The market for fillers and botox has blown up in recent years. But demand has surged yet further in the pandemic as lockdowns have given people more time to inspect their appearance, experts believe. However, the beauty filler industry, which has been routinely branded the “wild wild west”, remains worryingly unregulated.
And one of the biggest yet most hidden dangers which surrounds fillers and botox is the practice of so-called “doctor shopping”. The phenomenon, which places people’s health and lives at grave risk, involves patients finding a new doctor after their initial practitioner refuses to carry out more procedures on them or orders them to wait the appropriate amount of time of three to four months between treatments.
Sterile needles, legal waivers and felt tips are not items you would find at your average party. But at a botox or filler party – where young women inject each other while drinking Prosecco – these objects are prerequisite.
Dr Wong, who trains doctors around the UK in aesthetics, says that “doctor shopping” often sees patients cross borders in search of cheaper treatment. The dearth of regulation and information-sharing in the industry means the new doctor often may not know what procedures the patient has had previously. “Patients don’t realise they can put their lives at risk,” Vincent Wong, one of leading cosmetic doctors in London, tells The Independent. “Doctor shopping is a dangerous thing to do. If you are unable to provide information to a new provider, whatever they put in can lead to infection, inflammation, nodules and lumps.”
“I’ve seen a patient who had lip fillers done,” he adds. “She wanted more volume. The original provider refused to give her more, so she went to a new provider. It resulted in occlusion of a blood vessel, that if left untreated could lead to tissue death and blindness.”
Tissue death refers to skin going dark and dying, and if the skin gets infected, it then must be surgically removed. “It is pretty scary stuff,” Dr Wong adds. “It can kill you. If the infection is treated late, it can lead to sepsis – widespread infection over the body – and you can die.”
In his view, the high volume of workers who have lost their jobs or been placed on furlough in the pandemic has triggered a rise in people with no medical background offering treatment after doing as little as a day of online training. Side effects from botched procedures include scarring, pain, permanent blindness, and even death.
“Also, over lockdown, people spent more time analysing themselves without makeup, and more time looking at themselves on Zoom, and on social media,” Dr Wong, who has had patients deliberately conceal their previous treatment, says. “They realised the true state of their skin. There has been a huge increase in demand for aesthetic procedures post-lockdown. Demand for my services has increased by at least 50 per cent since lockdown.”
Exclusive data shows Save Face, a national register of accredited practitioners who offer non-surgical cosmetic treatments, receives an average of 20 and 30 reports of rogue practitioners in the UK each week. And their web traffic increased by an average of 60 per cent from March 2020 to March this year.
“The amount of rogue practitioners has been climbing for the last couple of years but since the pandemic it has increased even more,” Ashton Collins, executive director of Save Face, tells The Independent.
Hannah Blair, who works in the NHS, has first-hand experience of how terrifying it is when fillers go wrong. The 42-year-old, who lives in west London, stumbled across a service on Instagram offering lip fillers during the pandemic last summer.
“I saw loads of pictures of really good results,” she tells The Independent. “Everything {else was closed. It was a lot cheaper than a lot of places. It was £90. When they did it, I had lumps, swelling and bruising.”
She attempted to call, text, and message the beauty service called Velvet Aesthetics UK on Instagram but they totally ignored her. The Independent also contacted them but received no reply.
“Typically, doctor shoppers are quite manipulative, often have issues such as body dysmorphia and can be very difficult to manage, often being dissatisfied with treatments provided.”
Vice chair of the Joint Council for Cosmetic Practitioners
“It was terrible,” Ms Blair adds. “I was in a lot of pain. It was horrific. It was traumatising. I couldn’t go out. I didn’t feel comfortable with how I looked even at home. People looked at me in public. I was very anxious and self-conscious. I had to call in sick from work for three weeks.”
Dr Martyn King, vice chair of the Joint Council for Cosmetic Practitioners, warns doctor shoppers often wind up being treated by “more unscrupulous practitioners or lay people”.
“Patients will often visit multiple doctors to hear what they want to hear or play one doctor, or another aesthetic practitioner, off against another,” Dr King tells The Independent. “Patients can be quite manipulative, asking them to price match another practitioner, or inventing stories of bad experiences with another local doctor to win favour.”
While filler can legally be bought or injected by anyone in the UK, even if they do not hold a license, botox must be prescribed by doctors, dentists or nurses. But rules around who administers botox are far less strict and it can be injected by people without adequate training. Non-surgical cosmetic treatments are estimated to bring over £2.75bn into the UK each year.
A recent report by MPs discovered the lack of regulation of non-surgical beauty treatments, like botox and fillers, is highly dangerous and needs to be urgently overhauled. Carolyn Harris, a Labour MP who co-chairs the parliamentary group which carried out the report, says doctor shopping is a substantial issue.
“A lot of people do doctor shopping,” she adds. “It is common practice. If they hit a wall with the doctor, they just move on to the next. Most of these clinics will allow them to have what they want done.”
“They fly in and do the surgery, then fly out, and it is hard to contact them. They can refuse to cooperate.”
Dawn Knight
The politician said everyone has the right to choose what they do with their body but warned it is highly easy to get addicted to botox or fillers. “A lot of this has to do with people being influenced by social media,” Ms Harris adds. “People are made to look perfect but nobody is perfect. People are being exploited.”
She argued many qualifications are not worth the paper they are written on, branding them “Mickey Mouse” certificates. “Charlatans have come into the industry because they can see it is a way of making a quick buck”.
Dawn Knight is one of many casualties borne from the wildly unregulated aesthetics sector. The 52-year-old was having excess skin from the upper and lower eyelid removed to eradicate wrinkles back in 2012.
“It was a fly in fly out surgeon,” Ms Knight, now a leading campaigner in the aesthetics sector, adds. “That is something we suffer from in the UK. Doctors who have done some medical training abroad but qualify to go on to our register. They fly in and do the surgery, then fly out, and it is hard to contact them. They can refuse to cooperate.”
Ms Knight, who lives in County Durham, has suffered life-changing injuries in the wake of the procedure. She is now forced to sleep with her eyes open and has been diagnosed with post-traumatic stress disorder.
“I now sleep with a large hard spheral sense in my eyes that is filled with artificial tears,” she adds. “My eyes flare-up. They are itchy, swollen, uncomfortable, and painful. It has completely changed the course of my life. There is a lot of pain, discomfort, stinging, and sitting with the light off.”
