Doctors in the United Arab Emirates say residents are potentially putting their lives at risk by “cutting corners” opting for cut-price cosmetic procedures such as fillers carried out by unlicensed ‘back street’ practitioners.
Botched procedures can lead to gangrene, blindness and even death while fake injectables can cause potential catastrophic side-effects. Yet, licensed plastic surgeons are constantly being asked to fix fillers gone wrong, doctors across the country have told Al Arabiya English.

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A macro shot of syringe with needle. (Unsplash, Raghavendra Konkathi)

“People are getting into trouble with the use of non-approved permanent fillers,” said Dr Andrew Ordon, a consultant plastic surgeon at Tajmeel Royal Clinic, Dubai. “What is alarming is that women unknowingly get these illegal fillers made of silicon and plastic polymers in the form of oils and gels.”

“These procedures are being done at homes, hotels and other non-medical facilities.”

Injectables, as the name implies, are used to fill an area, a crease, a wrinkle or a fold or add volume to a certain area like over the cheeks where people age, said Dr Ordon.

“There is no approved permanent medical filler other than one’s own body fat, which is taken from the patient's body and injected as a filler into the breasts, buttocks, and other parts. This procedure can only be done by a plastic surgeon who harvests the fat through liposuction, purifies it and injects it into the body.”

“There are many approved medical fillers, primarily hyaluronic acid products like Juvederm, Restylane, etc. These are the most commonly used fillers but they are not permanent ones. They are safe in the hands of a board-certified plastic surgeon or a dermatologist.”

‘Don’t cut corners’

Dr Ordon said there are no safe permanent fillers.

“Anyone who is not a licensed professional should not be using these fillers,” he warned. “I’ve personally seen the disaster from these fillers. There are cases where people have lost limbs or died from using injections of these illegal fillers.”

“There is no way to remove them from the body and they can become chronically infected and lead to septic shock. There's no way to 100 per cent remove these so-called fillers from the body and it becomes a chronic problem that lasts forever. They may require multiple procedures.”

“Patients must realize that there should be no cutting corners in plastic surgery.”
“Your life and body are at stake. Do the right thing. Use only approved, medical-grade fillers and injectables in the hands of board-certified plastic surgeons and dermatologists.”
Dr Mona Ragab Mohamed el-Meligy, a specialist in dermatology at Tajmeel Royal Clinic, Dubai, said fillers are relatively safe and effective – if in the right hands.
“Filler can be very risky if the injector doesn’t have the experience required or if the products are not trustworthy. Improper injection can lead to side effects. If the products are not original, they can induce allergic reactions, infections, or trauma and death of the skin cells.”

A stock image of a woman getting cosmetic botox injection in her forehead. (File photo)

Vasilica Baltateanu of Vasilica Aesthetics, told Al Arabiya English that, in her experience as a clinic manager, she can recall a few cases of 'permanent fillers' that have led to side effects like chronic infections and migration.”

“One patient had such a filler injected in her face. A part of it was removed through a facelift, and she had to take ongoing steroid injections for the remaining. If the filler is embedded with the nerves, the surgeon cannot touch it.”

“Another patient had the filler injected in the butt area, but it migrated to the pubic area and got infected. The biggest part of it was removed through liposuction. This patient was lucky, and she had no further problems. Another patient had the filler injected in the labia majora and needed multiple surgeries.”

“Most of the patients that I encountered and had these fillers, were unaware of the serious side effects. The answer most of the time was ‘my friend did it” and ‘I liked the initial result, so I did it too’. Problems can appear months later, not straight away.”

All these patients, she said, chose to have the procedure at home with an unlicensed cosmetologist and “most probably, just because a friend did it”.

“I would urge all patients interested in fillers to remember that there is no such thing as safe permanent filler, and it is better to use products and practitioners that are licensed by the Dubai Health Authority.”

Dr Mahmoud Soliman, a specialist plastic cosmetic and reconstructive surgeon at Dubai’s Saudi German Hospital, told Al Arabiya English as cosmetic procedures have become so common, the concern now is that those undergoing the procedures “do not adequately appreciate the risks associated with having fillers from an unregulated provider”.

“Women are risking permanent disfigurement and, in some cases, blindness by having unlicensed facial filler injections,” adding that almost a quarter of his work now involves repairing “botched” jobs done by hairdressers and beauticians.

“A lot of people do not realize that filler injections can cause serious problems if injected into the wrong place – for example, blood vessels.”

“These problems can include swelling, pain, hard lumps beneath the skin and, in severe cases, loss of vision and strokes when fillers are injected into the retinal artery. Problems can also occur if fillers are injected into blood vessels or too much filler is injected around blood vessels so that they compress. This can stop the blood supply to the tissue which causes necrosis (the death of the cells).”

‘Devastating consequences’

The doctor said many non-invasive cosmetic treatments are not regulated and, if treatments are carried out incorrectly, they can have “devastating consequences”.

“This is particularly distressing for patients who have had treatment on their face, where the side effects cannot be so easily covered up,” he said. “So all customers that are seeking for filler injection and cosmetic procedures should search first for well-known licensed center with professional specialists so that they can ensure safety before any cosmetic procedure as at the end our safety is priority all the time.”

Dr. Iman Itani, of Dubai’s Lueur Aesthetic Clinic, also warned over unlicensed practitioners carrying out non-surgical procedures such as fillers.

“If the filler has been placed incorrectly or excessively, over-filling will affect the face contour and its appearance,” said the doctor, warning, if done wrong, injections can cause “local tissue necrosis, embolization of blood vessels, infection, blindness and stroke.”

He added: “It is very important to find the right doctor to do the dermal filler injection because he can handle needles safely, understand the intricate anatomy of the face, assess a person’s health and indicate he is suitable for this type of aesthetic procedure or not.”

“In addition to that the experienced doctor understand the benefits and the side effects and even the potential risks.”

Dr Itani said the structure of the face is made up of four major components: skin, fat, muscle, and bone.

The loss of volume in these substances contributes to symptoms of aging, such as wrinkles, smile lines, and changes in the size of the cheeks and lips.

As the elasticity of the skin decreases and the contraction of the facial muscle’sincreases, the skin becomes sagging.

Dermal fillers are a medical procedure which can help diminish these wrinkles, restore lost volume, and give a younger appearance.

There are different type of FDA-approved fillers made of different substances, such as Hyaluronic Acid, Calcium Hydroxylapatite, Poly-L-lactic Acid, and others. Each product has a certain texture, density, properties, and injection depth for a certain area.

“The dermal filler, if done by inexperienced doctor, or if a low-quality product is used or if done at an unauthorized place, might lead to dangerous side effects such infection specially if it’s done in a non-sterile way,” said Dr Itani.

Before starting face filler treatment, the doctor advises patients to first work on strengthening and improving the skin quality, by doing several combined treatment sessions, that induce collagen and elastin production and helps tighten the skin.

This, he said, can include micro-needling, laser, and other rejuvenation treatments.

“Do that for the best and better result as the skin plays a big role in facial attractiveness and (it) minimizes the dermal filler injections to the necessarily dose.”

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