According to Daniel Marchac, MD, patients who get "filler" injections may end up with irreversible damage to facial tissue. His alert follows warnings from British experts who have criticized ministers for not regulating the industry. They say the Government is doing nothing to stamp out "cowboys" offering filler injectables.

Marchac says that he has been consulted by 25 patients with irreversible damage to their subcutaneous tissue—the layer of fat underneath their skin—and their fibrous connective tissue. He says that they were victims of "abuse" of jabs by practitioners who injected too much filler.

"All of the permanent fillers are creating, from time to time, serious problems with bumps and deformities, and sometimes you have to operate," says Marchac.

Sherrell Aston, MD, chairman of plastic surgery at Manhattan Eye, Ear and Throat Hospital, in New York, says that botulinum toxin Type A is OK, but she has concerns about other fillers.

"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," says Aston.

Two months ago, the British Association of Aesthetic Plastic Surgeons warned that women were at risk from cowboy aesthetic practices.

President Douglas McGeorge says the beauty industry is full of aestheticians with little or no training handing out treatments that can go wrong.

"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," says McGeorge.

He says Britain is storing up future health problems if it does not bring in statutory regulation.

"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 says.

[www.dailymail.co.uk, November 5, 2007]