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‘Qualified’ in Non-surgical Aesthetics…

Many adequately trained healthcare/ medical professionals within the aesthetics industry will always suggest when seeking injectable treatment that you always go to a professional with appropriate qualifications. The case of Rachel Knappier which has been in the media recently is proof why this is so important! Dr Tim Pearce, director of ‘Skin Viva’, a well respected, well known medical practitioner in the aesthetic field and an expert in complications, explains his view on what constitutes an adequately qualified professional:

“There’s a keyword that gets horribly abused in medical aesthetics. The word ‘qualification’. There are an endless number of people who claim to be ‘qualified’ in medical aesthetics. Unfortunately no matter how much training you do, there is a massive difference between training and qualifications. To make matters worse, there are many who think they have done level 7 but in fact have not done an official qualification, which means it’s just training. Qualifications are government recognised, they come from universities or validated training institutions. They are validated in a very much more comprehensive way than training. Our whole education system is divided up into levels from your GCSEs to your PhDs are levels 1 to 8. Though no Healthcare degree is geared towards medical aesthetics, they are geared towards validating the LEVEL OF COMPLEXITY in healthcare that clinicians can work at.”

I repeatedly say that just because an injector has not got a healthcare/medical background does not mean they are not good at injecting and achieve lovely results. This is not the point of why it is a common debate as to whether unqualified people should inject. As suggested by Dr. Tim Pearce, the issues arise when a complication occurs as a result of facial injectable treatment. This is when the lack of healthcare/medical experience becomes apparent. The ability to recognise a complication is one thing and then to treat appropriately is another, no individual should inject without feeling confident they can do both! 

The case of Rachel Knappier:

Whilst receiving botulinum toxin (AKA botox) treatment at a party (eye roll- this is my next blog topic), the injecting beautician (another eye roll) highlighted a lump on Rachel’s lip, an insecurity Rachel had had since childhood. The beautician advised she could ‘fix’ the appearance of the lump and suggested Rachel opt for a lip filler treatment. It is important to note Rachel was not initially utilizing the beauticians aesthetic services for any dermal filler treatment. Rachel felt “drawn in” to agree to such treatment! The treatment itself was carried out at a friends house. The amount of red flags within this information is overwhelming.

After the beautician had administered the lip injections, Rachel’s lips swelled so extensively that they touched her nose, she felt unwell and later that night lost sensations in her lips. All filler treatments carry an element of risk, some more common and less concerning, but there are risks of arterial/vascular occlusion, infection, lumps and nodules etc that can occur. It is absolutely vital that the practitioner who has initially treated can establish and recognize when a complication has occurred and treat it appropriately, in a timely manner to minimize further complication! In the case of Rachel Knappier, the beautician had injected filler in to an artery causing an occlusion, meaning the blood supply could no longer get to the tissue. If left untreated this serious complication can lead to necrosis, which is the death of soft tissue of your lip (see image below).  The beautician who treated Rachel was shocked at the extent of her swelling but did not make it a priority to review Rachel appropriately and recognise the complication that had occurred, instead she just advised an antihistamine and an ice pack, giving no further advice or treatment. In the case of an occlusion many practitioners have hyaluronidase an enzyme solution that degrades hyaluronic acid based fillers, unblocking the artery, restoring blood supply and preventing necrosis.

WARNING: IMAGE BELOW IS GRAPHIC, VIEWING DISCRETION ADVISED: Image from the Consultant Clinic. This is an example of a poorly managed complication leading to lip necrosis. This poor lady has now got this disfigurement at the hands of an unqualified injector.

Did you know that even though this beautician had very poorly managed this emergency complication and did not do everything she could to maintain Rachel’s safety. Not offering continuity of care and preventing further, possibly life long damage from occurring, this beautician has no regulatory body to hold her accountable and so essentially gets away with compromising the safety of her clients! Another huge difference between those who are and are not healthcare/medical professionals. I myself as a registered nurse am accountable to the Nursing Midwifery Council for all of my practice and additionally following the completion of my level 7 will be joining the Joint Council for Cosmetic Practitioners (JCCP) register, another regulatory body that set practice standards.

This is fundamentally important, an unqualified injector with no one to hold them accountable is a recipe for disaster and disaster is exactly what occurs. It is also then down to other qualified practitioners to pick up the pieces and correct the damage that has been done out of compassion for the unfortunate botched cases.

I urge more people who are considering any aesthetic treatment to be vigilant about who they are allowing to inject their face. Ask them for their qualifications/experience. Ask them what products they are using and why! Ensure they have comprehensively discussed the possible adverse effects that could arise from your chosen treatment and feel assured they they can manage what ever complications should arise. Yes, certain prices may be cheaper but this could be a reflection of the products they are using, are they approved, are they from a high standard pharmacy and not the black market! Dermal filler varies in price greatly! High quality legitimate products are more costly for the practitioner.

Unfortunately, even though Rachel Knappier’s case has been covered in Parliament, the aesthetic industry still remains unregulated, only voluntary registers exist and specific professional body regulations for doctors, nurses, dentists and surgeons etc.  It is not currently unlawful for non-healthcare/medical professionals to inject. Please be vigilant and fingers crossed we will soon see stricter regulations in the aesthetics sector to improve client safety!

Thank you for reading!

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