Facing the facts about facial fillers

THE pressure to look younger has never been greater. But several leading Irish plastic consultants are worried that Irish women and men are being used as “guinea pigs’’ by opting for cheap, quick-fix anti-ageing procedures.

Dr Patrick Treacy, medical director of the Ailesbury Clinic, Dublin, says the number of patients who have asked for help following adverse reactions to the permanent or semi-permanent fillers injected into their faces has dramatically increased during the last few years.

“I have seen some pretty horrendous cases, far worse than Leslie Ash’s trout pout. I had an awful run last winter, with 13 cases in the space of six months — four from the same doctor,’’ he says.

“Irish women are going abroad getting these procedures done cheaply, then I am the dumping ground when they go wrong. How these people can inject crap into somebody’s face and sleep at night, I just don’t know. It would not be allowed in America.’’

Dr Kumbiz Golchin, a facial and plastic surgeon at the About Face Clinic, in Dublin agrees, and blames poor quality products being used by poorly trained practitioners.

“Unfortunately the number of patients with problems from fillers has doubled in the last year. I have seen a lot of horror stories and we are seeing more of them.

“I am very concerned about the quality of the fillers being used in the Irish market. Every day we get loads of e-mails at the clinic trying to entice us with unbelievable deals for fillers, literally getting 20 for the price of one,’’ he says.

“Because of the recession some clinics have switched to these cheaper products to keep up with demand. But someone will pay a high price because these products have not been vigorously tested in terms of quality and their effects.’’

Currently there are over 150 permanent and semi-permanent fillers on the European market, as opposed to just six in America. Under the EU these fillers are classified as ‘implantable devices’ and so are not clinically tested and only need a CE Mark, to be sold on the market.

“In America fillers are classified as ‘medicines’ and will have been clinically tested for at least five to seven years before being FDA approved,” says Dr Treacy.

“In Europe, we give them a CE mark which is exactly the same as given to a teddy bear or a plastic Christmas tree. So patients are being used as guinea pigs, to see what problems show up.”

According to the British Association of Aesthetic Plastic Surgeons, the dubious quality of these fillers could lead to another scare within the industry like the recent PIP breast implant scandal and has urged the European Union to reclassify fillers as ‘medicines’ so they can be stringently regulated and tested.

And the BAAPS has also issued a warning against the use of permanent fillers. Once injected into the body, these substances cannot be removed and often the body will reject them or they can get infected. This can lead to facial necrosis (a blocked blood supply to the face causing paralysis ) disfigurement, nerve damage and anaphylactic shock.

“The problem with a permanent filler is that you are introducing an alien substance into the body,’’ explains Rajiv Grover, a consultant plastic surgeon and honorary secretary of the BAAPS.

“The body is designed to protect itself from this sort of thing and can initiate an immune response resulting in scar tissue or inflammatory nodules, which appear as large lumps under the skin.’’

Although permanent fillers are not available in Ireland, they are in Britain, and are often cheaper than a semi-permanent filler which usually only last seven to nine months.

At a clinic in Manchester, prices for permanent cheek augmentation are around £630, and for heavy wrinkles £420. A quick trawl of the internet revealed clinics in Belgium, Poland, Russia and the Far East all offering such procedures, at even cheaper rates again.

Although there aren’t any official statistics to show exactly how many Irish women are travelling abroad for permanent fillers, when it goes wrong, they are left in a difficult position as many Irish consultants do not want to intervene.

“I think permanent fillers are very, very bad,’’ says Dr Labros Chatzis, a consultant plastic surgeon at the River Medical Group. “Many years ago I saw a woman who had problems, it kept getting infected and the surgeon literally had to cut through her face to try to remove it. She was left with a huge scar.

“I have had a couple of women who came to see me and had permanent fillers done in Poland. Again, it had gone wrong. Basically, I said; ‘I am sorry, I cannot help.’ I didn’t want to get involved. What ever I did, I knew it was going to leave a scar and look bad.’’

Dr Andrew Skanderowicz, of the Dublin Cosmetic Surgery Centre, agrees. “I would often see them. They will have all sorts of stuff injected into their faces but I don’t get involved,” he says.

“When it is a permanent filler you have to cut them to get it out. I just tell them to go back to the doctor who did it.’’

Another concern for many Irish plastic surgeons, is the large number of Botox and surgical procedures being offered on-line at “clinics ’’across Ireland at heavily reduced rates.

Indeed only last week I received an email offering facial injections in two areas of my face for e179, instead of the usual e395, a saving of 55%.

“Do not fall for any of these cut-price deals,’’ warns Dr Treacy. “We have been overwhelmed with clients complaining about these cheap deals where the Botox is either totally ineffective or last for just four weeks instead of four months.

“They are diluting it or they are using the very cheap stuff. Botox is being given to people in hairdressers, foot spas and nurses are flying in from England to do it. All of this is against the law, but as the recession bites people want a bargain. They are not thinking about what is being injected into their face or the qualifications of the person who is doing it.’’

Brendan Fogarty, a plastic surgeon consultant at Royal Victoria in Belfast cites several recent cases of patients losing nostrils after their blood supply got blocked.

“Botox and semi-permanent fillers can seem like a relatively straight forward procedure, people think it is easy to do. But if a person does not know the anatomy of the face very well they can inject it into a vessel which will block the blood supply. We are talking the difference of just millimetres.

“It may seem an innocuous procedure but it can have significant consequences if managed incorrectly. There have even been cases of blindness.’’

Dr Danielle Meagher, the Clinical Director of DermaFace Clinic, Dublin, treats around 25 patients a day and urges people to do their homework before having any procedures done.

“Ask what is being injected into your face and make sure it is FDA approved. Ask about their training and how often they actually do that procedure. If it is too cheap, think about why it is."

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