OPINION: 'I'm a cosmetic doctor. Here's what I want you to know about cheap injectables.'

There was a recent piece published on Mamamia, which looked at the rise of cosmetic injectables and reversal of treatments, often for poorly done work, and a reflection on why this might be increasingly the case.

A common reason cited, which is well known among those of us who’ve been around a while, is the explosion of aesthetics and injectables in the beauty space. 

Watch: SBS programme Insight looks at the growing popularity of cosmetic procedures such as anti-wrinkle injections and fillers. Post continues below.

Video via Mamamia

This has undoubtably led to the proliferation of chain clinics and corporates that pull in relatively junior and inexperienced nurses and doctors, with minimal medical training post graduation, into this industry.

People can be trained in injecting after as little as a weekend or a week-long bootcamp, and then set up in salons and chain clinics to inject with minimal oversight and supervision.

With the large numbers recruited by these chains, prices drop and potential consumers - who know no different - and may choose based primarily or only on price, may go to these places. 

And while we are all empowered to make our own choices, it's also important to know that this may come with a possibility of margin for error. 

Because while most of these patients will be fine, some will have complications.

When I see patients in my clinic who’ve had something go awry elsewhere, or because they are coming to me as new patients, some express anxiety and surprise at the potential issues and concerns I discuss with them when going over consent.

This includes risk of bruising and bleeding, risk of injury to a blood vessel with dermal filler causing blockage, which, if not caught in time, can cause skin death as well as the rarest complication of them all - blindness in one or both eyes.


Yet, other patients I see who’ve been going elsewhere routinely cannot tell me if they’ve had anti-wrinkle or filler to areas of concern, or what brand or how much was used.

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A post shared by Dr Imaan Joshi | Aesthetics (@drimaanjoshi)

All this points, disturbingly, to a lack of regulation and oversight of often very junior and inexperienced nurses and doctors, who may lack the necessary skills to educate and choose patients appropriately. This includes managing unrealistic expectations, much less unexpected complications such as vascular occlusion (blockage of a blood vessel).

Most people will assume that it is similar to shopping at ALDI vs shopping at Coles or Woolworths. 

However, it's important to be aware that when it comes to medical procedures, qualifications matter, experience matters, as does the ability to discuss risks and consent, manage expectations and say 'no'. 

Medical procedures are not the same as non-invasive hair and beauty procedures but they’re being heavily advertised and sold as such through marketing.

Again, while patients are entitled to make their own decisions, it's also worth being armed with the right information so you can make the best possible choice for you.

That's why it's important to keep in mind that most experienced clinicians will not be cheap. If they are, you really need to ask yourself why.

Most experienced clinicians will usually be fast, but that is because we’ve done the years of work that goes into learning, and honing our skills. It may take us a fraction of time to do what a newer clinician will take twice as long doing, and usually with fewer mistakes.


Lastly, most experienced clinicians, outside of COVID times, tend to be booked out and can’t fit you in on the day, barring emergencies post-treatment. They will hold you accountable to your treatment goals as it’s in your best interest to do so.

Most experienced clinicians are more interested in educating you, and helping you choose what’s best for you in the bewildering array of cosmetic procedures, including skin improvement, rather than simply selling you a pre-planned, generic package or a deal that may or may not suit.

So, just be cautious of this.

The current marketing push from big chains and corporates may be one of the contributing reasons for why we see vending machine-style aesthetics, in which the patient largely designs their own treatment and the person injecting simply says, 'yes'.

Doing cosmetic enhancements on the face especially, where millimetres of change are apparent, complex, delicate work, and it takes a combination of science and art to bring it all together and years of experience and practice. 

You cannot learn that in a five-day boot camp or a weekend course and certainly not without some foundational years in the basics of medicine, during which you learn the art of medicine - consultation, assessment, correct diagnosis as well as recognising complications when they occur and how to manage them. 

Junior staff are heavily supervised in hospitals and other settings for this very reason and not left to their own devices for years, until deemed competent and safe to the public.

As with the 'Cosmetic Cowboys' expose not that long ago, many people are being harmed by non-invasive medical aesthetics - we just don’t see it as much of a problem because, to some degree, we’ve become so desensitised to it.

We all know of someone who’s walking around among us with frozen faces, over-inflated lips, exaggerated cheeks and hollow temples and a face that does not match the neck/décolleté and hands.

It is not what aesthetic medicine, at its core, was even intended to be.  

I hope we are taking back the reigns, and as doctors and nurses, returning to the core of what we undertook in training for this in the first place - to first do no harm. 

Keen to share your thoughts on the topic? Drop them in the comment section below.

Feature Image: Instagram: @drimaanjoshi.

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