With the rise of celebrity culture, social media platforms such as Instagram, and all-round easier access to cosmetic procedures, British and American statistics reveal an increase in many aesthetic treatments in the past five years. Ireland is following suit but hard industry stats are difficult to come by.
In that time, there has been a rise of about 30-35 per cent in non-surgical cosmetic procedures but a much smaller increase, about 5-10 per cent, in surgical cosmetic procedures in both the US and the UK.
Botulinum toxins (Botox, Dysport etc) still rank as the number one non-surgical procedure followed by hyaluronic acid filler treatments. Liposuction and breast augmentation are the top two surgical procedures being performed, while there has been a huge rise in male breast reduction in the last five years.
In 2018, there were 17.7 million cosmetic procedures performed, about 15.9 million of these were minimally invasive and non-surgical, reflecting the continued trend toward less invasive procedures that have little or no downtime.
With so many individuals now opting for cosmetic procedures, in an industry that remains highly under-regulated, how do you go about picking the right procedure, with a highly trained specialist, in a clinic that is safe?
With any treatment, whether ‘surgical’ or ‘non-surgical’, it’s vital that you ask plenty of questions and do some research before you go ahead, says Dr Eithne Brenner, medical director of Manara Skin Clinics.
“You need to ensure that the medical practitioner you choose gives you plenty of time for a consultation, assesses your suitability and discusses the risks and benefits of the treatment options. They must be highly trained, experienced, safe, and be using proven, effective products from a licensed pharmacy or manufacturer, in clean, appropriate premises. They must be available for follow-up in case of complications, and they must be insured. You can check the professional registers of the Irish Medical Council, Irish Dental Council, or Nursing and Midwifery Board for their details,” she says.
Formal training and certification in cosmetic procedures is quite varied, ranging from half-day courses and weekend workshops to observerships and fellowships.
Doctors, dentists, and nurses perform injectable treatments all over Ireland. Worryingly, there is an increasing number of non-medical practitioners injecting patients with fillers and even threads, often with serious consequences. The lack of regulation in the field, coupled with the classification of fillers as mere medical devices, has potentiated this trend.
Expertise and safety
The highest levels of expertise and safety are imperative when it comes to these cosmetic procedures, says Prof Caitriona Ryan, consultant dermatologist and co-founder of the Institute of Dermatologists, says.
“It is your face, and complications can lead to permanent disfigurement. Do your homework. If you want to make sure that you are safe and in expert hands, choose a consultant dermatologist or plastic surgeon who is on the specialist register of the Irish Medical Council for dermatology or plastic surgery – this way you are assured of expert training. There is no equivalent to the comprehensive training, certification and continuing education in the medical, surgical and cosmetic care of the skin, which are required to attain and retain specialist registration,” she says.
Alarmingly, an explosion in places offering cheaper procedures, with non-medical practitioners administering injectables, has been accompanied by a dramatic increase in the volume of patients presenting to A&Es, dermatologists and plastic surgeons with complications of filler injections.
“Beauticians typically offer dermal fillers at a fraction of the price charged by medical specialists and it has been shown that often the products used have been sourced from the internet without traceability or adequate quality control.
“There are also chains of commercial clinics that employ non-specialist doctors, junior doctors and dentists with sometimes as little as a day of training. These practitioners are being paid at nominal rates to reduce costs and increase margins but, of course, this may put the public at risk,” Prof Ryan says.
Body dysmorphia
Often a procedure is not the right course of action for a patient, no matter how much they believe it to be the case.
“Doctors and surgeons performing cosmetic procedures regularly should know when not to treat a patient and be familiar with the signs of body dysmorphic disorder. During a consultation, your doctor will determine whether having treatment is in your best interest or not,” Dr Peter Prendergast, owner of Venus Medical, says.
"A practitioner should be looking at the client's expectations and if he/she is being unrealistic in what they're looking to achieve, then they should not be taken on for treatment," Lorraine Lambert, chief executive and founder of Ailesbury Clinic, says.
“Also, the practitioner should be looking into how many other aesthetic procedures the client has undergone before, to ensure they don’t suffer with body dysmorphic disorder. It is a real issue these days also that many individuals are on anti-depression medication and also some take recreational drugs which cause paranoia and depression, and practitioners should also be avoiding these clients as they may be looking to undergo aesthetic/cosmetic surgery for the wrong reasons,” she adds.