'Filler' injections can cause permanent damage, say doctors

The world's leading cosmetic surgeons claim thousands of people face permanent damage from new facial "filler" injections. They warn the risks faced by people having such treatments in the UK have also increased because of government failure to regulate "cowboys".

Douglas McGeorge, consultant plastic surgeon and president of the British Association of Aesthetic Plastic Surgeons, said: "The public needs to be realistic about the outcomes it can expect from new cosmetic treatments, at least until solid clinical evidence of their efficacy exists."

He added that failure to bring in statutory regulation of people offering such treatments would lead to serious health problems in the future. "To foster a 'wild west' approach [of industry self-regulation] is not only an affront to reputable professionals who follow the rules, but ultimately creates an unsafe environment for the public," he said.

His warning was echoed by other plastic surgeons who are warning that long-term use could permanently damage skin.

Dr Daniel Marchac, an eminent French surgeon, said he and other surgeons share deep concerns about facial fillers. He said he had personally been consulted by at least 25 patients already with untreatable fibrous tissue and subcutaneous changes that he believes were caused by "abuse" of these injections – long-term use that he defines as twice a year for four years. Dr Marchac has asked 900 surgeons in Belgium, France and Switzerland for more evidence and he plans to report his findings later this month.

Dr Marchac believes the results of his survey could show that up to one in 20 of those who have had facial filler injections may suffer irreversible damage to the facial tissue.

There are two types of injection: one intended to be permanent and another to be absorbed into the skin, and then repeated after six months. Dr Marchac said both are potentially risky. "All of the permanent fillers are creating, from time to time, serious problems with bumps and deformities, and sometimes you have to operate. All serious plastic surgeons agree one should avoid permanent fillers," he said. "We will see in the future patients of 50 who have had 15 years of fillers with fibrous, tough tissue we wouldn't be able to do anything with. The serious things are the permanent fillers, and the second is abuse of resolvable fillers."

His concerns echoed those of Dr Sherrell J Aston, surgeon director and chairman of plastic surgery at New York's Manhattan Eye, Ear and Throat Hospital.

"Botox is OK, but I have concerns about the other fillers," he said. "My concern is that as time goes on with these foreign materials placed in the face, there are going to be quite significant problems. I am really concerned that in 15 years we will see a lot of people with lumps and bumps and no good way to treat it."