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Know your eye surgeon part 2: The Future of Cosmetic Surgery Regulation

In the near future, we hope to have more stringent and transparent cosmetic surgery and treatments regulation, of both the practitioner and the premises where the surgery or treatment is done.
There is a long way to go in the cosmetic industry for raising the safety standards for patients. All too often we read of surgeries and non-surgical treatments, such as filler injections that have gone wrong. This can be hyaluronate gels, Sculptra or semi-permanent Radiesse or even autologous fat. To reduce this risk, the potential patient is responsible for thoroughly researching their practitioner’s reputation, qualifications, skill and experience before accepting surgery or treatment by them. As basic standard, you should be able to see the practitioner’s qualifications, you should know about their training and their experience in the area that you are hoping to receive treatment.
You should have a thorough examination, following which a written report, which you receive within two weeks of the consultation and then have time to reflect about the proposed treatment, time to ask questions, do your research and then return for the treatment after having discussed it with family and friends. Full informed and signed consent should be obtained for not only surgical cosmetic procedures but also non-surgical procedures, including dermal fillers and Botulinum toxin, even chemical skill peels and non-surgical face lifting such as Ultherapy have to have a proper assessment, plan and informed signed a consent form.
The last word on fillers – you must know the name of the filler that has been used. It should be a well established one that has been purchased through reliable sources in the UK and with which your practitioner has training and experience. If the product is being used around the eyes, then you should establish that your practitioner has experience of tear trough treatments and that they use cannula.
There have been cases of visual loss with filler injections with needles. Therefore, the medical opinion is that cannula administration of fillers such as Restylane and Juvederm into the tear troughs (TearFill) is safer.
This is particularly important from my point of view as an oculoplastic surgeon as I have seen so many cases that have been optimal. Fortunately, I have only seen two patients who had filler elsewhere and whose vision was affected, but the literature contains just under 60 reported cases. I often see patients who have had “bad filler” and request its reversal with the enzyme hyaluronidase, for lumps, asymmetry, wrong place injected.
In summary, cosmetic regulation certainly does need a face lift.

British Journal of Opthalmology 2017 number 8112, page 11


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