The perils of the Love Island pout’: They’re the injectable ‘tweakments’ girls as young as 12 are asking for, thanks to reality TV… but now doctors are warning they can lead to stroke and even BLINDNESS

• Cosmetic ‘tweakments’ becoming as mainstream as a manicure for some women
• Lydia Smith, 28, ended up with pronounced lumps and severe bruising after filler
• The Government has pledged to make dermal fillers a regulated medical device 

Like many of her friends, Lydia Smith, 28, longed for fuller lips. ‘I wanted them to look like the pout I make when I pose for a selfie,’ explains the hairdresser from Castle Bromwich. ‘More clients were coming into the salon having had their lips done, so I thought I’d try it, too.’

Lydia first had lip filler two years ago, given to her by a woman she met through work. Lydia didn’t ask what qualifications she had, and no medical history was taken.

The procedure took place in a ‘beauty room’ at the back of a hairdressing salon, where a product was injected into Lydia’s lips.

‘Although one side was bigger than the other and I had to pay her to re-do them a few weeks later, I didn’t have any major problems,’ she says.

‘But when I went back to the same lady a year later, she was using a cheaper product and said the procedure would cost £170 instead of £220.’

Lydia Smith, 28, (pictured) ended up with pronounced lumps and severe bruising after filler treatment 

While the first procedure had been uncomfortable, this time Lydia was in excruciating pain.

‘Every time the needle went in, it felt as though she was injecting acid — it was horrific,’ she says.

‘To combat the pain, she injected local anaesthetic into my gums, but she kept hitting a nerve and my chin filled up with hard bumps. The more pain I was in, the more she seemed nervous and panicky.’

Within minutes, Lydia’s lips had swollen to three times their normal size, with pronounced lumps and severe bruising. She also felt sick and disorientated.

‘My mum, who picked me up afterwards, was horrified,’ recalls Lydia, who was advised to massage her lips to break up the lumps and help the swelling subside.

‘But they were too painful to touch. For seven months afterwards, I woke up every morning looking as though I’d been punched in the face.’

When she complained, the practitioner suggested ice packs and antihistamines to reduce swelling.

Within minutes, Lydia’s lips had swollen to three times their normal size, with pronounced lumps and severe bruising. She also felt sick and disorientated

FILLERS CAN PUT YOUR LIFE AT RISK

Once the preserve of celebrities, cosmetic ‘tweakments’, including dermal fillers to plump up areas of the face, are becoming as mainstream as a manicure to a generation of young women reared on before and after pictures of the Kardashians and used to digitally re-shaping their own faces in photos to post on social media.

But few realise the risks they run — not just to their appearance but also to their health, when things go wrong.

In unskilled hands, fillers, which are used to plump up lips or cheeks, can lead to permanent lumps and bumps, raw, sensitive lips, infection and abscesses. Worse, they can lead to tissue death, vascular occlusion — when filler is injected directly into an artery, causing blindness — and life-threatening complications.

Dr Anne Mendelovici, a London-based aesthetic doctor, explains that some girls ask for their lips to be plumped to two or three times the size of their natural lips, ‘which no responsible surgeon would agree to.

‘We’re almost looking at a new beauty ideal — and it’s as far from the natural aesthetic as it could possibly be. Not only is it a disaster aesthetically, [but] the gross over-stretching of delicate skin can result in permanent and disfiguring scar tissue.’

Dr Max Malik, a Harley Street cosmetic doctor, eventually removed Lydia’s lip filler by dissolving it with injections of hyaluronidase, a naturally occurring enzyme.

‘You can never, ever be gung-ho with someone’s face,’ he says. ‘Administering filler is a medical procedure which involves a product being delivered to all levels, even down to the bone.

‘The potential for damage, including infection and skin necrosis — where the tissue dies — is huge. I know of cases where, in unskilled hands, the blockage of a blood vessel has led to blindness and stroke.’

Yet awareness of these potential health risks remains low while demand for these procedures soars. Research from the British Association of Aesthetic Plastic Surgeons has found that requests from those aged 19 to 34 for Botox (to reduce wrinkles) and filler rose by 41 per cent between 2011 and 2015.

Indeed, 70 per cent of those aged 18 to 24 interviewed said they would consider having such procedures, which account for 75 per cent of an estimated £2.75 billion industry in the UK. The vast majority of these procedures are carried out by people without medical training.

Dermal fillers usually contain hyaluronic acid (a substance that occurs naturally in the body and can retain moisture to give a plumping effect on cheeks or lips) and Botox, or botulinum toxin, which is injected to ‘smooth out’ wrinkles by temporarily blocking the nerve signal to facial muscles.

TV stars such as Charlotte Crosby (pictured) have had lip fillers. But few realise the risks they run — not just to their appearance but also to their health, when things go wrong

The figures associated with these procedures speak for themselves.

