7.5 Practicing in a Medical Setting: Injectables, Surgery Terms, Medical Terminology & PRP/PRF
Key Takeaways
The NIC Advanced Practice outline tests the purpose and effect of medical procedures such as injectables, light modalities, and surgery, plus relevant medical terminology.
Botulinum toxin type A relaxes dynamic wrinkles by blocking acetylcholine release at the neuromuscular junction, while hyaluronic acid fillers add volume and can be dissolved with hyaluronidase.
The suffix -plasty means surgical repair or reshaping, -ectomy means surgical removal, and -itis means inflammation; a rhytidectomy is a facelift and a blepharoplasty is eyelid surgery.
Platelet-rich plasma (PRP) is made by drawing the patient's own blood and centrifuging it to concentrate platelets and growth factors; platelet-rich fibrin (PRF) forms a fibrin matrix that releases growth factors more slowly.
Blood draws and injections are medical procedures; in Washington, injections are outside the esthetics and master esthetics scope.
Why This Topic Is on the Exam
The NIC Esthetics Advanced Practice outline includes "apply knowledge of practicing in a medical setting," with two subtopics: "recognize purpose and effect of medical procedures (e.g., injectables, light modalities, surgery)" and "define relevant medical terminology." The services domain adds "medical regenerative therapies (e.g., PRP, PRF)." You need to understand these procedures well enough to schedule safely, give consistent aftercare, and recognize what you may not do.
Injectables
| Treatment | What it does | Esthetician considerations |
|---|---|---|
| Neuromodulators (botulinum toxin type A) | Block acetylcholine release at the neuromuscular junction, relaxing the muscles that cause dynamic (expression) wrinkles. Effects appear over several days and typically last a few months. | Follow the injector's aftercare. Avoid pressure, massage, and heat over fresh injection sites unless the injector clears it. |
| Hyaluronic acid fillers | Add volume and fill static folds and hollows. The body absorbs them over time. | They can be dissolved with the enzyme hyaluronidase if a problem occurs. Avoid aggressive massage and heat over newly filled areas. |
| Calcium hydroxylapatite and poly-L-lactic acid | Biostimulatory fillers that also prompt collagen production | Same aftercare caution; poly-L-lactic acid is sometimes paired with injector-directed massage. |
| Deoxycholic acid | Injected to break down submental (under-chin) fat | Expect swelling and tenderness. |
| Sclerotherapy | Injected solution that closes spider and varicose veins | Avoid heat and compression changes unless the provider directs them. |
All of these are injections. RCW 18.16.020 states that the practice of esthetics never includes injections, so they are outside both Washington esthetics licenses. WAC 246-919-606 lets physicians delegate injections only to physician assistants, registered nurses, and licensed practical nurses (section 1.3).
Light and Energy Modalities in the Medical Setting
The outline lists "light modalities" as a medical procedure. Lasers, IPL, radiofrequency, and plasma are covered in Chapter 6. In Washington, prescription versions are medical devices that a master esthetician may operate only under a physician's delegation that meets WAC 246-919-605 (section 1.3). Ablative resurfacing and other procedures that amount to surgery cannot be delegated under that rule.
Cosmetic Surgery Terms
| Term | Meaning |
|---|---|
| Rhytidectomy | Facelift (removing excess skin and tightening deeper tissues) |
| Blepharoplasty | Eyelid surgery |
| Rhinoplasty | Nose reshaping |
| Mentoplasty | Chin surgery or augmentation |
| Otoplasty | Ear reshaping |
| Brow lift (forehead lift) | Raises the brows and smooths the forehead |
| Liposuction (lipectomy by suction) | Removes fat through a cannula |
| Abdominoplasty | "Tummy tuck" |
| Mammoplasty | Breast surgery |
| Dermabrasion | Medical resurfacing with a rotating instrument, deeper than microdermabrasion |
The 2014 NIC Advanced Esthetics sample question asked which term means a facelift; the answer was rhytidectomy. The 2025 sample asks the medical term for wrinkle: rhytid.
Section 7.4 covers pre- and post-operative esthetic care. The rule of thumb: begin any post-surgical service only after the surgeon clears it, and stay away from incisions.
Medical Terminology Building Blocks
| Part | Meaning | Example |
|---|---|---|
| derm-, dermat- | skin | dermatitis |
| -itis | inflammation | folliculitis |
| -ectomy | surgical removal | rhytidectomy |
| -plasty | surgical repair or reshaping | blepharoplasty |
| -osis | condition | hyperhidrosis |
| hyper- / hypo- | over / under | hyperpigmentation |
| a-, an- | without | anhidrosis |
| erythema | redness | post-peel erythema |
| edema | swelling | post-operative edema |
| ecchymosis | bruise | after injections |
| hematoma | collection of blood under the skin | after surgery |
| seroma | collection of clear fluid | after liposuction |
| necrosis | tissue death | from deep burns |
| pruritus | itching | eczema |
| rhytid | wrinkle | rhytid treatment |
Directional terms: anterior (front) and posterior (back), superior (above) and inferior (below), medial (toward the midline) and lateral (away from it), and proximal (closer to the trunk) and distal (farther away). Lymphatic drainage, for example, clears proximal nodes before distal tissue (section 7.3).
Regenerative Therapies: PRP and PRF
- Platelet-rich plasma (PRP): a licensed professional draws the patient's own blood and spins it in a centrifuge. The concentrated platelet layer releases growth factors such as PDGF, TGF-beta, VEGF, and EGF, which support healing and collagen production. PRP may be injected or applied during medical microneedling.
- Platelet-rich fibrin (PRF): usually prepared with a slower spin and often without an anticoagulant, so it forms a fibrin matrix that releases growth factors more gradually.
- Because they are autologous (from the patient's own body), allergy risk is low, but infection control and bloodborne pathogen rules apply in full.
In Washington, the blood draw, preparation, and any injection are medical procedures, and injections are outside the master esthetician scope. Any esthetician role must follow physician delegation rules, the device rules in section 1.2, and OSHA's Bloodborne Pathogens Standard (section 2.1).
Working Safely With a Medical Team
- Know who can do what: physicians, physician assistants, advanced registered nurse practitioners, registered nurses, and licensed practical nurses each have their own scope.
- Medical history changes everything. A client with a cold sore history before a medium-depth peel needs a physician's evaluation for antiviral prophylaxis; the 2025 NIC sample question keys "be treated by a physician."
- Chart in a consistent format (SOAP, section 7.4) and follow the clinic's privacy policies. HIPAA applies when the practice is a covered entity or business associate.
Important
When a question asks what a master esthetician should do about a medical procedure, the answer is usually to understand it, coordinate aftercare, and refer. It is not to perform it.
What does the medical term blepharoplasty mean?
Nose reshaping
Facelift
Chin augmentation
Eyelid surgery
How is platelet-rich plasma (PRP) prepared?
By extracting growth factors from cultured plant stem cells
By drawing the patient's blood and spinning it in a centrifuge
By freezing the patient's blood and thawing it before use
By mixing donated plasma with hyaluronic acid filler
How does botulinum toxin type A soften dynamic wrinkles?
It blocks acetylcholine release, so the treated muscle relaxes
It fills the wrinkle by stimulating new collagen in the dermis
It dissolves the fat beneath the wrinkle so the skin lies flatter
It exfoliates the stratum corneum so fine lines look smoother
Sections you finish are checked off in the contents.