Facial Aesthetics Review – knowing the risks of dermal fillers and anti-wrinkle injections

facial aesthetics reviewIn a new column, Shilpa Jain reviews the latest trends in facial aesthetics. Here she examines two cases on Instagram that didn’t go to plan.

Over the last year we have heard of two Instagram influencers, both based in the US, who have openly shared their adverse reactions after having non-surgical cosmetic injectables.

We don’t often hear about the risks of having these sorts of treatments. And so it was a valuable teaching moment for both the profession and members of the public.

Botox injection

The first case was back in April. Lifestyle influencer, Whitney Bhua, took to her Instagram (@somethingwhitty) to speak very candidly about what happened when she had Botox injected too low. It caused one eye to drop (ptosis) and the other to appear very wide open.

She was so brave in opening up about what happened to her. She even carried out daily updates with pictures and videos so we could track her progress.

After this unfortunate incident, different doctors and plastic surgeons saw Whitney. She was given eyedrops/massaging techniques to help her body break metabolise the botox quicker. Eventually after a few months she did get back to normality.

Whitney Bhua

Vascular occlusion

What’s so invaluable is that this complication is usually so rare. In fact there is a 5% chance of this happening.

So many injectors have never seen this on a patient before. So the awareness Whitney brought to this particular condition and the importance of informed consent was great for the profession.

Lilly Ghalichi

The second case was another US influencer and former reality TV star, Lilly Ghalichi.

She also took her to Instagram (@lillyghalichi) to reveal her complication after having filler injected under her eyes.

Lilly started to notice her skin become discoloured where she had the procedure. It soon became apparent that some filler was injected into the blood vessel causing a vascular occlusion.

This is a very serious complication. Having dermal fillers injected anywhere in the face/body can ultimately lead to skin necrosis if not corrected.

A UCLA filler response team saw Lilly in time. She had the reversal agent – hyaluronidase injected into the area – and eventually made a full recovery.

Dentists and facial aesthetics

The benefits of these influencers taking their stories to Instagram isn’t to ‘scaremonger’. Instead it can actually help raise awareness and aid professionals to discuss examples of the risks of having these treatments. As well as what we can do to reduce these risks.

Injectables and non-surgical facial rejuvenation packages have become increasingly popular in the last five to seven years.

One reason is the fact that patients deem them ‘low risk’ and ‘little or no downtime’, which is often true; however, there is also a blurred line. Patients don’t necessarily understand the level of risk is only low if administrated by a trained medical professional.

The industry of dermal fillers is still highly unregulated in the UK. I feel patients need better information into the quality of filler they are getting, whether or not their injector has the reversal agent in stock/knows how to use it, and also the ability of their injector to know how to manage a complication such as a vascular occlusion.

Dentists spend five years training in the head and neck region. As well as injecting local anaesthetic intraorally. We are pretty well equipped to start on a facial aesthetics journey.

After going on appropriate courses and training modules, we can make great injectors. However, as with any procedure, informed consent as well as discussing all possible risks with a patient is key.


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