In 2018, Save Face, a voluntary national register of accredited aesthetic doctors, received 934 complaints, the vast majority (86 per cent) from parents of teenage girls who’d had treatments carried out by beauticians, hairdressers or lay people.

Last year, the number of complaints almost doubled to 1,617. Most relate to lumps and nodules, but 113 women have also suffered vascular occlusions. This is when a blood vessel is blocked with filler, which can lead to tissue death.

Two lost the sight in one eye, and yet another had a stroke after tear duct treatment involving filling dark under-eye circles.

‘It’s a devastating situation because there is nowhere they can turn to for redress,’ says Save Face director Ashton Collins.

TREATMENTS CAN CONTAIN CONCRETE

Fillers normally come with a CE mark on the packaging — which is a sign that it has passed health and safety standards.

Worryingly, though, some fillers — particularly cheaper imports from China — have fake CE marks.

‘At best, these contain poor quality, ineffective ingredients,’ says Dr Malik. ‘But at worst, they can contain all sorts of contaminants and dangerous chemicals.

‘I’ve even seen cheap fillers from the Far East which contain concrete. They can also contain a long list of poisonous heavy metals.’

But while it is illegal for those aged under 18 to be given tattoos and teeth-whiteners, or to use sunbeds, there is no age restriction for Botox injections and fillers, and — unbelievably — no regulations dealing with who can perform these invasive procedures.

Dermatologists and plastic surgeons are concerned by the alarming rise in girls as young as 14 being lured by adverts on social media sights such as Snapchat and Instagram, where unskilled practitioners working in non- medical settings, such as beauty salons, advertise cheap ‘Love Island’ packages.

Dr Nick Lowe, a dermatologist and cosmetic doctor at the Cranley Clinic in London, warns that self-proclaimed social media ‘medical influencers’ are not just putting young people at risk physically but also harming their mental health.

‘Girls are having treatment at a time when they don’t need it, and we’re seeing body dysmorphic syndromes as a result [where a person worries obsessively about their appearance].

‘It’s extremely troubling. The standards set by Instagram and Snapchat filters are impossible to meet in real life,’ he says. ‘To stop the widespread uncontrolled use of fillers and Botox, they simply need to be classified as medical procedures.

Once the preserve of celebrities, cosmetic ‘tweakments’, including dermal fillers to plump up areas of the face, are becoming as mainstream as a manicure. Pictured: Love Island’s Anna Vakili

‘Unfortunately, though, nothing is being done about it.’

Cosmetic surgeon Dr Jean-Louis Sebagh, questions why the UK is the only European country not to have laws preventing non-medically trained practitioners — such as beauticians and hairdressers — from injecting Botox and fillers.

‘In France, these procedures can be administered only by properly qualified doctors — plastic surgeons, dermatologists and neurologists,’ he says.

‘The thing you need to know above all else is never consider having any kind of injectable treatment at a beauty salon,’ he warns.

Dr Mark Henley, president of the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) and a consultant plastic surgeon at Nottingham University Hospitals NHS Trust, warns: ‘It is incredibly easy — and legal — for untrained beauticians or members of the public to purchase cheap dermal filler kits online and carry out procedures themselves. We urge the Government to introduce tighter regulation as a priority.’

‘CLINICS’ SET UP IN GARDEN SHEDS

In 2013, a Department of Health report reviewing cosmetic regulations produced 40 recommendations, including creating approved training schemes and standards and a code of ethical practice.

None has been put in place — and the situation has got worse. Save Face has seen a huge increase in the number of cut-price deals advertised by unscrupulous and untrained operators.

‘When we investigated the 934 complaints we received in 2018, almost all involved practitioners who were hairdressers or beauticians with no medical training whatsoever,’ says Ashton Collins, adding that four out of five people had found their practitioner on social media.

‘This is a unique sector where you have skilled plastic surgeons alongside someone who has watched a YouTube video, ordered some products from China and set up a ‘clinic’ in their spare room or garden shed.

‘The problem is, most young girls see the word ‘doctor’ preceding a username with a large number of social media followers and think they’re getting the same treatment as celebrities who post before and after pictures on Instagram.

‘If something goes wrong, the patient is blocked on social media, the account deleted —then the ‘doctor’ pops up under a new name and the process begins again.’

In 2018, Sally Taber, a former director of nursing at a London teaching hospital, set up the Joint Council for Cosmetic Practitioners (JCCP) a self-regulating body for the UK non-surgical aesthetics and hair restoration sector. The JCCP has so far exposed 13 people claiming to be medical professionals ‘when they’ve had no more medical training than your postman’.

One, who claimed to be a plastic surgeon yet had no medical experience at all, was jailed for four years last year after four women suffered anaphylactic shock when he injected them with beef gelatine instead of Botox.

