Calls for tougher regulation of dermal fillers gather pace

Surgeons have voiced concern about the safety of the high street beauty industry responsible for injecting dermal fillers.

The British Association of Oral and Maxillofacial Surgeons (BAOMS) has added its voice to calls from the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) for regulation of this industry.

Dermal fillers are readily available on the high street and those administering the treatment do not need to have had medical or formal training. Yet when these procedures go wrong they can have devastating consequences.

Caroline Mills, BAOMS lead on aesthetic/cosmetic surgery and consultant maxillofacial surgeon at Great Ormond Street Hospital, points to a recent patient who had taken up an offer of inexpensive dermal fillers promoted at her gym.

She said: “The treatment went badly wrong and the patient has now had over 30 facial operations, and has been forced to leave her job.”

Mills suspects that the costs to the NHS for treating botched, dermal filler procedures was growing. But she said the cost were unknown as there is no NHS coding for non-surgical treatment problems when the client has to go to A&E.

BAOMS agreed with calls from MPs last week – following a parliamentary debate led by MP Alberto Costa – that dermal fillers should be considered medicines and that guidelines ought to be introduced. But BAOMS goes further and argues that full regulation of the industry is needed.

Consultant plastic surgeon David Gateley, who co-directs the non-surgical clinic nakedhealth MEDISPA in Wimbledon, said: “The reality here is that fillers represent a huge, profitable industry and that many companies involved will be lobbying hard to make sure regulation is kept to a minimum.

“With patients having injectables at a younger age, it is now more important than ever that we deliver a safe, fully regulated service.”

Gateley said one of the main problems with fillers is that they are currently categorised as medical devices, rather than as drugs, which doesn’t command adequate legislation.

As a result, non-surgical injectables are poorly regulated, both in terms of the injector’s training and the premises where treatments are administered.

He added: “Currently patients can receive fillers from any number of practitioners and in ‘hidden’ settings, such as private homes.

“In this context, I do believe it is actually preferable that patients are treated on the public high street, where its administration and management is more visible and therefore must be more closely monitored.

“However, it still remains that practitioners must be properly set-up with good governance, training and appropriate auditing in place.”

A report from national non-cosmetic treatment register, Save Face, found 934 patient complaints regarding unregistered practitioners. The majority, 616, were dermal fillers.

Complaints relating to dermal fillers were: 213 swelling and bruising; 156 lumps and nodules; 122 felt they looked worse; 89 said they had an uneven result; 27 had infections; and six had a vascular occlusion or impending necrosis.