The state of the science of injectable products such as soft tissue fillers and neurotoxins is often a bone of contention in the post-PIP, post-Keogh world of cosmetic surgery. Throughout Europe, there is a high number of such products available to choose from, with seemingly little to differentiate the products. And with more focus now on regulation, our methods and standards of practice are coming increasingly under the spotlight.
As I prepared to write this issue’s editorial, a UK newspaper, the Daily Mail, published the results of an undercover investigation, which found a number of cosmetic surgery practitioners willing to administer injections of botulinum toxin to girls as young as 16 years old. I think I can hear the collective gasp of shock among readers as I type!
In the investigation, reporters from the paper secretly filmed doctors and nurses preparing to inject botulinum toxin ‘following consultations in which the teenagers spoke of fears they would develop ‘worry lines’ as they grew older’. One doctor even commented that it was the ‘easiest money’ he makes.
Now, one can argue that the report merely exposes a few rogue practitioners and that perhaps an undercover investigation may not be entirely fair, as often the girl asking for treatment was accompanied with an adult purporting to be her parent. However, the question remains: how ethical it is to offer teenagers botulinum toxin for purely cosmetic reasons? Is there even any evidence that neurotoxin injections for teenagers can prevent wrinkles from developing in later years?
It seems that these days young people are growing up and wanting to be adults sooner and sooner, which certainly isn’t helped by beauty pageants and the image and perfection-obsessed culture presented in television programmes, web advertising, social media, newspapers and magazines. Girls in particular are becoming more and more aware of cosmetic interventions from a very early age — so much so that non-surgical treatments have become so normal that they are often surprised to find that procedures like teeth whitening are classified as cosmetic interventions at all.
The UK Department of Health’s report, Regulation of Cosmetic Interventions: Research among Teenage Girls (published April 2013), argues that while none of the girls interviewed felt pressure on the part of providers to consider procedures, they did sometimes feel that there was awareness on the part of providers that they presented a potential market and the ground was being prepared, with targeted emails in particular and advertising placed in the sorts of magazines that teenage girls read.
And so it seems we return to the age-old question of regulation: who should be responsible for performing treatments, accessibility of products, advertising of products/treatments to the consumer, the age of consent, and for anti-ageing procedures in particular, the right patient?
We recently conducted a survey on the state of the science of injectable products, which provided us with an interesting snapshot of how you, the aesthetic practitioner, views this part of the industry. Many responses to an open question on unmet needs in this market called for more regulation as to who can access and inject the products — with many as far afield as Australia arguing for better regulation to prevent ‘charlatans’ giving the industry a bad name.
The public wants better regulation for cosmetic surgery interventions. The industry wants better regulation. Professionals want better regulation. Why are we still talking about it? Why aren’t the lawmakers doing anything to make cosmetic surgery better for all involved?
The UK government’s response to the Keogh Review is due January 2014.
Health Education England has now been tasked to conduct a review of the qualifications required for non-surgical cosmetic procedures and the qualifications required to be responsible prescribers. This follows the Keogh Review of Cosmetic Interventions published in April 2013.
They have opened a call for evidence, which can be found here.