Dermatology Update: Dermal fillers: Help patients put their best face forward
Victor Czerkasij AS, BA, MA, MSN, APRN-BC, FNP-C

The Nurse Practitioner
October 2010 
Volume 35  Number 10
Pages 43 - 47
  PDF Version Available!

In 2009, the American Society for Aesthetic Plastic Surgery revealed that in spite of the recession and decrease in personal financial security, Americans spent approximately $10.5 billion dollars on cosmetic procedures; men accounted for nearly 10% of the estimated 10 million procedures.1 Surgical interventions included liposuction, breast augmentation, eyelid surgery, and breast reduction, and popular nonsurgical interventions included botulinum toxin product injections, laser hair removal, and microdermabrasions. The antiaging field encompasses a wide array of cosmetic and surgical interventions aimed at changing both physical wellness and outward appearance, including cosmetic dermatology.One of the fastest-growing options is injectable dermal fillers, which offer the advantage of quick, relatively inexpensive, and increasingly longer-lasting results for facial wrinkles and deeper folds. Dermal fillers have become the first-line treatment for nonsurgical options, as they are safe, efficient, and result in improvements for age- and photodamaged areas of the face with minimal adverse effects. NPs need to understand the differences between the types of fillers and their use, as many supportive scope-of-practice bylaws allow NPs to perform these injections.Although some NPs do not consider themselves involved in "cosmetic procedures", many do have daily encounters with patients seeking assistance with conditions they feel are important to their well-being, but are not medically necessary and not categorized as traditional cosmetic procedures. Patients present with acne and warts; acrochordons (skin tags); seborrheic keratosis; melasma (brown facial patches); liver spots (flat, brown patches on sun-exposed areas such as the dorsal surface of the hands, forearms or neck); vitiligo; stretch marks; keloids following invasive surgery; alopecia or generalized thinning at the top of the scalp; or bruising and purpura in elderly patients, due to aspirin use, warfarin

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