Aesthetic Nursing and Harmonization: What COFEN Says

Anyone who types "can a nurse do facial harmonization" finds opposite answers, often from people who sell courses or who compete for the market. The safest way to understand the topic is to read the rules of the Federal Nursing Council (COFEN) one by one, with number, date, and subject, and then see what the courts decided about them.

This page builds that map. Situation checked on October 20, 2026, against texts and news published by COFEN and news from medical bodies. It does not state what a nurse may or may not do: it reports what the rules and decisions say and points to where to confirm. For any professional decision, ask the Regional Nursing Council (COREN) in your state. This page is not legal advice.

What is the legal basis for nursing?

The practice of nursing in Brazil is regulated by Law No. 7,498/1986, which defines the activities of nurses, technicians, and assistants. COFEN and the COREN supervise the profession and issue rules to detail that practice.

On the other side is Law No. 12,842/2013, the Medical Act Law. Article 4, item III, lists as exclusive to physicians the "indication of the performance and performance of invasive procedures, whether diagnostic, therapeutic, or aesthetic". Two points in the text weigh on the debate:

• The definition of invasive procedure was partly vetoed. Paragraph 4 of Article 4 had items I and II vetoed, leaving only item III (invasion of the body's natural orifices, reaching internal organs). Each side interprets that gap its own way.
• Paragraph 7 safeguards the competencies of other professions, including those of nurses, biomedical professionals, and pharmacists.

COFEN holds that its resolutions detail what the nursing law allows. Medical bodies hold that injectable aesthetic procedures are invasive and therefore exclusive to physicians.

Which COFEN rules deal with aesthetics?

What does Resolution 626/2020 list?

Resolution 626/2020 lists procedures that the qualified nurse may perform: carboxytherapy, cosmetics, cosmeceuticals, dermopigmentation, lymphatic drainage, electrotherapy and electrothermophototherapy, combined ultrasound and microcurrent therapy, micropigmentation, cavitation ultrasound, and vacuum therapy. The rule also provides for nursing consultation, medical history, chart documentation, and participation in selecting materials.

Note that botulinum toxin and fillers are not on that list. They appear in Technical Chamber Opinion 001/2022, which is why the opinion concentrates much of the dispute.

What does Resolution 715/2023 require?

Resolution 715/2023 reworded Article 4 of 529/2016: practice in aesthetics presupposes a lato sensu postgraduate degree in aesthetics with at least 100 hours of supervised practice. COFEN opinions from 2026 addressed title registration cases, such as proving that supervised practice is part of the program curriculum and whether those hours may be counted within the minimum total required by the MEC (Brazil's Ministry of Education). Before enrolling, ask the institution for the pedagogical project and confirm with the COREN that it meets the rule.

What did the courts decide?

The situation is fragmented: there are different lawsuits, in different courts, with merits rulings and preliminary rulings.

According to the medical body's own news item, the TRF1 ruling on 529/2016 did not expressly address botulinum toxin or fillers; the body holds that both would also be exclusive to physicians. COFEN holds the opposite. A preliminary ruling is not a merits judgment, and a decision in an individual lawsuit applies to that case.

The overview of lawsuits between councils, including the one involving dentistry, is in the legal dispute over HOF. The position of the medical bodies is detailed in facial harmonization and the CFM.

Facial harmonization course for nurses: what should you evaluate?

The search "facial harmonization course for nurses" mixes two different things: the short course of a few days, and the postgraduate degree the rule requires. Points to check before paying:

1. Is it a lato sensu postgraduate degree in aesthetics? A short course, however good, does not replace the training required by Resolution 715/2023.
2. Is supervised practice in the curriculum? Ask for the pedagogical project and see where the 100 practical hours are and who supervises.
3. Can the title be registered with the COREN? Ask the institution whether graduates have registered titles and confirm with the COREN.
4. Does the content cover anatomy and complications? Vascular danger zones, recognizing occlusion, and using hyaluronidase are as important as technique.
5. Does the course promise what the rule does not say? Be wary of "guaranteed qualification" or "approved by the council" without citing the rule.

The general criteria are in facial harmonization course: how to evaluate and in HOF specialization: how to choose. Remember that "orofacial harmonization" is the name of the specialty recognized by the Federal Dental Council; its history is in HOF as a dental specialty.

What should you follow if you are an aesthetic nurse?

• Current rules. Resolutions 529/2016, 626/2020, and 715/2023, Opinion 001/2022 and later opinions, on the COFEN website.
• COREN guidance. When in doubt about a specific procedure, ask in writing and keep the answer. There are regional interpretations of their own on some procedures.
• Court progress. Lawsuits over 529/2016 and over the 2022 opinion are still ongoing.
• Health surveillance. The service license, responsible technician, and facilities follow health rules. See responsible technician at the HOF clinic and biosafety in HOF.
• Registered products. Use only products registered with ANVISA and note the lot. See how to check an injectable's registration with ANVISA.
• Advertising. Follow the nursing code of ethics and CONAR; do not present yourself with the title of another profession.

What about emergencies?

Any professional who injects needs to recognize and manage the first response to a complication and know where to refer. This applies to vascular occlusion, severe allergic reaction, and syncope. Have a written protocol, a checked kit, and a medical referral contact. See emergency kit for the HOF office and safety and complications.

How do you respond to a patient who asks?

Patients who saw a news story or a post may ask whether the nurse "can" do the procedure. The answer should be honest, short, and not attack other professions.

And the other professions?

And in Harmy?

Checklist for nurses keeping up with the rules

1. Resolutions 529/2016, 626/2020, and 715/2023 read on the COFEN website.
2. Technical Chamber Opinion 001/2022 and later opinions checked.
3. Postgraduate degree in aesthetics with proven supervised practice and title registered with the COREN.
4. COREN guidance on specific procedures requested in writing.
5. Progress of the lawsuits followed, with the date of each check.
6. Products registered with ANVISA and lot noted in the patient record.
7. Complication and referral protocol written.
8. Advertising reviewed against the nursing code of ethics.