By Isabel Togoh
There have been almost 1,000 complaints about botched botox and filler treatments lodged in the past year, amid warnings that people risk being “duped by cowboys” for cosmetic procedures.
New figures seen by HuffPost UK reveal that infections are the biggest problem, with many people who underwent lip filler treatment seeking corrective treatment from the NHS.
Disgruntled clients also told of poor or uneven results, citing “unsightly lumps”, or “unusually painful swelling and bruising”.
The figures, which feature in a new report by Save Face, the UK’s largest register of accredited non-surgical practitioners, reflect a growing trend for facial fillers and Botox, despite the industry lacking widespread regulation.
Of the 995 people who complained, more than two thirds (688 procedures) of all treatments that went wrong were dermal fillers, which are injected into the skin to smooth out wrinkles or alter certain features such as lips or under the eyes. Nearly a quarter (233 treatments) were Botox-related in the year up to the end of October.
Health minister Jackie Doyle-Price told HuffPost UK: “Too often people are duped by cowboys who are providing dodgy cosmetic procedures, with false promises about results and recovery times.
“The truth is, if not undertaken in a reputable place, by a trained professional, these procedures can be dangerous and potentially cause life-threatening complications.”
Marcelle King, a patient ambassador for Save Face, fell victim to one such practitioner who administered toxic unpurified beef gelatin into her face – in his kitchen.
King, 63, was left with permanent nerve damage in 2013 after paying £400 for two sessions. She now campaigns for tougher restrictions against rogue practitioners.
Ozan Melin, the bogus doctor who carried out the treatment, was jailed for four years in June after he was found guilty of two counts of grievous bodily harm without intent.
King, from Poole in Dorset, was unsure of the substance injected into her face until police raided Melin’s house and tested vials of “botox” they found in his freezer, which turned out to be gelatin.
King, 63, told HuffPost UK: “When I went to the forensic expert, he told me sometimes it could be dog protein and sometimes it could be chicken protein.
“The thought of having dog injected into my face was horrendous.
“I ended up paying more than if I’d gone to Harley Street.”
The fresh statistics stand against a backdrop of poor training, experts say, a lack of regulation, concerns about bogus practitioners, alongside a rapidly growing demand for the treatments in an industry which generates £2.75 billion per year.
Cheap deals, Instagram adverts, and the influence of image-conscious reality TV shows such as Love Island have all been blamed for the influx of demand – especially from younger patients, doctors say.
A Save Face report out earlier this year said: “There are masses of one-day training courses open to beauticians and other non-medical practitioners which fuels the issue as they will not have the knowledge or expertise to competently inject after such little training.”
The report added that 72% of all complaints received were from patients who had found the practitioner on Facebook, Instagram or other social media platforms.
In the latest figures “thread lifts”, which are used to treat sagging skin, were responsible for 26 complaints, while chemical peels brought about 13 complications. There were seven complications caused by plasma treatments, which include the “vampire facials’” made popular by reality TV star Kim Kardashian.
Ashton Collins, director of Save Face, told HuffPost UK: “There’s been a huge increase in the last two years [of aesthetic treatments]. It’s driven by a number of factors, mainly, I think, to do with social media, reality TV stars in particular, the whole Kylie Jenner lip filler scenario that saw a huge increase in women, especially young women seeking these procedures.”
Jenner, 21, admitted she got temporary lip fillers in 2015 on an episode of Keeping Up With The Kardashians.
Collins continued: “There’s an unfortunate perception among younger women that these treatments are risk-free. [They] go on to social media where a lot of these unscrupulous people target their business and they will see a cheap deal – £99 lip fillers, £99 whatever it may be, and they think there’s no risk involved.
“So they go along, have a procedure, inevitably, something goes wrong, as soon as something does go wrong, the almost certain trend is that that practitioner will cut all communication with that patient and turn their back on them.”
Save Face counts at least 680 practitioners on its register including nurses, doctors and dentists – all of which administer botox and dermal filler treatments.
It aims to drive up standards in the largely unregulated industry by carrying out checks, reviewing training and qualifications, and scrutinising order forms and invoices to track how and where products are sourced.
According to Collins, an average of 25,000 people visit the site every month, with 60% of those going on to book a consultation through the register. She says use of the resource has accelerated “hugely” in recent years.
But it is not just the customer side which has soared – an increasing number of medical professionals and beauticians are training to administer the treatments to meet growing demand.
Dr Tristan Mehta runs Harley Academy, which has trained up some 1,500 healthcare professionals including doctors, nurses and dentists to become injectors. A former A&E doctor, Mehta moved into cosmetic medicine six years ago and launched the academy over three years ago, which he says is now the “largest education provider in aesthetic medicine”.
The academy prefers working with healthcare professionals registered by the Nursing and Midwifery Council, General Medical Council or General Dental Council – something he is particular about given the presence of “underground black market training” of beauty therapists.
