Dermal Fillers: the next scandal waiting to happen?

“It is our view that dermal fillers are a crisis waiting to happen.” These are the chilling words that appeared in Sir Bruce Keogh’s Review into cosmetic interventions, published six months ago.

Non-surgical treatments, including dermal filler injections, account for nine out of ten procedures in the UK and, although they may be enticingly described as ‘non-invasive’, ‘lunchtime’ or ‘walk-in, walk-out’ procedures, this is false reassurance: they should be treated very seriously as they can have an irreversible impact on your long-term health and/or appearance.

Yet, there is little regulation covering dermal fillers and the British consumer is at risk.

Understanding legislation

The PIP breast implant crisis happened in part because an implant is categorised as a medical device rather than a medicine. As a result, implants are only monitored as closely as a wheelchair, yet these are products that are inserted into the body, with all the potential complications that entails.

Amazingly, dermal fillers aren’t even categorised as a medical device as their use is deemed cosmetic and so there is little control over product quality. That’s not to say they are unsafe, but it means that you’re entirely reliant on the manufacturer enforcing strict safety controls.

USA versus UK

The PIP crisis didn’t happen in the USA because they have stricter guidelines. Implants and dermal fillers are all classified as medicines which must undergo rigorous testing before receiving approval.

The Food and Drug Administration in the US have only approved fourteen dermal filler brands – compare that to the UK where there are 160-plus temporary and permanent dermal fillers certified for use.

Anyone can inject

As well as concerns about the actual products that are being injected, what is even more worrying is that there is no legislation covering who can inject these dermal fillers. Anyone can set themselves up as an ‘aesthetic practitioner’ and, legally, there is no requirement for them to have knowledge, training or previous experience.

Obviously, no one like that has the necessary experience to be able to deal with complications if something does go wrong, leaving their patients worryingly adrift.

At my Leamington-based practice, I have become increasingly concerned about poor practice in the unregulated dermal filler market, particularly through patients seeking correction of botched dermal filler ops.

Sir Bruce Keogh’s recommendation in the review is that beauty therapists and aesthetic practitioners should simply receive more training and have to pass certain qualifications, but I, along with many of my plastic surgery colleagues, believe that only specific medical professionals should provide injectables.

So, in the absence of government legislation, how can patients protect themselves? Check your practitioner’s qualifications and, to ensure your safety and that you’re being offered the right treatment for you, only see an adequately trained medical professional such as a Plastic Surgeon who offers the full range of cosmetic surgery and non-surgical procedures. Membership of BAAPS (The British Association of Aesthetic Plastic Surgeons) is a good starting point.