Perform rejuvenation, regeneration and/or enhancement of the skin using dermal filler procedures

​This standard coexists alongside, SKANSC1: Implement and maintain safe, hygienic and effective working practices during elective non-surgical cosmetic procedures and SKANSC2: Consult, assess, plan and prepare for elective non-surgical cosmetic procedures within the working environment. This standard is for aesthetic practitioners performing procedures using dermal fillers to temporary disguise signs of ageing, modify facial symmetries and structures. You will also be required to do a post procedure evaluation and reflection for continuous improvement. The aesthetic practitioner must have a First Aid at Work qualification or equivalent and be able to carry out the functions within SFHCHS36: Basic life support and have access to life support equipment as identified in the emergency plan. Users of this standard will need to ensure that their practices reflect up-to-date information, policies, procedures and best practice guidance.

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1. carry out a concise and comprehensive consultation face to face with the individual and maintain your responsibilities for health and safety pre, during and post the dermal filler procedure
2. discuss to establish the individual's objectives, concerns, expectations and desired outcomes to inform the dermal filler procedure plan to include:
   1. alternative treatment options
3. develop an emergency plan with the identified healthcare professional/regulated independent prescriber trained to deal with adverse reactions to dermal fillers
4. establish the dermal filler procedure plan in accordance with legislative requirements and organisational policies and procedures to include:
   1. the individual procedure plan
   2. advice, support and guidance
   3. emergency plan
   4. pain management strategy
5. reiterate, confirm and agree with the individual, they have understood the proposed dermal filler procedure and pain management to include:
   1. contra-actions
   2. adverse reactions
6. obtain the individual's written informed consent for the dermal filler procedure and pain management, allowing an adequate time scale for the individual to make an informed choice
7. review the written informed consent for the dermal filler procedure and pain management
8. select an effective hygiene preparation product to meet the individual's needs in accordance with the manufacturer's instructions
9. prepare the individual's treatment area in accordance with the dermal filler procedure protocol and associated risk avoidance strategies to include:
   1. mark out pre-procedure markings if applicable
10. source and select the hyaluronic acid dermal filler, detailing the G prime, viscosity and longevity of the product to meet the individuals needs and area to be treated, including associated risks
11. inject the dermal filler with the sterile single use needle and/or cannula in accordance with the dermal filler procedure protocol to include:
    1. adaptation of injection techniques, depth and placement
    2. in accordance with the pre-procedure markings if applicable
12. monitor the individual's health, wellbeing and skin reaction throughout the dermal filler procedure in accordance with legislative requirements and organisational policies and procedures
13. in the event of an adverse reaction or incident, the aesthetic practitioner must take prompt corrective action as set out within the emergency plan to include:
    1. seek and implement immediate medical intervention from the identified healthcare professional trained to deal with complications as set out in the emergency plan when a prescription only medication is required
14. conclude the procedure in accordance with the dermal filler procedure protocol, legislative requirements and organisational policies and procedures to include:
    1. removing any pre-procedure markings if applicable
15. take and store consensual visual media of the individual's treatment area in accordance with insurance requirements, organisational policies and procedures
16. complete the individual's non-surgical cosmetic procedure records and store in accordance with data legislation
17. use reflective practice to evaluate the dermal filler procedure and take appropriate action
18. provide and obtain confirmation of receipt of the verbal and written instructions and advice given to the individual pre and post procedure to include:
    1. the aesthetic practitioners contact details
    2. emergency plan
    3. contingency plan in the event of absence
19. record the outcome and evaluation of the dermal filler procedure to agree and inform future procedures
20. discuss and agree future procedures with the individual

