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When it Comes to Facial Fillers, it's Buyer Beware

11/18/2013 05:35 EST | Updated 01/23/2014 06:58 EST

Photos of trout pout, pillow face and chipmunk cheeks -- facial fillers gone wrong -- dot the pages of celebrity and style magazines these days. But look around and you'll also see these facial mishaps on non-celebs, ordinary people like you and me.

Easy access to facial fillers, a dizzying range of products, and the heady promise of eternal youth with no surgical downtime sound like heaven. But the message, say experts, is buyer beware! Good advice if you're contemplating a facial fix-up for the upcoming party season.

First, a primer on injectibles: Number one is still Botox with annual North American sales of over $1.6 billion. Filler injectibles are the second most common non-surgical cosmetic procedure in North America. In 2011, 1.9-million soft tissue filler treatments were done, and 5.7-million procedures with Botox. That's a lot of faces plumped and smoothed.

For the record, I have not yet taken the plunge -- yet! I actually started thinking more about this stuff when, last year, I read a press release from the British Association of Aesthetic Plastic Surgeons which noted that two out of three surgeons are seeing botched filler procedures, some of them untreatable due to permanent damage.

A bit of investigation on my part indicated that a few doctor bloggers were also sounding the alarm: Worried about practice drift in which injectibles are administered by, well, who knows who, Illinois plastic surgeon Dr. Peter Johnson warned that injectibles are now offered at hairdressing salons and spas, that online discount coupons give the impression injectibles are no-brainers, and that "weekend courses to teach 'injectionists' abound."

When a friend told me that she gets her Botox touch-ups at a local hairdresser/spa staffed by beauticians, I asked Dr. Vince Bertucci, a Toronto cosmetic dermatologist and board member of the Canadian Dermatology Association, how this could possibly be true. In an interview, he told me that in Canada 30 varieties of injectibles are approved for use, and while the law states that injection must be under the supervision of a physician or nurse, he says that is not always the case. "There are people out there practicing medicine who are not physicians."

Consumers need to make educated decisions -- especially today when Botox isn't the only game in town. Botox, that old favourite, blocks the release of nerve impulses to relax crow's feet, brow lines and forehead wrinkles; hyaluronic-acid based fillers such as Restylane, fill in wrinkles or acne scars and plump up lips; and stimulatory fillers give your body's natural collagen a boost to help sculpt your face.

But while these fillers are either absorbed by your body as they break down or simply wear off, other fillers made of microscopic beads mixed in a collagen base are permanent. The only way to remove these is "to cut them out," says Dr. Bertucci.

He adds that in skilled hands, the risk of fillers is low. "But consumers should know if the person injecting is equipped to manage complications. Because even the best of the best have complications." Impending necrosis and infections due to hypersensitivity may be rare, but they happen. Fillers injected improperly or unevenly can result in ugly lumps under the skin.

Fillers "help create shape and restore contours. They subtly restore facial features that time has taken away," says Dr. Bertucci. But do your homework, he advises: Research, check credentials, and seek out skilled professionals. "Give Picasso a paintbrush and paint, and he creates a work of art," he says. The same tools in someone else's hands, maybe not so good.

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