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Nonsurgical Aesthetic Treatment Conversion to Surgery: Implications for Patient Selection and Practice Modeling
Mario S Blondin1, Jaimie L Bryan1, Gayle S Wiesemann1
1From the College of Medicine.
Annals of Plastic Surgery
|June 3, 2025
Summary
Advanced practice providers (APPs) can safely perform nonsurgical facial aesthetic treatments. A study found a low conversion rate to surgery, supporting APP-led nonsurgical care for facial aging.
Area of Science:
- Plastic Surgery
- Aesthetic Medicine
- Dermatology
Background:
- Nonsurgical treatments for facial aging are integral to plastic surgery.
- Two practice models exist: surgeon-led and advanced practice provider (APP)-led nonsurgical treatments.
Purpose of the Study:
- To evaluate the practice model where APPs perform nonsurgical treatments.
- To gather objective data on APP-administered botulinum toxin and dermal filler treatments.
Main Methods:
- Retrospective chart review of 737 patients treated between 2015-2021.
- Exclusion of patients who had cosmetic surgery prior to nonsurgical treatments.
Main Results:
- Overall conversion rate to surgical procedures was 5.3%.
- Patients with prior cosmetic surgery had a higher conversion rate (12.5% vs 4.1%).
- Older patients receiving fillers were more likely to undergo surgery (facelifts, liposuction).
Conclusions:
- The APP-led nonsurgical treatment model is supported by low surgical conversion rates.
- Older patients and those receiving fillers may require more comprehensive counseling regarding surgical options.
- Nonsurgical aesthetic treatments are a fundamental component of plastic surgery practices.