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1. the importance of collaboration with competent professionals to support effective and safe working practices
2. your role and responsibilities in performing non-surgical cosmetic procedures and the importance of working within your competence
3. why you must comply with ethical practice and work within the legislative requirements
4. the importance to engage in, and document continuous professional development to include, up-to-date information policies, procedures and best practice guidance
5. the anatomy and physiology relevant to this standard
6. the types, composition and pharmacological effects of chemical compounds in dermal filler solutions to include:
   1. the physiological effect of hyaluronic acid solution has on facial anatomy, skin tissue and blood supply
7. how to adapt injection techniques to place hyaluronic acid solution safely beneath the skin tissue into underlying structures to meet the individual's needs
8. the adverse reactions associated with a dermal filler procedure to include:
   1. knowledge and avoidance of danger zones
   2. non-Hyaluronic Acid dermal fillers (semi-permanent)
9. how to implement the correct course of action in the event of an adverse reaction or incident to include:
   1. why and when immediate medical invention is necessary
10. the risk avoidance strategies
11. the importance of obtaining and following instructions from the identified healthcare professional/regulated independent prescriber in the event of an adverse reaction
12. the purpose, use and limitations of dermal filler procedures in relation to:
    1. past and current medical history
    2. previous non-surgical cosmetic and/or dental procedure history
    3. relevant lifestyle factors
    4. contraindicated medication and medical conditions
    5. the individual's physical and psychological suitability for the non-surgical cosmetic procedure
    6. individual's expectations
    7. hyper-immune response management
    8. anaphylaxis management
13. the regulatory and legislative requirements for 'medical devices'
14. the regulatory and legislative requirements for sourcing, recording and administering dermal filler to include:
    1. product name
    2. batch number
    3. expiry date
    4. material data sheets
    5. storage
    6. disposal
    7. audit and accountability
15. the types of pain management and associated risks
16. the legislative requirements and restrictions for sourcing, storing and using licensed topical anesthetics
17. the health and safety responsibilities in line with legislation before, during and after the dermal filler procedure
18. why it is important to discuss and establish the individual's objectives, concerns, expectations, desired outcomes and agree the non-surgical cosmetic procedure plan
19. the importance of using visual aids to inform the individual of the physical effects
20. the fee structures and treatment options
21. the legislative and indemnity requirements of gaining signed, informed consent for the dermal filler procedure
22. why it is important to allow time for the individual to reflect before confirming and agreeing to receive the elective non-surgical cosmetic procedure
23. the importance of obtaining written consent for the dermal filler procedure and pain management strategy
24. the types of hygiene products for the skin and the importance of following manufacturer's instructions
25. the importance of adhering to the dermal filler procedure protocol
26. the importance of monitoring the health and wellbeing of the individual during and post procedure
27. the importance of adhering to the emergency plan in the event of an adverse reaction
28. the legislative, insurance and organisational requirements for taking and storing visual media of the individual's treatment area
29. the legislative and regulatory requirements of completing and storing the individual's non-surgical cosmetic procedure records
30. the expected outcomes from a dermal filler procedure
31. the purpose of reflective practice and evaluation and how it informs future procedures
32. how to collate, analyse, summarise and record evaluation feedback in a clear and concise way
33. the importance to record the outcome and evaluation of the dermal filler procedure
34. the instructions and advice pre and post the dermal filler procedure

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Additional information

It is expected that the aesthetic practitioner undertaking this standard already has the skills, knowledge and behaviours identified within the aesthetic practitioner's procedure guidance and non-surgical cosmetic National Occupational Standards.

The aesthetic practitioner is expected to already be able to demonstrate competency in determining the relative (restrictive) and absolute (preventative) contraindications for the non-surgical cosmetic procedures. In addition, the aesthetic practitioner should be able to identify adverse reactions or incidents and take prompt corrective action as agreed within the emergency plan.

It is expected that this Standard is used in conjunction with SKANSC1: Implement and maintain safe, hygienic and effective working practices during elective non-surgical cosmetic procedures and SKANSC2: Consult, assess, plan and prepare for elective non-surgical cosmetic procedures.

Items listed within the scope/range should be evidenced in line with the specific type of non-surgical cosmetic procedure being performed.

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Individual's objectives

1. safety
2. anti-ageing
3. skin tissue augmentation
4. remedial

Contra-actions

1. hyperemia
2. wounds
3. bruising
4. oedema

Injection techniques

1. bolus
2. intradermal
3. micro-papular
4. linear threading
5. cross hatching
6. fanning
7. tenting

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Anatomy and physiology

1. the structure and function of the body systems and their interdependence on each other
2. skin and systemic pathologies
3. severe adverse event pathologies
4. basic knowledge of pharmacology and sciences
5. effects of medications have on the skin and muscles
6. study of the ageing process of the skin and underlying tissues/ effects of bone reabsorption and understanding of complex facial anatomy and venous and arterial blood supply

