'Having fillers and Botox has become as normal as getting a manicure'

Martha Kalifatidis, of Married at First Sight, has been relaxed about discussing the choice to have "minor tweaking" to ...
Martha Kalifatidis, of Married at First Sight, has been relaxed about discussing the choice to have "minor tweaking" to her appearance. Photo: Supplied

While the prospect of undergoing a breast or nose job has always been cause for lengthy consideration, for many, having fillers or Botox has become as normal as getting a manicure.

Reality TV shows such as Love Island  have "normalised" nonsurgical cosmetic procedures, and the desire to look good in selfies is driving more under-35s to have them, according to the American Academy of Facial Plastic and Reconstructive Surgery.

Dr Jeremy Cumpston from Ageless Clinics says there is an increased social acceptance of minor cosmetic procedures and social media is driving "pressure" to look like celebrities and social media influencers.

Last month, criticism in the UK about how the procedures were fuelling mental health problems triggered Superdrug, a high street health and beauty retailer, to bring in tougher mental health checks for customers in search of a quick filler fix.

In Australia there are currently no guidelines around screening for body dysmorphia before undoing a cosmetic treatment. 

The procedures also carry physical risks – including severe reactions and facial disfigurement. So how do you know what is safe? And who can you trust with your face?

What can go wrong with Botox?

"Botox" is a brand name for botulinum toxin, which is produced by bacteria and relaxes muscles when injected by blocking signals from nerves that tell the muscles to contract.

When injected into the face it can help soften hard lines caused by facial muscles contracting, so is commonly used to help minimise the appearance of forehead lines and crow's feet, with the effects lasting around three to six months.

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The Australasian College of Cosmetic Surgery (ACCS) has called for tighter regulation around cosmetic procedures in Australia stating many beauty salons offering cosmetic procedures and injectables were out of their depth.

According to Tina Viney, CEO of Aesthetics Practitioners Advisory Network, all cosmetic injectables are classified as Schedule 4 drugs and require a prescription by a registered medical physician. A registered nurse can inject but only under the supervision of physician. It is illegal in Australia for non-medical practitioners to administer Botox or cosmetic fillers.

Cumpston says consumers should do their research before undergoing botox or fillers.

Things to look out for include making sure the practitioner owns the clinic, pays the insurances, relies on return trade and has real experience ( i.e. proper medical training and at least five years full time injecting. He says google reviews also are a reasonable guide.

He also warns against practitioners who are too willing to take on customers.

"Have a consultation... if you are getting a hard sell to do multiple procedures when you are 35, maybe think again. In any given day I can turn away as many people as I treat. Not everyone needs something," he says.

The main risk with injectible toxins is that they can make the face appear lopsided if not administered correctly.

David Gateley, a consultant plastic surgeon and owner of London's nakedhealth Medispa says: "Too much injected into the face can change the way the jaw moves, making you look like a robot or unable to smile or frown. Problems injecting into the forehead can cause your eyebrows to sit at different heights or one eyelid to droop.

"In all these cases, the only thing to do is wait for around three months until the effects have worn off."

He warns that rarer, but more serious, risks include infections, blurred vision and allergic reactions –particularly if the toxin has been ordered online. Botox is also not suitable for pregnant women, because the effect on unborn babies is unknown, or for people with myasthenia gravis, an immune condition that causes muscle weakness.

What risks are involved with fillers?

Fillers involve injecting a substance that "plumps up" the face. It is mainly used to make lips bigger and cheeks more pronounced, but can also be used to smooth wrinkles by filling under lines and creases, with effects lasting from four months to a year.

Fillers can be made from different substances, but the most common is naturally occurring hyaluronic acid. Synthetic fillers, including those made from silicon, and collagen fillers are also used.

As with Botox, fillers injected incorrectly can cause facial features to appear wonky or swollen – "trout pout" or lumpy lips are common complaints – or make skin appear red or bumpy.

The effects can last for months and "permanent" synthetic fillers can be very difficult to remove if things go wrong.

There are serious potential health risks from fillers, according to a review of evidence published in the Journal of Dermatology and Dermatologic Surgery in 2016.

The most dangerous is vascular occlusion, which happens when filler is accidentally injected into or close to an artery, stopping blood flow. A lack of blood flow to the face can quickly cause the flesh to begin to die off - a condition called necrosis. If this happens near the eyes it can cause blindness and, in severe cases, the filler can travel through the arteries to the brain, causing a stroke.

The Telegraph, London