FACE UP
HAVING 'work done' is no longer the secret it once was - and for some it's as normal as getting your hair highlighted.
But if you're considering having fillers, it's important to make sure you've made an informed decision first.
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It's a real procedure after all - and if it goes wrong then there can be serious consequences, including permanent disfigurement and even blindness.
That's why The Sun launched the Had Our Fill campaign - to highlight the dangers of having fillers and crackdown on rogue practitioners.
Dr Christopher Rennie, one of the UK's leading aesthetics training practitioners, says the rise in the 'Love Island' look has fuelled a boom in the injectables industry, which is worth £275million in Britain alone.
"There is a generational gap in the industry with younger clients wanting the strong jawlines and over-inflated lips they’ve seen on Love Island whereas the older clients just want subtle rejuvenation," he tells the Sun Online.
It should pass the 'Tesco test' where you bump into someone and they say ‘wow, you look well’ rather than ‘What have you done to your face?’
Dr Christopher Rennie
"It’s clear that too much work has been done on some of the Love Island contestants, and the practitioner has not taken into account the underlying face shape of the client. It becomes a generic look, with everyone trying to look the same as everyone else
"In aesthetics, the best treatments are those that are not immediately obvious, but will make you feel comfortable and more confident.
"It should pass the 'Tesco test'. You should be able to go to the local supermarket, bump into someone you've not seen for a few weeks and for the immediate reaction be ‘wow, you look well’ rather than ‘What have you done to your face?’"
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Dr Rennie, of Romsey Medical Aesthetics, says the booming industry means many untrained beauticians are getting in on the act and he believes medical training should be essential for those practising injectables.
"You wouldn’t want a doctor to paint your nails, so why would you want a nail technician to inject your face?” he asks.
As part of our campaign, Dr Rennie has come up with ten key questions you need to ask before you let anyone near your face with a needle.
1. What are your qualifications?
When you find your aesthetic injector, your first port of call is to find out if they have a medical qualification and how long they've been qualified for.
Dr Rennie says: “It is important to ask these questions to ensure that your practitioner has working knowledge of anatomy, physiology, medicines management.
"They should also have some grounding in psychological aspects relating to aesthetic treatment and experience of dealing with patients in a holistic manner.
"This is impossible to learn over the course of a weekend at a training academy and will have been developed over years of general medical, dental and nursing training and exposure."
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2. Where did you train?
As of yet, there isn't legislation in the UK to prevent non-medical professionals from delivering injectable cosmetic treatments.
But the general consensus in the industry is that they should only be performed by qualified and experienced medical professionals.
Ask your practitioner where and when they attained their aesthetic qualifications - better yet, find out if they can provide you with documented evidence.
You are also within your rights to question them on how many procedures they've carried out.
Dr Rennie says: “If the training that has been attained is suitable for medically and non-medically qualified individuals, the appropriateness of that training has to be questioned.
"With such diverse backgrounds, how can the level of training be the same for both sets of trainees?
"Recent reports suggest that correcting poor work at the hands of non-medically qualified practitioners has cost the NHS over £20 million in the last three years alone and that figure is increasing.”
3. Are you fully insured?
All aesthetic practitioners need to have indemnity insurance to cover themselves for medical malpractice claims.
Reputable cosmetic insurers will only provide cover for medical professionals such as doctors, nurses and dentists to administer toxin and filler injections.
Beauty therapists may qualify for cover for other treatments such as skin peels, micro-needling or laser treatments.
If someone performs injectable cosmetic treatments without the correct insurance and medical training, they are putting you at risk, so ask to see documents.
“Insurance protects both the practitioner and the client," says Dr Rennie.
"Specialist insurers will not provide insurance to non-medically qualified or medically-affiliated practitioners.
"The question then has to be where beauticians, hairdressers, nail technicians and other non-medically qualified individuals are getting insurance from, if they are at all?”
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4. Are your products and procedures safe?
Anyone can currently buy fillers online and no prescription is needed.
In the UK, dermal fillers with a medical purpose are classed as medical devices and require a CE mark.
