Queries about where to get botox or fillers are posted so often on social media groups. Why? Because any savvy consumer knows that its is the Wild West when it comes to this industry. It is largely unregulated. Which should worry you.
Top Tips for Cosmetic results: Choose a doctor, not a beautician. The expert qualifications you are looking for is IMC-registered doctor who is on the Specialist Register as a Plastic Surgeon or Dermatologist. Cosmetic/aesthetics is still not on the specialist register, which allows this grey area.
Top Tip for getting Botox for any other condition: See a consultant first (such as a neurologist for migraine). Let’s use just use migraine as an example: Botox can work for certain types of migraine BUT takes at least 2 sessions of multiple injections, it doesn’t work for all types of chronic headache and is usually considered third-line treatment (Means that while botox treatment is needed by some patients, there may be better, cheaper, or less invasive treatments out there that should be tried first and second.)
Just to note: I criticise the media coverage of health and medicine a great deal. I will note that @TheJournal.ie is consistently the most reliable medical and health news, and in Ireland, usually the best fact-checked. https://www.thejournal.ie/cosmetic-procedures-regulation-botox-fillers-5750880-May2022/
If you missed it, the HPRA recently released a warning about melotan: https://emdoc.ie/2022/06/28/ownyourtone/ ad
Read the Archived Discussion:
I originally wrote this as a 4 part series into medical tourism and cosmetic procedures in June 2019! It’s still relevant.
Aesthetic (Cosmetic) Surgery and procedures (including minor procedures, like Botox) in Ireland is not well-regulated, and this is a problem. There are practitioners advertising procedures that they are not properly trained to perform. Surgery abroad has its own risks. If you are considering an aesthetic/cosmetic procedure, you should do your research. Where to start?
Before we get started talking about common procedures, in part I, I want to highlight some industry facts that any savvy consumer should know:
1. This industry is almost completely unregulated. And this should frighten you. There is virtually no consumer protection.
2. Potential consequences of incorrectly done procedures such as dermal/lip fillers and lasering including blindness, permanent scarring/disfigurement, and sepsis.
3. The name “clinic” does not necessarily mean anyone in that facility is actually medically trained. Even in fancy scrub tops.
4. The advertising in this industry is completely unregulated in practice, and is often extremely misleading.
5. The Irish Medical Council does not recognise Aesthetic Surgeon or Cosmetic Surgeons. These are not specialties. These doctors may have general registration on IMC, but does not indicated any further recognised training. There is, unfortunately, no law against a doctor with no specialist training advertising himself or herself with these titles.
6. The safest choice for fillers, botox, dermabrasion, laser, etc. is always a Consultant Dermatologist or Consultant Plastic Surgeon, registered on the IMC on the specialist register.
Want to read more? I HIGHLY recommend: https://www.plasticsurgery.ie/patient-safety-requires-regulation-of-plastic-surgery-sector/
Part II: The query from a mammy that started the topic discussion in 2019:
“I wondered if you might consider a post about beauty treatments. I visited a beauticians in [County Meath] for a manicure, where they offer a range of procedures including fat massage, colonic irrigation, teeth whitening, ‘anti-wrinkle injections’ etc. Whilst I was there I overheard a discussion about not turning away customers no matter their circumstances or conditions, recommending colonics as a cure for IBS, and a few other things that made me concerned for the other people who might be going in there. For example I asked what the whitening agent in the tooth whitening procedure was and no one could tell me.”
Remember when I said that, as a doctor, I am a firm believer in mammy gut reactions or mother’s intuition? This is a good example. Your instincts were right to be hesitant about that salon. And that is key: if you are feeling unnerved by any beauty treatment or therapist, listen to your gut. Walk away. A properly qualified surgeon or dermatologist will encourage you to have a waiting/cooling down period after consultation as a matter of routine, and will NEVER pressure you for anything that you aren’t fully comfortable with.
I’d like to introduce here is a concept from the International Society of Aesthetic Plastic Surgery, (ISAPS): the “safety diamond” . To protect their patients, they promote that cosmetic procedures should only be offered to a suitable patient who has had their medical history (competently) reviewed, in an accredited/approved facility that can cope with a medical emergencies, and a suitably qualified doctor.
So, just small bites with trusted resources for further reading: what you should know just about the treatments you raised in that query:
Tooth whitening at a salon? Always, always go to a dentist, not a beautician! Why didn’t they tell you what is in it? They probably wouldn’t tell you because it is illegal for beauticians and salons to be using peroxide. Worse case? They actually had no idea what chemicals they were using. Read more: https://www.dentist.ie/_fileupload/Tooth%20whitening%20-%20final.pdf
Anti-wrinkle injections of all sorts should only be done by a qualified dermatologist or plastic surgeon. These are consultant doctors who are on the IMC specialist register. “Aesthetic doctors” or “cosmetic surgeons” do not have recognised training. The risk of permanent scarring and disfigurement here is real. More about risks of dermal filler? https://www.dentist.ie/_fileupload/Tooth%20whitening%20-%20final.pdf
Colonic Irrigation – It has no actual health benefits. Full stop. Laxatives are recommended if you are constipated. Constipation is unhealthy, and can lead to health problems. It is not recommended or necessary to wash it out with 60 litres of coffee or herbal water. If you are having chronic problems with constipation, your GP may recommend laxatives, a referral for a colonoscopy, or gastroenterology opinion. Advertisers claim colonic irrigation “detoxes” (it can’t; Anyone who says this has a complete lack of the most basic knowledge of human anatomy and physiology.) And as for curing everything from depression to migraine to PMS to irritable bowel…. No. It can’t.
It doesn’t. ( https://www.asai.ie/asai-code/health-and-beauty/ technically regulates this sort of advertising or promoting false treatments, but it just doesn’t seem to be enforced, really.)
If you choose to have it, you should ask alot of questions about hygiene and all equipment should be disposable. They should inform you that you could have complications of abdominal pain, cramping, bloating, diarrhoea, dizziness, nausea/vomiting, anal irritation and soreness. More severe side effects include: dehydration, serious electrolyte imbalances, infection!!!!, hole in your bowel. Some herbal additives to the irrigation fluid can damage the kidney, liver, or bone marrow.
Any place offering colonic irrigation should also advise you when you should definitely NOT have colonic irrigation: Anyone who has severe anaemia (“low blood”), uncontrolled high blood pressure, any disease that causes bowel inflammation, such as diverticulitis, Crohn’s disease or ulcerative colitis, anyone who has bowel or rectal cancer, anyone with anal fissures, painful haemorrhoids, or any cause of rectal bleeding, anyone with heart problems, kidney disease, liver disease, or who is pregnant.
As for fat massage? Doesn’t really work, but aside from discomfort, no serious risks.
Resources you can trust:
Choosing a Surgeon for cosmetic procedures. This was written by my colleague: https://www.fitzgeraldplasticsurgery.ie/about-fitzgerald-plastic-surgery/choosing-a-plastic-surgeon
Current Government regulations and guidelines: https://www.gov.ie/en/publication/97de69-patient-safety-and-advocacy-policy/#cosmetic-surgery