Growing numbers of individuals from nurses and aestheticians to all types of physicians are trying to get in on the injectable game, but plastic surgeons consider themselves and dermatologists to be the most skilled of all the injectors out there, according to a  new study in the International Society of Aesthetic Plastic Surgery (ISAPS) Aesthetic Plastic Surgery.

Kevin Small, MD, and Henry M. Spinelli, MD, from the Division of Plastic Surgery Presbyterian Hospital in New York and Kathleen M. Kelly, MD, from Columbia University in New York asked plastic surgeons six questions assessing various healthcare practitioners’ ability to administer BOTOX®, fillers, and vaccines. Healthcare practitioners included plastic surgeons and dermatologists, gynecologists, dentists, nurses in plastic surgery and dermatology, or nurses in other fields.

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Plastic surgeons consider themselves and dermatologists to be the most capable cosmetic injectors, and they believe nurses in other fields to be best at administering vaccines. Specifically, 77% believed nurses were not as capable as plastic surgeons in administering Botox; 81% felt the same for fillers. When asked to rank according to patient perception, the order remained the same, the study showed.

“This preliminary study may initiate a substantive discussion concerning the role of various practitioners in an increasingly competitive injectable environment,” the study authors conclude.