Can a NP perform plastic surgery?

Advanced Practice Columnist / Guide · Sep 25, 2011

Cosmetic procedure is a broad term that encompasses all non-surgical and surgical procedures that enhance or improve the patient's appearance. It is a totally elective procedure that focuses on aesthetics or beauty. When you say surgical procedure or surgery, that's even a much broader term that includes all procedures performed on a patient that requires an operation involving an incision on the body.

NP's practice based on a scope that is determined by the state where they are licensed and certified. Their independence and involvement in procedures and surgery will vary depending on the state and the institution they practice under. The general rule is that major insurance carriers (such as Medicare, for example) will reimburse NP's for any procedures traditionally performed by physicians at a lower rate of payment.

Your example is a common office procedure in cosmetic surgery. It is not surgery in the sense that no incision is made. There are NP's that are trained to do the procedure you mentioned and they typically work under a cosmetic surgery practice with physicians who offer such services.

P.S. I hope you don't take offense but since we are talking about medical procedures, it is probably more appropriate to use anatomical terms when describing body parts since many of our readers are in the healthcare field.

linearthinker, DNP, RN · Sep 25, 2011

I get my botox and juvaderm from a NP provider, but the price is the same if I have the MD do it. It is just faster to get an appointment with the NP. My lipo and surgery, obviously, were done by a MD. I don't think NPs do lipo. At least not here.

Advanced Practice Columnist / Guide · Sep 25, 2011

I get my botox and juvaderm from a NP provider, but the price is the same if I have the MD do it.

That makes complete sense because no insurance company covers cosmetic procedures.

klone, MSN, RN · Sep 25, 2011

That makes complete sense because no insurance company covers cosmetic procedures.

Not exactly true. Post-mastectomy breast reconstruction is purely cosmetic, yet most insurance companies do cover it.

roma4204, BSN, RN · Sep 25, 2011

Not exactly true. Post-mastectomy breast reconstruction is purely cosmetic, yet most insurance companies do cover it.

Purely cosmetic? That's like saying a prosthesis is only for cosmetic reasons.

foreverLaur · Sep 25, 2011

NPs, in general, cannot operate. They are not trained or licensed to do so. A NP can also be a RNFA in which they can assist in surgery. PAs are trained in surgery and operate collaboratively with physicians in the OR (usually being a 1st assist) although can take the lead when the PAs supervising physician allows it.

Isabelle49 · Sep 25, 2011

I would bet the NP injecting silicon/silikon into client's buttocks by flying under the radar!

If I'm not mistaken, an NP has to practice under a physician's direction. I could be wrong, but I don't think NP's have independence in prescribing and treatment.

klone, MSN, RN · Sep 25, 2011

Purely cosmetic? That's like saying a prosthesis is only for cosmetic reasons.

A prosthetic limb helps a person walk or grasp/hold things. A prosthetic breast (especially when they create a nipple and tattoo on the aereolae) is indeed purely cosmetic. That's not a value judgment, it's just a statement of fact. Prosthetic breasts serve no purpose but aesthetic. There's nothing WRONG with that, nor do I in any way judge women who choose them. But it is a cosmetic procedure that most insurance companies cover.

klone, MSN, RN · Sep 25, 2011

I would bet the NP injecting silicon/silikon into client's buttocks by flying under the radar!
If I'm not mistaken, an NP has to practice under a physician's direction. I could be wrong, but I don't think NP's have independence in prescribing and treatment.

Depends on the state. In most states, NPs can indeed practice on their own, complete with prescriptive authority.

klone, MSN, RN · Sep 25, 2011

I know RNs can do botox injections. I don't see why not an NP can inject things. Is injecting a substance into the body technically surgery? An NP removed my son's toenail, which I guess is considered minor surgery, right?

bsnanat2 · Sep 25, 2011

NPs, in general, cannot operate. They are not trained or licensed to do so. A NP can also be a RNFA in which they can assist in surgery. PAs are trained in surgery and operate collaboratively with physicians in the OR (usually being a 1st assist) although can take the lead when the PAs supervising physician allows it.

NP's do not have to be RNFA to first assist. RNFA is an expanded scope for an RN. Just being an APRN allows one to first assist based on CMS reimbursement, while facility credentialing may be a different story. First Assists are allowed to open and close independently in many cases.