Cosmetic injections

Dermal fillers are piped by injection to ‘fill’ the wrinkle, line or skin depression producing a wrinkle smoothing effect.

Botulinum toxin can be used in cosmetic procedures, despite the fact that one of the most serious complications of the toxin is paralysis. In cosmetic procedures, small, diluted amounts are directly injected into specific muscles causing controlled weakening of the muscles and smoothing wrinkles and facial creases.

Botulinum toxin is now commonly used to smooth frown, crow's feet (lines around the eye) and forehead lines. Wrinkles caused by sun damage and gravity will not respond to botulinum toxin.

The cosmetic effects of most cosmetic injections are temporary.

The fact that the above cosmetic injections are a prescription only medicine shows there is an element of danger associated with its use.

Safe use of these products requires proper medical oversight due to:

• risks from the medication itself
• risks from administration (injection)
• complexity of the conditions being treated.

After having a cosmetic injection it is common to experience local pain, tenderness, and bruising. With any injection, there is a low risk of infection or allergic reaction.

The botulinum toxin can cause serious side effects if it spreads past the muscle into which it has been injected. These side effects can include drooping eyelid, double vision, difficulty swallowing and speaking, general weakness and respiratory failure.

In rare instances deaths have occurred in patients who have used botulinum toxin and who have other significant illnesses.

Prescribing and administering prescription-only medicines is controlled by the Medicines and Poisons Act 2014 (external site) and Medicines and Poisons Regulations 2016 (external site).

Only a medical practitioner, nurse practitioner or dentist may prescribe its use. The authorised prescriber must be lawfully practising their profession and acting within their professional scope of practice.

Treatment with cosmetic injections cannot be started without first having a consultation with an authorised medical practitioner or nurse practitioner.

Only after this is it legal for a Registered Nurse to administer a prescription medicine under the direction of that practitioner. If a consultation is not carried out, it is illegal for anyone to independently purchase, obtain, administer or supply prescription medicines.

To determine if a medical practitioner, nurse practitioner, or nurse is registered, a check can be made on the Australian Health Practitioner Regulation Agency (AHPRA) website (external site).

Prior to receiving cosmetic injections it is strongly recommended that these checks be made to ensure the validity of both the authorising doctor and administering nurse.

• Ensure your practitioner is a qualified doctor or nurse. This can be checked on the AHPRA register (external site).
• Ensure the cosmetic injection to be used is registered with the Therapeutic Good Administration. All registered medicines must display an 'AUST R' number (external site) on the label as proof of registration.
• Ensure practitioners use the necessary aseptic techniques (external site) to avoid contamination of sterile injection equipment.
• Talk to the provider about his/her safe injection practice (external site). For example, healthcare providers should not use the same syringe on more than one patient, even if the needle is changed.
• Injection bottles that are labelled as single-dose or single-use should be used for a single patient and single case/procedure/injection.