environment to improve patient satisfaction and outcomes. Given that the majority of growth in cosmetic injectables is being driven by providers other than plastic surgeons and dermatologists, further clarification on training requirements and practice guidelines may be necessary to ensure a consistent, reproducible experience for the patient.

[Socio-aesthetic care blending professionalism and humanism]. / La socio-esthétique, entre professionnalisme et humanisme.

After working for several years as an aesthetician in a beauty institute, then as a trainer in a beauty training school, Fabienne Jolivel, 44 years old, became a socio-aesthetician to use her skills in a different way, giving aesthetic treatments to people suffering from illness. Here she gives a personal account of her work which offers job satisfaction and a different perspective on life.

Permanent cosmetics.

Plastic surgery practices have become more accepting of the implantation of permanent cosmetics over the last few years. Many plastic surgery practices have added the implantation of permanent cosmetics into their offered services. Many clients who would not have considered having permanent cosmetics implanted because of having to go to a tattoo parlor are now having the procedures performed. The most popular procedures being performed are the implantation of permanent eyeliner followed by eyebrows and lip liner. Other implantations of permanent cosmetics are the full-lip applications, eye shadow application, cheek blush, and a beauty mark implantation. Micro pigmentation can be used for nipple coloration following reconstruction or camouflaging skin pigmentation problems due to trauma, birthmarks, cancer, etc. This article focuses on the use of micro pigmentation for the use of permanent cosmetics (WebMD, 2009).

Nonsurgical body contouring with focused ultrasound.

UltraShape is an exciting, clinically proven, nonsurgical and noninvasive body-contouring solution for both men and women. It offers an alternative to patients seeking effective reduction of localized areas of fat deposits without surgery. The procedure uses ultrasound technology to deliver focused ultrasound waves to target and break down fat cells without any effect on surrounding tissues or organs.

What are the necessary practice competencies for two providers: dermal fillers and botulinum toxin type A injections?

There has been a steady increase in the number of individuals who undergo dermal fillers and botulinum toxin Type A injections. The majority of these procedures are performed by nurse providers. The purpose of this study was to collect national data on the current practice among nursing providers within the American Society of Plastic Surgical Nurses (ASPSN). The goal was to utilize the national data and develop a document of the necessary competencies to guide the practice of providers of dermal fillers and botulinum toxin Type A injections. A survey tool was developed and validated for content by expert nursing providers among the membership of the ASPSN and disseminated via e-mail to the membership of the ASPSN. In addition, data from investigator training, mentoring, and evidence from a review of the literature were also incorporated into the competency document utilizing the Competency Outcomes and Performance Assessment (COPA) model. Common core issues became apparent that included contraindications for the use of botulinum toxin Type A and dermal fillers, postprocedure complications as well as strategies in terms of managing complications. The data also revealed that there is no common method providers are taught to assess the aesthetic patient and a lack of a collaborative relationship in current practice. Overwhelmingly, the respondents supported the need for defined practice competencies. A competency document to guide the practice of providers of dermal fillers and botulinum toxin Type A has been developed for completion of this DNP project.

Using the arcing technique to perform an injectable thread lift procedure.

The Injectable Thread Lift offers your patient the latest concept in facial contouring. The goal of this procedure is to reassign volume into the triangle of beauty, while supporting the falling skin, with created structural columns. This procedure tacks the skin back into the triangle of beauty. There is a new concept of delivering dermal fillers that I refer to as "arcing." It is important to realize that the skin is a 3-dimensional structure. The current injection techniques treat the skin in only 2 dimensions, where the filler is placed all in the same depth in the dermis. With the arcing method used in the Injectable Thread Lift procedure, filler is injected along a path of variable depths using one continuous thread, creating an arc of support for the overhangs. Because of this variation, the arcing method offers another major advantage. Scaffolding is created, which prevents folding of the skin in this area, keeping the crease from being created during animation.

Overview of skin aging and photoaging.

Aging skin is an issue of concern to many patients. In this review aging and photoaging are defined, mechanisms which underlie these processes explored, and available treatment options discussed.

Soft tissue augmentation: nonsurgical approaches to treatment of the mid and lower facial regions.

Fillers are playing an increasing role in dermatology practice, complementing the use of laser and other procedures used in skin rejuvenation. Prior to the injection of any filler, the patient should be counseled about what to expect in terms of any discomfort that may occur during or after injection, possible side effects, the results that he or she can expect, and the likely durability of correction. Knowing how and when to use dermal fillers throughout the face can help clinicians confidently educate patients regarding the full range of rejuvenation procedures that are available.