Tariq Drabu Dentist Affairs Around Cosmetic Practice

The time has come for better and effective regulation of non surgical cosmetic treatments such as Botox and dermal fillers. This follows the publication of a report published on 24 April by the Department of Health in England. The report is entitled the "Review of the Regulation of Cosmetic Interventions". The Department of Health reporting group was asked to review regulation in the cosmetic interventions sector following the PIP breast implant scandal which revealed serious lapses in product quality, after care and record keeping. I was astounded to read that the report also draws attention to widespread use of misleading advertising, inappropriate marketing and unsafe practices right across the sector. The report points highlights that cosmetic interventions are a booming business in the UK, worth £2.3 billion in 2010, and estimated to rise to £3.6 billion by 2015. They can either be surgical – such as face-lifts, tummy tucks and breast implants – or non-surgical – typically dermal fillers, Botox or the use of laser or intense pulsed light (IPL). These latter account for nine out of ten procedures and 75% of the market value.

The report authors were surprised to discover that non-surgical interventions, which can have major and irreversible adverse impacts on health and wellbeing, are almost entirely unregulated. The report highlights that a person having a non-surgical cosmetic intervention has no more protection and redress than someone buying a ballpoint pen or a toothbrush. This type of finding points to an industry that is out of control with no regulatory input where everybody and anybody with minimal training can set themselves up to provide services. The industry is glamourised by the media who fail to discriminate between legitimately trained and ethical practitioners with a scientific background and operators who are just cashing in.

As a concerned, responsible and ethical practitioner I support the key recommendations of the report namely:

• The scope of the EU Medical Devices Directive should be extended to include all cosmetic implants including dermal fillers, UK legislation should be introduced to enact the changes sooner. Legislation should be introduced to classify fillers as a prescription-only medical device.
• All those performing cosmetic interventions must be registered.
• The Health Education England’s (HEE’s) mandate should include the development of appropriate accredited qualifications for providers of non-surgical interventions and it should determine accreditation requirements for the various professional groups. This work should be completed in 2013.
• Surgical providers should provide both the person undergoing a procedure and their GP with proper records.
• A breast implant registry should be established within the next 12 months and extended to other cosmetic devices as soon as possible, to provide better monitoring of patient outcomes and device safety.

Regrettably for some people nonsurgical cosmetic treatment is not seen as a medical procedure. This has led to events such as Botox parties where non-qualified non-trained members of the public can inject other members of the public with a drug and a chemical with no regulation, license or inspection. This is a situation that has to be stopped and cannot continue for safety of the public. This is not about cost and any arguments that are put forward to advance that are missing the point. This is simply about public safety.

We have looked at the regulation of these procedures. If you are working in an unregulated environment where you do not have to worry about hygiene, safety, inspections and regulations you will be able to provide this procedure at a cheap cost. There are no issues of training or continuing professional development or education involved. In this way you are putting your health at risk and those people who administer these treatments they are a danger to the public and must be stopped. I am not saying that doctors and dentists provide these treatments cheaper. However at least you know that you will be treated in a safe, clean, hygienic environment to the highest standards by a professional whose job is to put your safety above all else. I continue to support the position that only trained doctors, dentists and nurses should provide nonsurgical cosmetic treatments.

I and my team at Langley Dental Practice, Middleton, Manchester have been offering treatments such wrinkle smoothing and dermal fillers for almost 10 years with excellent results. We also offer tooth whitening administered by UK trained and qualified dentists from only £199. Currently non-surgical procedures such as laser treatments or injectables can be administered by people with no healthcare qualifications whatsoever. I was quite astounded when I read that you do not need to be medically trained to administer these types of procedure. Regulation of these procedures is important and I hope that the government will act swiftly and decisively.