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Nurse’s specialty is rejuvenating patients

Georgia Cirese likes to wow her patients in a field she says is exploding.

“I’m just so passionate about this,” said Cirese, an RN, CLT and aesthetic nurse specialist at Dermatology & Skin Cancer Center’s Cosmetic Skin Care Center. “It is such a fun field. I call it the wow factor.”

Cirese considered herself a nurse pioneer in medical aesthetics when she started working in the field 10 years ago. She said she has always enjoyed skin care. She sold Estee Lauder skin care products to pay for nursing school.

“I’ve always had a passion for skin care,’ Cirese said. “I’ve always had an interest in it.”

The former labor and delivery nurse took skin care to another level when she decided to start her family at 39 years old. She joked with one of the nurses in the mother-baby unit where she worked for 10 years, saying if she had a baby now she would be 45 years old when her child entered kindergarten.

“I need to work for a plastic surgeon,” Cirese said she joked with her co-worker.

Watch what you wish for. Cirese’s co-worker immediately told her of an opening in a newly developing medical spa. Would she be interested?

“In 2001 I started doing injections,” she said. “It was very exciting. Plastic surgery was really booming then. We were pretty busy.”

Cirese became a mother and switched to medical aesthetics. She assisted in the opening of one of the first ambulatory plastic surgery center and medical spas in the Kansas City area with Gerome Lamb, MD. She started in pre- and post-op, then transitioned to the surgery center’s nurse administrator where she administered peer reviews, accreditation and managed the surgical side. As administrator, Cirese said she continued to assist Lamb with injections, but her interest in the hands-on care continued to grow.

“I just took such an interest it in,” she said. “I thought to myself, ‘ I can do this.’ We are nurses. We give shots all day long. I started injecting my staff.”

Cirese trained to perform injections with Allergan, Inc. She became certified in injections and laser-certified for hair removal, skin spot removal and scar therapy. She said the work is rewarding and fun.

“Just seeing the instant results,” she said. “The immediate gratification was what I got really excited about.”

Cirese joined the Dermatology & Skin Cancer Centers’ Cosmetic Skin Care Center practice in 2005. In 2009 she was selected as an ACE injector by Allergan, Inc., a position she received by appointment. She said the Allergan appointment means she is in the top 1.5 percent in the country with patient retention. Cirese travels across the states training mid-level providers, such as nurses, nurse practitioners and physician’s assistants, in injections.

“This is an elected position and I am honored to hold it,” she said. “As an ACE injector I am also a speaker and trainer for Allergan.”

Cirese said she was one of only several nurses when she started in medical aesthetics. Since then she has watched the industry develop new injectables, such as Botox, Dysport, Juvederm, Restylane, Perlane and Radiesse, which she uses in her practice. The most common fillers are Juvederm, Botox, and Radiesse, she said. More and more patients are electing less invasive fillers over surgery, she said.

“There are now a whole variety of fillers,” she said. “This field continues to grow, grow, grow. That’s one of the things that’s so intriguing for nurses. Products get better, technology gets better.”

Cirese has seen the industry evolve from an all-female base to include 25 percent males. Patients range from their 20s to 80s, she said, and arrive at the center for a variety of reasons. Sun-worshipping baby boomers seek treatment for skin damage. Men want help for the “eleven” double vertical lines near their eyebrows, expressing an angry look. People are living longer and working longer. They want their appearance to reflect how they feel, she said.

“All of a sudden you open your eyes to what happens to your skin,” she said. “So much of it is because we’re taking better care of our health. We’re living longer. We want to look as good as we feel. I want them to look better. When we look better, we feel better.”

Cirese said with any injection there is always a risk of bleeding, bruising or infection. She lets her patients know the risks of a needle breaking the skin, but in her decade-long career as an aesthetic nurse specialist, none of her patients have gotten infections.

“Everything IS done in a sterile technique,” she said. “I don’t use any fillers that have your higher risks of complications.”

Mid-level injectors, nurses, nurse practitioners and physician assistants represent more than 50 percent of all cosmetic injections in the country, according to Allegan’s 2011 report, Cirese said.

“When I started in this field, I was considered a nurse pioneer in aesthetic injections,” Cirese said. “Now many non-core providers are entering into the aesthetic field without much training or experience.”

It is why Cirese said she is passionate about training and educating providers. The field is a growing industry for nurses. There are now multiple education and training programs available, she said. More and more doctors employ nurse injectors today.

“The nurses will be more in demand,” Cirese said. “Practices are looking for nurse injectors.”

Nurses are taught to be patient advocates, to take care of the patient and educate them. To be successful, you need to have an artistic eye, she said, and meet your patient’s needs.

“It’s just transforming that skill to art,” Cirese said. “We are lifting, re-volumizing and rejuvenating.”

Angie Rogers, a physician’s assistant at Dermatology & Skin Cancer Center’s Cosmetic Skin Care Center, said Cirese has a good eye for detail.

“She gives good patient care,” Rogers said. “She has a great passion for what technology has to offer and defying aging.”

Cirese knows how to assess individuals well and treat them with the appropriate techniques and products, Rogers said.

“You’re sculpting,” Rogers said. “You have to restore youth. You have to be able to assess to be able to do that. She does a great job with that.”

Rogers said she was attracted to the field of aesthetics because of its ever-changing dynamics. The field is exciting, she said.

“You get to work with many different facial structures,” Rogers said. “Patients have different goals. There are so many different things you do. It’s rewarding to see a positive affect on someone’s life.”

Like Cirese, Rogers enjoys the long-term relationships she forms with her patients. She sees clients several times a year for years at a time. She said she still keeps in touch with former clients from a former practice in Minnesota. Rogers said medical aesthetics takes patience and an eye towards detail.

“That creative mind,” she said. “Take something and form it into another.”

Linda Friedel can be reached at Linda.Friedel@npgco.com