Botox and filler injections are among the most popular nonsurgical cosmetic procedures in the country. Fillers can be used to add volume to the lips and other areas on the face, while Botox is generally used to treat fine lines and wrinkles. But in the hands of the wrong people, injections ― especially of Botox ― can be extremely dangerous. Even lethal.
These days, there seem to be too many unqualified people sticking needles in other people’s faces. For example, in 2017, health regulators in British Columbia, Canada, sought an injunction against a woman they said was unlawfully providing injections out of her basement. Then there’s the issue of Botox parties, which involve someone coming to your home to administer Botox injections while you sip cocktails. These gatherings have gained popularity over the years.
As a result, it’s become quite difficult to distinguish those who are properly qualified from those who aren’t. So, how do you know you’re in good hands? We spoke to doctors to get some answers.
Going to a licensed medical professional is only the first step.
The person administering cosmetic injections should be a licensed doctor, nurse, nurse practitioner or physician’s assistant, with the latter two being supervised by doctors, Dr. Michelle Yagoda, a facial plastic surgeon in New York City, told HuffPost.
There isn’t a specific certification just for injections, Yagoda added, which is why looking for a certified medical professional is only the first step to knowing you’re in good hands.
Dr. David Cangello, a board-certified doctor with the American Society of Plastic Surgeons who is also based in New York City, went one step further, suggesting individuals should really only seek out board-certified plastic surgeons. In his opinion, they “[are] going to have the most knowledge and understanding to be the safest.”
If someone isn’t an experienced certified plastic surgeon, they might not have ever seen what’s underneath the skin, which means they might not know where blood vessels, nerves or other parts of the body you can injure are located, Cangello added. Plastic surgeons, he said, “see that sort of thing all the time when we’re operating.”
If something seems too good to be true, it probably is, agreed Yagoda and Dr. Michael Dobryansky, a board-certified plastic surgeon at Long Island Plastic Surgical Group.
Low prices aren’t always a good thing.
If the price seems extremely low or is extremely discounted, “the person administering it may not be an experienced provider,” Dobryansky said. Or, if the business’ hours of operation extend well beyond the typical workday ― say, they’re giving injections at 11 p.m. on a Saturday ― Yagoda simply suggested you “run.”
Ask to see before and after photos.
Another red flag would be a lack of before and after photos. If there is little or no photographic evidence of their work, that might be a sign the individual providing the injections doesn’t have a ton of experience, according to Cangello.
“Usually, people want to put forth their work and show what they’re capable of doing so that people come to them,” Cangello said. “I think it’s a little bit of a red flag if someone doesn’t have that at the minimum.”
Check the label of the product being used.
Dobryansky also noted that anyone looking to have injections should “beware of counterfeit injectable products from China or silicone injectables.” It can’t hurt to ask questions about the products or substances you might be having injected under your skin.
Beware of nonsterile environments.
Dobryansky also warned against injections offered in places like hotel rooms and other nonsterile environments. Yagoda echoed that point, noting that injections are “a medical procedure ... not a haircut or a blowout.”
“You need to be in the appropriate setting,” she said. “It shouldn’t be in a party, it shouldn’t be in someone’s house. There shouldn’t be drinking involved, not on behalf of the injector, for obvious reasons, and not on behalf of the recipient because there could be a lot of bruising and bleeding problems [since] alcohol interferes with blood clotting.”
In case of emergency ...
Anyone considering injections should also make sure the medical professional they go to has hospital privileges, according to Yagoda.
If your doctor has hospital privileges, it means they have permission from other specialists in the field to do these procedures, Yagoda explained. It also means your doctor benefits from ongoing medical education and likely has malpractice insurance in the case of an emergency, she added.
“If you’re walking into a place and there’s no M.D. on premises, what happens if you have an emergency? Who’s going to be the person to handle that? Who’s going to be the person to direct you to a place that is safe?” Yagoda said. “Any of those things should be the red flags.”
If a doctor doesn’t have hospital privileges, there could be “something weird going on,” Cangello said.
“If someone didn’t have hospital privileges, that would alert you to the fact that, if they’re trying to call themselves a board-certified plastic surgeon, they’re probably not really that,” Cangello added.
With all that said, what can you do to ensure you’re in good hands?
“I urge anyone considering injectables to do their homework,” Dobryansky said. “Research the provider you are considering, look at photos of their work on their website or Instagram, look into the experience they have and their level of training. Administering injectables involves a level of understanding.”
The practitioner should also do work that aligns with your desired aesthetic, Yagoda advised.
“If somebody on their Instagram feed is showing before and afters of lip injections that they label as natural and beautiful, and you think they look like ducks, then that’s not a good place to go,” she said.
According to Cangello, referrals from individuals you know are also extremely helpful when looking to find someone you can trust.
And finally, don’t be afraid to ask questions. Whenever you’re considering any sort of medical procedure, ask for as much information as possible to help inform your decision.
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