Botox industry register launched

Former beauty clinic manager Sarah Payne recalls how a dermal filler treatment went badly wrong

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A government-backed register for providers of injectable cosmetic treatments such as botox and dermal fillers has been launched.

Those who meet the standards set down for the Independent Heathcare Advisory Services' voluntary register, will receive a quality assurance mark.

The IHAS hopes people will be steered away from "botox parties" or treatments offered in inappropriate locations.

But cosmetic surgeons say such self regulation will not stop bad practice.

Botox boom

The introduction of the register comes amid a boom in demand for botox and dermal fillers.

According to the IHAS, there are currently about 5,000 providers of injectables in the UK, carrying out about 200,000 treatments each year.

Other estimates suggest far higher numbers of people in the UK are seeking out these treatments.

Start Quote

Self-regulation hasn't worked in the Houses of Parliament has it, and it hasn't worked in the banking industry, so why would it work in cosmetic medicine?”

End Quote Nigel Mercer British Association of Aesthetic Plastic Surgeons

But there are growing concerns over people receiving treatments in inappropriate settings.

"We've heard stories of botox parties and people going to even garden sheds [to have treatment], " IHAS director Sally Taber said.

"It's just amazing that the general public think that they can have an injection into their face in a nail bar, a garden shed or at a botox party, because you are dealing with a prescription medicine.

"They can cause permanent damage. The patient will be reminded all their lives that they've gone to an inappropriate practitioner who wasn't appropriately qualified," she warns.

No beauticians

The new register of injectable cosmetic providers represents an attempt by the injectables industry to regulate itself.

It will be funded by the treatment providers who must pay registration and annual fees to join.

Those signing up to the register must promise that all prospective clients receive a face-face consultation before any treatment goes ahead.

They must also ensure that procedures takes place in a clean and safe clinical setting and registered premises may be inspected at random by an outside agency.

Those injecting must also have the right training, with only doctors, dentists and registered nurses eligible.

INJECTABLE

A bottle of botox
  • Botox is a trade name for a protein produced by the bacterium Clostridium botulinum and is highly toxic
  • In small doses, Botox works by temporarily paralysing the muscles of the face which are used in frowning and raising the eyebrows
  • In larger doses, Botox can leave the face with a lack of expression
  • Dermal fillers are usually used in the lower face to "fill" in wrinkle lines and folds and to pump up cheeks and lips
  • Non-permanent dermal fillers include bovine (cow) collagen and products based on hyaluronic acid
  • Other injectable gels such as Macrolane are used to augment breasts and buttocks

"Occasionally a patient could have an anaphylactic shock when the patient has a reaction to the medicine and collapses and may need a tube down their throat to ensure their airway is sufficient for them to breath again," Ms Taber said.

"We don't feel that it is appropriate for a beauty therapist to have that kind of responsibility."

The new scheme has already come under heavy criticism from plastic surgeons. A recent poll among members of the British Association of Aesthetic Plastic Surgeons found only 4% would consider signing up.

The organisation's outgoing president Nigel Mercer says the scheme is more about clinics marketing their services than protecting the consumer.

"Self-regulation hasn't worked in the Houses of Parliament has it, and it hasn't worked in the banking industry, so why would it work in cosmetic medicine?" he said.

"Self-regulation effectively means it's a free for all.

"What we've been suggesting is something like 'Ofcos'. Obviously quangos are not the order of the day at the moment, but there really is public harm being done."

He also points to new European regulations that are currently under consideration, which he says, offer a more robust alternative.

Ms Taber believes such is the cost-cutting climate of the moment, that external regulation is off the agenda.

"All of the industry wanted regulation to begin with," she said, "but it's obvious from the previous government and now the coalition government, that has given this scheme its support, that we're not going to get it.

"A set of professionally led standards at the moment is the correct way forward."

Trout pout

Botox works by temporarily paralysing nerves in the upper face to reduce wrinkling when people smile or frown.

Dermal fillers, such as hyaluronic acid, are used largely on the lower face to fill in creases and wrinkles. They can also be used to pump up cheeks and produce a lip "pout".

Some of these fillers offer temporary solutions, others are semi-permanent or permanent.

But while many are turning to these treatments, there are undoubted risks.

Michael Saul of Manchester-based solicitors TJL specialises in representing victims of substandard cosmetic surgery and injectable treatments.

"You find a whole raft of problems following these treatments. There's asymmetry if they are not injected correctly, you can have lumps and nodules which look extremely unsightly in prominent areas of the face. There are problems with infection and terrible allergic reactions."

He also has a case where the injected product migrated under the skin.

"The dermal filler has migrated from the nasolabial fold into the eye orbit and is causing problems with vision. It's going to be very difficult and dangerous to remove it from the eye orbit and it carries a risk of blindness."

He too favours external regulation. "This industry is very profitable for practitioners and inadequately regulated and that's a very dangerous mix," he said.

He believes those who speak out or seek out legal representation represent only "the tip of the iceberg".

"A lot of people don't know where to run if they have problems so don't do anything. If something goes wrong after an aesthetic procedure, a common psychological reaction for people is to blame themselves. A lot of people want to lock themselves away."

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