There are, however, dermal fillers that are marketed for aesthetic use only that are not classified as medical devices as the manufacturer is not making a medical claim.
At the moment, the Medicines and Healthcare Products Regulatory Agency (MHRA) says it has no plans to make fillers prescription only.
However, they will be regulated as medical devices from May 2020.
Dr Rennie says you should always ask your injector what products they use, where they sourced them from and whether they have a CE mark.
Syringes should always be sterile, the new packet should be opened in front of you.
"You never use the same needle on two different people," says Dr Rennie.
"The only time you can use a needle again is for the same person using the same filler but in a different area. For example, if I only used a small amount of filler from a syringe in a nose, I could then use the rest in the same client's chin."
Also the injector should never touch the needle.
"A recent video of Lauren Goodger showed her holding the needle as she injected lip filler in a training video," he adds.
"A medical practitioner would never do that."
The easy access to product has also led to a rise in lip filler and Botox parties, which puts patients at even greater risk.
Dr Rennie says: "Anti-wrinkle treatment and dermal filler parties are an absolute no no. Alcohol and injections don’t mix.
"Being injected over a kitchen table, sitting on a chair with your friends around you, means you can not rely on infection control and the risks increase dramatically."
Had Our Fill campaign
Britain's Botox and filler addiction is fuelling a £2.75billion industry.
The wrinkle-busting and skin plumping treatments account for 9 out of 10 cosmetic procedures.
50% of women and 40% of men aged 18 to 34 want to plump up their pouts and tweak their faces.
Fillers are totally unregulated and incredibly you don’t need to have ANY qualifications to buy and inject them.
83% of fillers are performed by people with no medical training, often in unsanitary environments - with devastating results.
Women have been left with rotting tissue, needing lip amputations, lumps and even blinded by botched jobs.
Despite the dangers, there is no legal age limit for dermal filler, which is why Fabulous has launched Had Our Fill, a campaign calling for:
- fillers to be made illegal for under 18s
- a crackdown on social media sites plugging fillers
- a Government-backed central register for practitioners with accredited qualifications
We're working in conjunction with Save Face and are backed by the Royal Society for Public Health (RSPH), British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) and British Association of Aesthetic Plastic Surgeons (BAAPS).
We want anyone considering a non-surgical cosmetic treatment to be well-informed to make a safe decision.
We’ve Had Our Fill of rogue traders and sham clinics - have you?
5. Are you regulated by any professional bodies?
Find out if the person who is injecting filler into your body is regulated by at least one of the professional medical bodies, Dr Rennie says.
These include the General Medical Council (GMC), the General Dental Council (GDC), the Nursing and Midwifery Council (NMC) and the Health and Care Professions Council (HCPC).
Also check with an industry regulator such as Save Face, which operates a register for doctors, nurses and dentists who provide non-surgical cosmetic treatments.
Dr Rennie says: “As medical professionals, doctors, dentists, nurses, midwives and affiliated healthcare professionals are subject to a rigorous and frequent re-validation process to ensure of their continuing fitness to practice.
"Save Face is a voluntary industry regulator that is at the forefront of standardising and safeguarding the aesthetics sector.
"They ensure that all registered practitioners adhere to strict policies and procedures and they perform annual inspections of establishments to ensure high levels of safe care. They will only accredit healthcare professionals.
"Without any formal government regulation, Save Face are the only body that members of the public can rely on to ensure practitioner safety and suitability."
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6. What are your emergency procedures?
If something were to go wrong during an operation, you would expect medics to be on hand to fix anything immediately.
But when it comes to people with no medical qualifications you could be putting yourself at serious risk so it's vital you ask what procedures are in place.
Dr Rennie says: “As with any injectable treatment, whether this is a vitamin supplement at your GP surgery, intravenous antibiotics in hospital or an annual flu jab at the local pharmacy, there is always a risk of reaction, allergy or infection – that is the nature of medicine.
"Although dermal fillers are safe if handled appropriately, if complications aren’t dealt with quickly the results can be catastrophic and unfortunately permanent.
"Recently there have been a couple of cases of visual disturbance, leading to potential blindness, and someone having lost the tip of her nose following dermal filler.