Adverse reactions

1. infection
2. pigment irregularities
3. nausea
4. allergic reaction
5. anaphylaxis
6. medicine toxicity/incompatibility/ contraindications
7. vasovagal syncope
8. asymmetry
9. palpability of the filler
10. blindness
11. necrosis
12. nodules
13. vascular occlusion
14. tindal effect
15. arterial occlusion
16. compression occlusion
17. migration of the dermal filler
18. body dysmorphia
19. reduced lymphatic drainage
20. granulomas
21. needlestick injuries
22. stroke
23. death
24. pulmonary embolism

Risk avoidance strategies

1. emergency plan
2. risk assessment(s)
3. acquired medical history
4. procedure plan(s)
5. restrictive treatment areas
6. pre and post instructions and advice
7. avoidance of off license use
8. inoculations
9. first aid at work qualification and basic life support or equivalent
10. general health and safety working practices
11. infection prevention and control
12. working environment
13. collaboration with healthcare professional/regulated independent prescriber/appropriate professionals
14. legislative prescription protocol
15. medicine management
16. informed consent
17. data management
18. audit and accountability
19. understanding of the pharmacology
20. working knowledge of facial and neck anatomy
21. waste management
22. assessment of the individual's physical and emotional suitability

Visual aids

1. Illustrative images
2. Illustrative diagrams
3. pre-procedure markings

Dermal filler procedure protocol

1. working environment
2. health and safety
3. risk management plan
4. infection prevention and control
5. identified healthcare professional/regulated independent prescriber
6. emergency plan
7. procedure plan
8. informed consent
9. appropriate professionals
10. data management
11. audit and accountability
12. instructions and advice
13. waste management
14. evidence based and reflective practice

Instructions

1. the individual, regulated independent prescriber and aesthetic practitioner's legal rights and responsibilities
2. emergency plan
3. post procedure expectations and associated time frames
4. pre and post procedure instructions and care
5. restrictions and associated risks
6. future procedures
7. complaints procedure or concerns protocol

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Adverse reactions

Adverse reactions are also known as adverse incidents or associated risks. An Adverse reaction is an unexpected physical or physiological reaction from a procedure carried out.

Contra-action

Contra action is an expected temporary reaction from a procedure.

Emergency plan

The emergency plan is the responsibility of the aesthetic practitioner that includes use and access to the emergency kit. An identified healthcare professional will act as the regulated independent prescriber if a prescription only medication is required in the event of an adverse reaction. The regulated independent prescriber has a duty of care to their patients to follow regulatory guidelines set by their Professional, Statutory and Regulated Body.

Pre-procedure markings

Pre-procedure markings should be carried out using a sterile single use surgical pen. Pre-procedure markings are used to create guidelines to identify injection sites as set out in the non-surgical cosmetic procedure plan.

Treatment area

The indicative area to be treated, can also be referred to as treatment site or the anatomical name.

Universal precautions and standard precautions

Universal precautions are relevant if the practitioner is exposed to blood and/or some bodily fluid. It is the responsibility of the practitioner to implement infection prevention and control measures to prevent exposure to blood borne pathogens or Other Potentially Infectious Materials (OPIM).

Standard precautions are the basic level of infection control that should be used at all times within the working environment, such as hand hygiene, personal protective equipment, prevention of needlestick and injuries from sharps, risk assessment, respiratory hygiene and cough etiquette, environmental cleaning and waste disposal.

Visual media

Visual media is evidence generated through photography or video.

Working environment

The working environment requirements should comply with Health and Safety legislation and be in accordance within guidelines set out either by your local authority or governing body.

Risk assessments should be undertaken and control methods implemented and documented, updated regularly and/or if changes occur. The working environment should be hygienic and fit for purpose for the non-surgical cosmetic procedures to be conducted safely and effectively using aseptic techniques. Infection prevention and control procedures are required to minimise risk of infection and transmission of microbes. Personal protective equipment must be fit for purpose and available. Equipment and products must be maintained in line with the manufacturer's instructions and legislative requirements.

It is advisable to create a complication management and/or emergency plan for all non-surgical cosmetic procedures in the event of an adverse reaction or incident.

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​SKANSC1, ​SKANSC2, ​SKANSC3, ​SKANSC5, ​SKANSC6, ​SKANSC7, ​SKANSC8 and SKANSC9

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1

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2022

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Current

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Original

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SkillsActive

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n/a

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Beauty Aesthetics, Aesthetic Practitioner

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6222

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dermal fillers, injectables, injection techniques, cannula, emergency plan, hyaluronic acid, pain management, elective non-surgical cosmetic procedures, regulation, pharmacology

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