A patient can become resistant to the effects of Botox, possibly even resulting in facial asymmetry
Taking a hard stance on cosmetic procedures this month, Luxembourg’s health minister Etienne Schneider (LSAP) categorically stated that solely appropriately trained doctors were permitted to inject dermal fillers.
He cautiously addressed the growing concern over back-alley cosmetic procedures performed by untrained staff. Doctors who are not accredited plastic surgeons, nurses with inadequate training or beauty therapists are setting themselves up as filler experts with minimal knowledge or experience. Worse still is the fact that rigorous quality checks of the injected products are still lagging in this domain.
Luxembourg is, therefore, rightly cracking down on the doctors within the medical profession without the required training, thus making the procedure illegal. In the past year a doctor has been charged with carrying out procedures without adequate training, underlining the need for doctors and dentists to work within their sphere of competence.
So why the concern over fillers?
Categorised as non-surgical cosmetic procedures, these injectables include Botox, hyaluronic acid and permanent synthetic dermal fillers. In patients with deep wrinkles, the danger is that of heavy dosing, and the risk over time is that one develops antibodies as a result. In other words, the patient will become resistant to the effects of Botox, possibly resulting in facial asymmetry. If repeated excessively, Botox injections can weaken the muscle and paralyse adjacent structures.
Hyaluronic acid, on the other hand, can cause deep-seated infections in 1% of cases, while permanent fillers carry the risk of migration and inflammation within the skin. If a filler is injected incorrectly, cases of artery blockage have been known to cause severe visual loss or double vision.
As a patient, you have every right to ask how many procedures your doctor has performed to date, the expected outcome of the injection, how long the benefits will last and the associated costs should something go wrong. To maximise your care, provide all the relevant information--including allergies, previous procedures on the face and any supplement/herbal preparations--to the healthcare professional treating you.
The benefit of having a procedure with a qualified and trained doctor is that they reserve the right to refuse treatment if they think it is medically unsafe or unnecessary given your medical status. Therefore, be honest and open about your history and medication to avoid complications in the long-term. Beware of prescriptions of injectables obtained online, by phone or via Skype consultations.
“A crisis waiting to happen”
A survey undertaken by the Girl Guides Association found that almost 50% of young girls as young as 7 are happy with the way they look. The decline continues from there onwards. Patients who seek cosmetic treatment are already vulnerable, and those who do not adhere to strict procedures with regards to treatment will prey on this putting commercial interests ahead of that of the patient.
Described as “a crisis waiting to happen”, The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) aptly named this phenomenon as the focus on appearance boomed in the last decade. With the advent of social media, cosmetic procedures have now been rendered a commodity, and the risk patients are faced with is the lack of regulation in this field.
Luxembourg’s measures are a first step in ensuring that we tackle these procedures safely. The key areas to further address are informing the public, maintaining highly skilled and qualified delivery of care, ensuring safe products are on the market and implementing measures to address any complications.
Dr Lilani Abeywickrama is a Luxembourgish ophthalmologist currently based in London. Her main interest is advocating healthy living and precision technology within her specialty and is pursuing her interests in the field of healthcare management.