"If a reaction were to occur, could you rely on your injector to recognise the complication in the first place and then be able to deal with it and correct anything, especially in an emergency?
"You should always ensure that your practitioner has the ability to deal with complications themselves as opposed to having to send you elsewhere, or worse still, ignore the complication while it is occurring."
7. Will you be contactable if problems occur?
Ask them if they are going to be contactable within working hours and how soon you can see them for a review.
It's important to know that they can be reached, especially if there is a problem.
Dr Rennie says: “There are part-time or travelling injectors who, although potentially talented and qualified, are not available to assess patient requirements after treatments.
"We’ve heard examples of practitioners performing dermal filler procedures and then going on a foreign holiday the next day, leaving the patient languishing.
"I wouldn’t perform a procedure for a week before I go away. If your practitioner is away, make sure there is a contingency plan such as a trusted colleague who is available.”
Fillers by numbers
£2.75bn - estimated value of UK’s non-surgical cosmetic industry
59% - 13- to 24-year-olds see lip fillers as routine as getting a haircut or manicure
68% - young people say friends have had fillers
160 - different types of dermal filler available for use in Europe, compared to only 10 in the US where they have tighter regulations
1,617 - complaints received by Save Face last year regarding unregistered practitioners
1.2m - posts for #lipfillers on Instagram
3.9m - Google searches for ‘lip fillers’ in UK last year
40% - 13- to 19-year-olds say images on social media cause them to worry about body image
8. Can you trust the Instagram pictures and celebrity endorsements?
Most of us wouldn't make a blind purchase, especially if it was expensive and we knew we couldn't return it.
So when it comes to fillers, make sure you are extra vigilant about the authenticity of testimonials and whether the pictures have been filtered or doctored.
It's worth questioning the practitioner on their portfolio of work.
Dr Rennie says: "A lot of what we see on social media with celebrities, Love Island contestants and so on, is not real life and you can’t judge your practitioner's treatments on an Instagram picture which has used filters, make-up and clever lighting.
"Ask to see raw, unfiltered, straight off the needle work and then two week follow-up photographs to see what the final results of treatment really have been.”
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9. Will there be a consultation and consent forms?
Professionals should ask for your age, full medical history and discuss all risks before agreeing an injection.
So, find out if there will be a consultation before the treatment and if you'll be signing a consent form.
A consultation gives you the opportunity to ask all these important questions and to check whether the practitioner has got understanding of any existing medical conditions you may have.
If you're taking medication it's also crucial to know how they will interact with the fillers too.
Ensure your injector knows when to treat, but more importantly, when not to treat
Dr Rennie says: “There are certain absolute situations when injectable treatments should not be used, including, but not exclusively, pregnancy, breast-feeding, allergy or hypersensitivity, certain medical conditions and use of specific medications.
"If your injector does not have an underlying knowledge of these there is a very real possibility of causing potentially permanent or lethal complications.
"Ensure your injector knows when to treat, but more importantly, when not to treat."
As for consent forms, these are vital - and if you don't sign one, don't got ahead with the treatment, Dr Rennie says.
He also added that injectors need your permission to take medical photographs and tell you what they intend to do with them.
"Ask where your medical photographs and consent forms will be stored and for how long.
"Are they safe, secure and treated with confidentiality?"
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10. Do you feel coerced into treatment?
All medical treatments come with some level of risk, but of course there can also be benefits.
It's worth asking the injector whether or not you actually need fillers.
A good practitioner will be honest, especially if you've had fillers before or they have any concerns about your mental health, particularly body dysmorphia - which affects around 15 per cent of people seeking aesthetic work.
They should also give you two weeks after consultation to decide whether you still want to go ahead.
Dr Rennie suggests a way to test them is to ask whether they would perform these procedures on their own family members or friends.
He says: "These treatments are luxury and not necessity.
"Your injector should be seen to be putting your personal interests, health and mental well-being at the forefront of their thought and decision-making process.
"Too many injectors are now putting financial gain as their primary incentive as opposed to the overall wellness of their patient.
"If it does feel right, swerve it."