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Filler Regulations

The Keogh Report 2013: Clinica London welcomes planned reforms of cosmetic procedures
New proposals in a report by Sir Bruce Keogh to regulate cosmetic procedures, in particular dermal fillers, have been welcomed by oculoplastic surgeon and the Founder of Clinica London, Jane Olver.
A recent independent review called for wide reaching changes to the current situation which has been referred to as a “crisis waiting to happen”. It warned that cosmetic surgery had been “trivialised” warning, for instance, that dermal fillers which can cause “lasting harm” are currently covered by the same regulations as toothbrushes. It also attacked as “distasteful” companies which put profits ahead of care.
The review, which was commissioned by the British Department of Health, was launched in the wake of the global health scare caused by the French firm (Poly Implant Prothese or PIP) who manufactured breast implants filled with industrial grade silicone which had double the rupture rate of other implants. This scandal exposed “woeful lapses in product quality, after care and record keeping” in certain sectors of the cosmetic industry. It highlighted the fact that – while the cosmetic procedures industry is booming, regulations have failed to keep pace leaving patients vulnerable.
The biggest growth is in non-surgical procedures such as the use of fillers and Botox to tackle wrinkles. These procedures are often treated as casually as making a lunchtime appointment at the hairdresser’s or attending a “beauty party”, according to the review group. Currently in the UK this area is almost entirely unregulated meaning that anybody, anywhere, anytime can give a filler to someone else. As fillers are deemed to have no medical purpose, rules for their purchase and use is the same, for instance, as for a ball point pen. The report points out that “most dermal fillers have no more controls than a bottle of floor cleaner”.
Reputable cosmetic surgeons such as Jane Olver know that, in the wrong hands, these anti-ageing treatments can leave disastrous lasting problems.
“I am frequently asked by patients to correct botched treatments or remove wrongly applied fillers. Often these bad fillers have been injected in the back room of a hairdressers’ salon. Even if they have been carried out by a doctor or medical practitioner, it is not enough to quickly wipe down a random trolley – the whole area , including the floor, must be made for purpose. All these beauty treatments carry the risk of infection and can cause pain.
“As an oculoplastic surgeon, I am especially concerned with treatments around the eyes. Wrongly positioned injections in this area can have an effect on vision and – worst case scenario – even cause blindness”, she warned.
“Although these cosmetic interventions are not technically ‘surgical’ in nature, I believe that they should be treated with the respect and protocol of a medical procedure – albeit it a ‘minor’ one. The fact that we at Clinica London are Care Quality Commission registered should make our patients more secure.”
In addition to the use of correct surroundings – a specialised, sterile treatment room – Jane also called for proper protocols to be adhered to including keeping detailed theatre records and patients’ notes with any batch numbers of the product used.
Sir Bruce Keogh, the NHS medical director for England who headed the review, spoke of his particular distaste for aggressive marketing practices. The review group called for a ban of cosmetic surgery deals such as “buy one get one free” offers, putting up free procedures as raffle prizes; and time-limited incentives.
The report also found a need for greater protection of vulnerable people – such as young women – who saw cosmetic procedures as a commodity – something they might “get done”. The report attributed this worrying trend, in part, to the influence of the celebrity culture.
Jane agreed whole-heartedly. Any cosmetic treatment at Clinica London includes a detailed and lengthy facial assessment (which is charged), during which the patient’s expectations are discussed and whether or not the use of fillers would be beneficial. Any agreed treatment is explained thoroughly as are any issues raised in the consent form. Clinica patients are also given information packs and notes about the products that will be used as well as additional information about the chosen procedure.
May 2013


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