Unlicensed Providers Mean Problems

An increase in complaints regarding botched plastic surgery procedures may prompt new laws against untrained practitioners in the United Kingdom.
The Guardian reports that the high number of procedures that have reportedly gone awry has motivated doctors and activists alike to ask for improved legislation on who can perform procedures.

A large numbers of complaints involve dermal fillers, especially those used to enhance the lips. Victims of bad fillers report effects such as lumps, painful swelling, uneven results and infection. Individuals receiving dermal filler injections from unqualified providers are also at risk of developing necrosis, or premature death of cells. Necrosis can lead to lost tissue and permanent scarring.
The number of complaints associated with fillers and endotoxins like Botox nearly tripled from 378 in 2016 to 931 in 2017, according to Save Face, a U.K. governmental organization that works to connect patients with approved providers for nonsurgical and minimally invasive cosmetic procedures. The organization provides an approved register of physicians as well as information about treatments.
It also logs complaints about procedures gone bad.
Experts have linked the increased demand for procedures to increased notoriety brought about by celebrities publicly talking about the plastic surgery work they have had done.
Not only are more people looking to have cosmetic procedures, but there are also more people looking to capitalize on that demand and offering procedures at discounted rates.
Statistics from Save Face show that 83 percent of nonsurgical procedures performed in the U.K. were performed by people who lacked the necessary training and experience to perform the procedure.
Save Face data also show that 72 percent of the complaints logged in 2017 were from patients who had found their provider using social media.
This situation is not uncommon; a 2017 study by Northwestern University in Evanston, Illinois, found that posts from board-certified plastic surgeons accounted for only 17.8 percent of the 1.8 billion plastic surgery-related posts being pushed on Instagram.
The other posts were from cosmetic surgeons, dentists, general practitioners and OB-GYNS offering procedures. A percentage of the posts were also from hair salons and med spas.
The Guardian did its own study and found several Facebook pages hawking lip fillers at discounted prices.
“If the price seems too good to be true, it probably is,” said Dr. Gregory W. Chernoff, F.R.C.S.
Chernoff is a triple-board-certified facial plastic and reconstructive surgeon in Indianapolis.
He warns patients against going for cheap fillers and bargain Botox.
“Licensed providers typically all pay the same amount for products. For someone to offer it a discounted rate means they likely didn’t buy it from the same place as licensed providers do because they are not licensed, or the product is fake,” Chernoff said.
Currently in the U.K. there are no regulations on who can perform dermal filler injections, which means they can be performed by providers who have not had any medical training. Products can also be purchased online from many sources.
Many licensed plastic surgeons in the U.K. are clamoring for regulations and treating patients who are suffering as a result of untrained providers. One doctor mentioned seeing a patient who had received dermal filler injections in her upper lip and developed necrosis within three weeks of the procedure.
“If an injection or other cosmetic procedure fails or goes bad for whatever reason, a licensed provider will know how to treat that patient to minimize complications and protect the patient,” Chernoff said.
This is not the first time doctors in the U.K. have asked for more regulations on plastic and cosmetic surgery procedures. In 2013, Bruce Keogh, then the medical director of NHS England, asked legislators to implement restrictions on the cosmetic surgery industry after a situation in which breast implants made from unauthorized silicone ruptured at rates twice as high as sanctioned implants. Keogh also asked for laws that required staff to be qualified and licensed and that providers be required to keep detailed records of how fillers are used.
Chernoff suggests that people looking for plastic surgery seek out licensed providers by checking on credentialing sites like the state medical board or the American Society of Plastic Surgeons before having their procedure.
“Taking a few minutes to research who is injecting something into your body can save you pain and problems in the long run,” Chernoff said.
The Guardian. Botched cosmetic surgery: law change urged as complaints treble. 18 February 2018.

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