• Dr Claire Ashley

Choosing the right aesthetic practitioner for you and staying safe in an unregulated industry

The market is currently flooded with practitioners offering aesthetics treatments such as botox and fillers, and it can feel really overwhelming when you are thinking about who to go to for your treatments. Currently the industry is still completely unregulated (yes, can you believe it?!), which means that people with no medical qualifications or knowledge can set up and start injecting. I am led to believe that the UK is the only Western country in the world where non-medics can start offering injectable aesthetics treatments. This, coupled with the fact that often people don't discuss who they are seeing for their aesthetic treatments (let alone admitting they are having anything done!) means that picking who is reputable and safe to go to is a bit of a minefield.

The former Love Island contestant Rykard Jenkins has just announced to his 335k Instagram followers that despite being neither a medic or a beauty therapist, he is now trained to administer botox and fillers having been taught in only a matter of hours. I personally think that this is a shocking reflection of how easy it is for non medics to start practicing in aesthetics in the UK. Dr Tim Pearce, who is a leader on aesthetic complications in the industry, agrees that injecting itself is a technique that can be taught fairly easily. For instance, my husband who is not a medic and is also needle-phobic learnt how to give me injections in minutes when I needed to have them at home for a medical condition. However, these non medic injectors have no concept of the underlying anatomy of where they are injecting, and as such do not know how to prevent, recognise or manage complications. I spent 2 years learning anatomy in a dissecting room at medical school and therefore know when I am injecting know exactly how to change my technique to prevent complications. And should a complication occur, as I am a prescriber I am able to hold the drugs needed to immediately deal with complications- such as an allergic reaction, or vascular occlusion. Non-medics are legally not allowed to hold these drugs. They also have no knowledge about how underlying medical conditions or medications they are taking might affect the patient's suitability for treatment. Equally, their knowledge about the pharmacology of what they are injecting will be extremely limited.

It is also concerning that someone like Rykard, who has a huge social media following and influence, is able to promote and normalise unregulated and unlicensed practice to hundreds of thousands of potentially vulnerable patients.

So, my advice to anyone who wants to consider having botox or filler is to stay safe, and that means that you absolutely must go to someone who is medically trained, be it a doctor, a nurse or a dentist. I have heard horror stories of complications from people injecting themselves, or by unqualified practitioners - normally in the beauty industry- offering procedures cheaply. During my training I have been taught the importance of knowledge of facial anatomy, where it is safe to inject, and what techniques to use to reduce the rate of complications. This doesn't mean that complications won't occur, but practitioners with a medical background have the knowledge and skills to help reduce these risks.

The other thing to bear in mind with medical practitioners is that we are all licensed to practise and are accountable to our regulatory bodies. This has several advantages for the patient. Firstly, as a doctor I am bound by a strict code of conduct as outlined by the General Medical Council. I am not allowed, for instance, to do a hard sell with my patients or recommend expensive treatments that are not clinically appropriate. I also have to undergo regular appraisal of my work and prove that I am clinically competent in order to keep my licence to practice. When doctors don't uphold these standards they face consequences, such as restrictions on their practice, suspension from the register, or even being struck off. However, if you have a procedure from a non medical practitioner, and there is a complication, that practitioner is not accountable to any regulatory or professional body.

I absolutely understand the temptation to go to practitioners that are offering cheaper procedures, because medical aesthetic procedures are very expensive. However, that's because botulinum toxin and reputable fillers are expensive to buy. If someone is offering an injectable treatment for a very low cost I would be incredibly suspicious that they are not using a genuine product, and I would advise that you question why it is they are so cheap.

However, despite the advice above, in an unregulated industry how can you really ensure that your medically trained practitioner is going to do a good job? A really great place to start is to see how long they have been practicing, and how experienced they are. I would also suggest that you look at their website and social media so that you can see their body of work and results. Word of mouth is an excellent way of finding someone that is doing good work.

And finally, go and meet them! Any reputable practitioner will offer a consultation prior to treatment with a cooling off period so that you can have time to think about whether you want to go ahead with your treatment. And if you don't feel happy, walk away and find someone else.

I hope that this has been helpful. If you have any further advice to help others chose a good practitioner let me know in the comments.

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When I finally reopen my doors for business following the lockdown, I will be putting some measures in place to ensure the safety of my patients as well as myself and the other members of staff at @ro