Despite the overwhelming rise in popularity of aesthetic injectables, legislation and regulation of the aesthetics industry has not kept pace. This has led to botched dermal filler treatments going viral on social media and to a growing demand from practitioners and the media for greater government oversight of aesthetic injectables practice. In 2019, an All-Party Parliamentary Group (APPG) on Beauty, Aesthetics and Wellbeing was formed and in July 2021 they published their concluding report. This featured a number of recommendations for legislative action and regulatory oversight, including a call to reclassify dermal filler as a prescription-only medication.
Current Dermal Filler Classification
At the moment, Botulinum Neurotoxin is a prescription-only medication, only available from a trained prescriber after a face-to-face consultation with clients to ensure treatment suitability. In contrast, Dermal Fillers are currently classed as a medical device and are freely available for purchase and use by non-medics, with no need for a prescriber to assess clients beforehand.
This lack of medical oversight is a point of concern not only the APPG, but for voluntary bodies within the aesthetics industry including the Joint Council for Cosmetic Practitioners and the British Association of Beauty Therapy & Cosmetology; who have highlighted that “risks of fillers are significant and arguably even greater than those posed by botulinum”.
These risks have been on full display across the media over recent years. Leah Morton, a 26 year old woman from Liverpool, was left at risk of losing her nose after a practitioner caused and then failed to recognise a vascular occlusion during a non-surgical rhinoplasty. Dr Tijion Esho, an experienced aesthetic practitioner and medical professional, shared a clip that showed him treating lip cysts caused by superficial filler placement. Meiska Mamajeski, a 53 year old woman from Leeds was blinded in one eye when her practitioner injected directly into her eye rather than the skin around the eye in 2015.
Dermal fillers must be performed under the oversight of a prescriber who has gained the accredited qualifications to prescribe, supervise and provide remedial medicines if necessary.All-Party Parliamentary Group on Beauty, Aesthetics and Wellbeing
The APPG has recommended that dermal filler be reclassified from Medical Device to a Prescription Only Medication, with the view that this would “remove a significant danger to the general public.” It would make it necessary for all dermal filler providers to ensure that their clients are seen and assessed by a medical prescriber before treatment, helping to ensure that clients are suitable for treatment and that medication such as hyaluronidase can be quickly accessed should the procedure go wrong. This would allow for rapid treatment of vascular occlusions, should the practitioner have the skill to recognise and treat this complication.
MATA was established with the aim of standardising training in aesthetic injectables within the UK Aesthetics Industry, and as such we welcome greater legislation and regulation. Making dermal fillers prescription-only would be a positive step in the direction of establishing a properly monitored aesthetics industry.
Still, we must highlight that medical and aesthetic professionals have been seeking greater oversight of aesthetic injectables for years. Sir Bruce Keogh noted in his 2013 report that “dermal fillers are a crisis waiting to happen” and suggested that they be made prescription-only; yet almost a decade later, fillers are still freely available and the aesthetic industry is still under-regulated.
It remains to be seen whether the UK Government will work with the MHRA and Manufacturers to reclassify dermal fillers as prescription only. For now, we will continue to train our delegates to a high standard in both the theory and practice of aesthetic injectables through our Level 7 Diploma in Facial Aesthetics, ensuring that they enter practice with the skills they need to recognise and manage complications. We are also committed to supporting the activity of voluntary bodies in the aesthetics industry in their work to regulate and monitor our industry.