Medically-trained practitioners are also duty-bound to their practice and risk being struck off if a procedure goes wrong, whereas non-medically trained staff do not face the same stringent registration procedures.
Mehta told HuffPost UK: “Because the industry is unregulated, the standard that has been set over the last 20 years is: ‘You can do a basic one-day course’ and the minimum standard to reach is what the insurance companies are happy with, which is just a certificate saying that you’ve attended a one-day course in botox and fillers.”
“It doesn’t give you the [clinical] oversight or experience that you need.”
Harley Academy courses are a 280-hour diploma, as recommended by the Joint Council of Cosmetic Practitioners (JCCP).
Mehta said: “We’ve seen a huge growth in practitioners wanting to study like this and fewer people go down the basic course route, but the problem is, everyone is still piling into this and starting an Instagram page selling lip-fillers.
“My main message is: aesthetic medicine is more than lip-fillers – there’s so much to it.”
But in the age of social media and celebrity endorsements, that message is becoming harder to convey – especially in an industry that is growing up to 15% year on year, according to Mehta.
This is compounded by increased availability on the high street.
It is a minefield because there are no laws in place to govern how things operate in this industry, which is crazy
Vicky Vilas, ARC Aesthetic Professionals
Superdrug this year launched filler treatments starting from £99, while some clinics capitalise on celebrity clout to advertise treatments based on high profile stars.
The doctor said: “There are two kinds of patients – one, your rejuvenation patient – let’s say it’s a lady in her 40s who wants to look best for her age – that was the mainstream of patients and in the last few years, you’ve got a huge rise in beautification patients, who want a new feature like bigger lips, or bigger cheeks or a sharper jawline.
“Those patients you need to be more careful with and have a more thorough consultation with – often they are much more price-sensitive and seek out the cheapest treatment they can find, less cognisant of the risk involved, and often the victims of some terrible botched treatment that are sensationalised.”
Experts are becoming increasingly concerned that patients do not fully understand the risks associated with treatments.
A lack of regulation means there is little standardisation across training, according to Vicky Vilas, operations and marketing manager at ARC Aesthetic Professionals, recruiters for the aesthetic medicine and cosmetic surgery professionals.
“It is a minefield because there are no laws in place to govern how things operate in this industry, which is crazy. Because it’s a private industry, primarily.
“If a clinic is set up as a medical clinic which more reputable providers of aesthetic treatments are, it will be registered with the Care Quality Commission. The CQC won’t necessarily look at somebody’s filler techniques, but they will check whether the clinic [meets] safe, effective, compassionate, high quality care.”
Spas and beauty salons can offer botox and fillers, but are not regulated by the CQC so there is no way of telling whether they are operating in a safe environment.
Vilas said: “Things are moving towards there being a clear divide between people who are properly medically trained and people who are not, although there is not regulation at the moment.
“Good training clinics will ask for the medics to have registration with the General Medical Council, the General Dental Council or the Nursing and Midwifery Council. All of those have a website where you can check that [practitioners are registered].”
She said she has witnessed a “great demand” for aesthetic doctors and nurses over the past five years.
The profession is attractive to some because treatments are lucrative, hours are flexible and practitioners feel a sense of freedom, especially if they run their own clinic.
“I imagine that is directly in line with the increase in the number of people coming in for those treatments,” she told HuffPost UK.
“We certainly haven’t been short of vacancies to work on in clinics.”
She added: “Over the last five years, we’ve definitely seen more clinics opening.”
Where the growing industry was traditionally open to doctors, nurses and dentists, now pharmacists and even paramedics are opting to train as injectors.
Vilas said: “I can see why it’s appealing, but it’s a bit of a shame that we do lose some good NHS doctors and nurses because of that but it’s definitely a growing industry.”
Dr Martin Nimmo is a dentist and facial aesthetics expert practicing at the exclusive Cadogan Clinic in Chelsea, south west London.
Having been in the industry since 2011, Nimmo mostly treats women and men of all ages who he says seek to look refreshed, and not overly treated.
Although the majority of his patients are aged between 35 and 65, in recent years, he has noticed a younger clientele drawn to the clinic.
Nimmo said: “It is definitely a concern of mine because of the potential for body dysmorphia, which tends to stem from people wanting to look like the filtered image of themselves that they’ve post on social media.
“People are, with Instagram and social media, more conscious of the way they look and behave now. And I think that’s a trend that will probably increase as the cohort of patients who are maybe had mobile phones in their hands from day zero, they’ve been exposed to social media from a young age, I think in the decades to come, it would be interesting to see how they go about treatment.”
Health minister Jackie Doyle-Price told HuffPost UK that pictures on social media sites distort the reality of treatments. “I want to see these companies taking action to enforce their own terms and conditions and remove advertisements which contravene advertising rules,” she said.
“Anyone thinking about getting a cosmetic procedure should take the time to find a practitioner who is on an accredited register such as Save Face and the JCCP.”