09 May 2017
We’re all constantly trying to improve our appearance. For some a simple curly blow dry or professional make up is enough, but what do we do when we feel we need that bit more? If you’re worried about going under the knife then maybe you've considered that a non-surgical procedure is for you. But is it safe?
We asked Consultant Plastic Surgeon, Mr Se Hwang Liew to explain to us some of the risks associated with non-surgical procedures and pitfalls of going to unqualified or inexperienced practitioners.
What are the benefits of non-surgical procedures and who is suitable for them?
Non-surgical procedures are mainly divided into wrinkle relaxing injections or dermal fillers. These are mainly performed to improve facial appearance due to the effects of ageing but without invasive surgery. Wrinkle relaxing injections work best on wrinkles caused by muscle contraction such as frown lines, forehead lines and crows' feet. These can also be used in the lower face and neck and can be used to treat excessive sweating (hyperhidrosis).
Dermal fillers on the other hand are used to plump out the skin and add volume and structure. Dermal fillers can be used in many areas on the face including around the mouth, lips, cheeks, jawline and chin. Fillers may be biocompatible or synthetic and are used alone or in combination. Your practitioner should discuss the different types to you available depending on the look you want to achieve, so you can agree the best course of treatment based on the information available1,2.
Most people are suitable but as with any medical procedure there are contraindications (conflicts with other medicines or medical conditions) which should also be discussed in detail.
Who can inject wrinkle relaxing injections and fillers?
Doctors, dentists and nurse practitioners with appropriate training all carry out the procedures. Ideally, the nurse should be a Nurse Independent Prescriber as certain wrinkle relaxing treatments are prescription only medicines, which can only be given to an individual following a face-to-face consultation.
What are the risks of wrinkle relaxing injections and fillers?
No severe complications have been reported in the literature after the use of wrinkle relaxing injections, however very rarely excessive weakening of the target muscles and paresis (muscle weakness due to nerve damage) of adjacent muscles can occur, resulting in overall facial weakness1. The risks of dermal fillers depend on whether the procedure was done correctly and the type of filler used. Permanent fillers have the highest risk of problems and some practitioners feel they are best avoided.
General risks of dermal fillers include:
- rashes, swelling, itching and bruising
- the filler moving away from the intended treatment area over time
- in rare cases, the filler forming lumps under the skin – this may need to be treated with surgery or medication
- in rare cases, the filler blocking a blood vessel – this can lead to tissue death, permanent blindness or a pulmonary embolism.
How can you differentiate between the good practitioners and the bad?
This is where it becomes complicated as anyone - regardless of their training or experience - can legally carry out a non-surgical cosmetic procedure.
Unlike the clearly defined laws surrounding cosmetic surgery, the non-surgical cosmetic industry remains almost entirely unregulated; meaning that anyone can legally administer treatments. Although wrinkle relaxing injections do still require a face-to-face consultation with a prescriber (doctor, dentist or Nurse Independent Prescriber) in all cases.
When carried out by appropriately trained individuals the results of non-surgical cosmetic treatments can be really beneficial, helping to restore a more youthful appearance with subtle and discreet enhancements.
The best advice would be to do your research and once you’ve found someone don’t be afraid to ask questions such as: 'what are their qualifications?', 'are they registered with a professional body?', 'how long they have been practising?' or 'how many procedures have they performed?'. Secondly steer clear of sales promotions that sound too good to be true - it's a case of if it sounds too good to be true it usually is. And finally don’t be hasty in making decisions; while the procedures are non-surgical they still can pose significant risk if injected incorrectly.
Do you really need to know my medical history?
Medical history is very important when carrying out any sort of procedure whether surgical or not. It’s important for your practitioner to decide if that treatment is appropriate for you at that time, if a detailed medical history isn’t taken you should consider going elsewhere.
What is meant by 'informed consent'?
From the practitioners’ viewpoint, informed consent means that they have taken every effort to be sure that you understand the purpose, benefits, risks, and any other options of the treatment.
What advice would you give regarding the use of wrinkle relaxing injections and fillers?
Again, my general advice would be to do your research. Check out your practitioner, make sure you understand what is involved and ensure the practitioner is available for any follow up care or treatment. At Spire Liverpool we have a team of plastic surgeons covering all areas of surgical and non-surgical cosmetic treatments as well as highly skilled aesthetic nurses.
At Spire Liverpool Hospitals’ One Penny Lane Clinic you can book a free consultation with any of our aesthetic nurses.
The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.