‘These people seem to have an enormous amount of confidence and they see there is a lot of money to be made,’ says Sally Taber. She also cites the case of a 24-year-old who had Botox and filler after seeing an advert —which she trusted because it was in a magazine.

However, the procedures were carried out in unsterile conditions by someone with no qualifications, and she has been left with lumps and bumps under her skin ‘and nowhere to go for redress since the practitioner has disappeared’.

JCCP has worked closely with the Advertising Standards Authority, which since February 1 has started to clamp down on any salon advertising Botox. This is classed as a prescription-only medicine, and Human Medicine Regulations prohibit advertising of prescription- only medicines.

THE 12-YEAR-OLDS SEEKING LIP FILLERS

The Government has pledged to make dermal fillers a regulated medical device by May this year — which means manufacturers will be under more pressure to prove both the safety and efficacy of products.

However, Save Face and JCCP are concerned that this won’t stop unscrupulous practitioners and may even encourage the use of cheaper and riskier products.

A quick trawl through Facebook a few days before the ASA ban revealed hundreds of adverts still offering ‘Kim K or Love Island packages’ for unrealistically low prices.

Some offer as many as ten treatments — filling cheeks, jawline and tear troughs (under eye circles), ‘nose straightening’, lips and Botox — all for £500.

A reputable practitioner, on the other hand, can charge at least £300 per area for filler and £250 to £500 for Botox.

All the doctors featured in this article said they’d had requests from girls as young as 12 and 14 for lip filler treatments.

‘Absolutely no one should be having treatment under the age of 18,’ says Dr Malik firmly. ‘And I won’t treat anyone under 21.’

But, meanwhile, as the law stands, there are plenty of others who will — with some salons even showing fake credentials and insurance certificates to unsuspecting young customers.

A spokesperson for the Department of Health told Good Health: ‘We are committed to improving the safety of cosmetic procedures, and options are being considered to help people make informed decisions, including introducing age restrictions on accessing certain cosmetic treatments and improving training for practitioners.

‘Anyone seeking a cosmetic procedure should take the time to find a reputable, safe and qualified practitioner.’

Ideally, the doctor should be a member of some or all of the industry associations — the British Association of Aesthetic Plastic Surgeons, the British Association of Plastic, Reconstructive and Aesthetic Surgeons and the General Medical Council specialist register.

‘The real issue is that girls see filler as a no-risk treatment,’ says Ashton Collins. ‘It simply isn’t.’

Tiny sensor that keeps an eye on heart patients 

A sensor the size of a 5p piece could revolutionise the treatment of heart failure, sending a daily readout wirelessly to a doctor.

The sensor, which monitors the blood pressure leaving the heart, could provide a vital early warning of deteriorating cardiac health.

Almost a million Britons have heart failure, an incurable condition in which the heart, weakened by a heart attack, high blood pressure or another condition, struggles to pump sufficient blood around the body.

This can cause exhaustion and a build-up of fluid in the lungs and body, causing breathlessness and swollen legs and ankles. A third of patients die within a year of diagnosis, a survival rate worse than for many cancers.

Treatment includes medications such as ACE inhibitors, beta blockers and diuretic drugs that make patients pass more urine to help relieve swelling and ease breathlessness.

A sensor the size of a 5p piece could revolutionise the treatment of heart failure, sending a daily readout wirelessly to a doctor

However, patients often don’t realise their condition has deteriorated until it is too late to adjust their treatment at home, and many face repeated hospital stays at a cost to the NHS of £2 billion a year.

In a U.S. trial in 2014, the CardioMEMS sensor cut admissions by 37 per cent, almost halved the length of stay in those who were taken into hospital, and improved quality of life. Now, doctors are researching whether it will be similarly beneficial to the NHS.

The tiny sensor is threaded into the pulmonary artery, which carries blood from the heart to the lungs, via a small incision in the groin under local anaesthetic; a procedure that takes 60 to 90 minutes.

The sensor constantly monitors the pressure of blood leaving the heart. Once a day, the patient lies for a few minutes on an ‘electronic pillow’ that collects data and beams it wirelessly to the hospital.

The data is read by a doctor or nurse, who will also receive an automatic alert if the patient’s condition is deteriorating. Staff can then call the patient and advise them, leading to earlier treatment.

‘CardioMEMS is a revolutionary system,’ says Dr Stephen Pettit, a consultant cardiologist at the Royal Papworth Hospital NHS Foundation Trust, one of ten UK centres trialling the device.

‘It allows us to pick up any change in the patient’s condition immediately and make the necessary adjustments to their medication.’

Dr Zachary Whinnett, a consultant cardiologist at Imperial College Healthcare NHS Trust, says: ‘A previous study found that using regular pulmonary artery pressure measurements reduced admissions to hospital in people who have moderate heart failure.

‘It will be interesting to see whether treatment guided by this technology proves to be beneficial in other groups of heart failure patients.’

CAROL DAVIS

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