Cosmetic procedures have become so commonplace that people now pop in for anti-wrinkle injections during their lunch hour. But there can be complications.
“Many cosmetic procedures are called ‘non-invasive’, which is a misleading term that encourages complacency about some of their potential dangers,” Professor Mark Ashton, the president of the Australian Society of Plastic Surgeons, said.
“Cases have occurred where, within seconds, filler has reached the eyes and caused irreversible blindness.”
Professor Ashton said most complications occur when cosmetic injectors have little knowledge of facial anatomy and use products that have not been approved by the Therapeutic Goods Administration (TGA).
In August this year, Jean Huang died after an alleged botched cosmetic procedure at a Sydney clinic. Two people have been charged over her death.
There are ways to safeguard against potential complications or side effects. Here’s what you need to know before setting foot in the doctor or cosmetic surgeon’s office.
Know your treatments
According to the Cosmetic Physicians College of Australasia, Australians spend about $1 billion on non-invasive cosmetic procedures each year. The college said non-surgical procedures such as laser hair removal, anti-wrinkle treatments, chemical peels and fat reduction top the list.
Fillers: These fill out and smooth wrinkles such as crow’s feet, laugh and frown lines.
Jayson Oates, the medical director of Academy Face and Body Clinic in Perth, said most clinics now use hyaluronic acid (HA) instead of collagen. The acid is a sugar found naturally in body tissue that binds water, hydrating tissue and making it more gel-like, he said.
Treatment cost: $600-$1000
Muscle relaxers: Botox is the best-known but there are other brands such as Dysport.
Dr Oates said muscle relaxers stop the nerves from contracting the muscles, thereby preventing wrinkles such as frown lines.
Treatment cost: $100-$1000
Fat melters: These utilise the naturally-occurring dioxycholic acid to break down fat, usually under the chin.
Treatment cost: $2000-$3000
Liquid facelifts: These combine dermal fillers and muscle relaxers.
Treatment cost: Around $2000-$4000
Possible complications or side effects
Bruising: This is rarely severe and usually resolves naturally within days of the injection.
Blindness and tissue death: Complications can occur when filler such as HA is accidentally injected into an artery.
“A huge inflammatory response can then occur, which can shut down and block the blood vessel,” Professor Ashton said.
“Signs can start within an hour – the skin turns mottled, then purple. At this point, if special injections called Hyalase (Hyaluronidase) are given, the enzymes they contain can reverse the damage. Otherwise within a few days the tissue can permanently die and turn black.”
Infections: With any injection, bacteria on the skin may be introduced into the body. If infection occurs it is usually treated with antibiotics.
Lumps and nodules: Ronald Feiner, the Medical Dean of the Australasian College of Cosmetic Surgery, said lumpiness from fillers like HA and collagen could occur but in many cases were reversible with correct treatment.
“However, longer lasting or illegal fillers may cause lumps that are difficult or impossible to treat and may require surgical removal, risking scarring of the skin,” he said.
Misplaced muscle injections: “This can cause drooping of the eye, eyelid and mouth and facial weakness or an uneven smile,” Dr Feiner said.
An experienced injector might be able to balance out some of these side effects but if not, the problem could last up to three months until the relaxant loses effect.
Cosmetic injections checklist
Before your procedure:
- Check the practitioner is a registered doctor or nurse on the Australian Health Practitioner Regulation Agency website
- Have a face-to-face consultation: Ask what the practitioner knows of facial anatomy and the main danger zones (bridge of the nose, area between the eyes and area next to the nostrils)
- Ask to see the clinic’s stock of Hyalase, which is needed to reverse filler complications
- Allow a cooling-off period of up to week before the procedure
- Check the clinic has a medical doctor present at all times
- Check your practitioner is registered with the ASPS.
On the day of the procedure, you should check that your injector:
- Opens a new, sealed packet and draws from it for your treatment
- Wears gloves
- Cleans your skin with antiseptic before injecting
- Uses small injections and moves the needle continuously.