The Press 14th January 2004

Face the facts

Instant beauty, or an unacceptable health risk? STEPHEN LEWIS faces up to a few facts about Botox and collagen treatments.

WE LIVE in the age of the instant fix and beauty on demand. Quick and easy cosmetic treatments are readily available, with clinics, salons and even your local gym promising to smooth out wrinkles or plump up lips.

Many women these days seem to treat going out for a quick botox treatment as lightly as they would once have regarded popping out for a lunchtime manicure.

But should we really be treating our bodies so casually?

A hard-hitting report from Which magazine this week reveals many popular clinics offering “lunch hour” cosmetic procedures are making exaggerated claims about their treatments – and failing to explain fully the risks to patients.

Undercover investigators from Which? magazine visited clinics in London and Manchester posing as patients wanting procedures such as Botox injections to remove facial lines, laser treatment and chemical peels.

Their consultations were recorded and assessed by an expert panel – which felt that only five of the 16 consultations were “good”.

The panel concluded half of the consultations, where practitioners were expected to explain the possible risks and side effects of any treatment, were “poor”.

Which? editor Malcolm Coles said the magazine’s research uncovered a “worrying lack of safety checks” and showed providers were glossing over risks.

“Inadequate and inappropriately performed cosmetic treatments can lead to facial scarring, blistering or a trout pout,” he pointed out. Lesley Ash could no doubt tell you all about that.

So just how much of a risk is there?

Maxine Hill, co-owner of manicure salon NailBarOne in York, swears by Botox.

The 37-year-old says she has been having treatments for more than two years now, up to twice a year.

Her salon used to offer collagen and Botox treatments provided by Doncaster-based Collagenics, which operates in something like 120 clinics nationwide.

NailBarOne still offers a cream treatment, relaxaderm, but no longer offers the injections. That is because the salon “wasn’t the right environment” for such treatments, rather than because of any doubts about them, says Maxine.

Maxine, who now travels to Doncaster for her regular injection treatments with Collagenics, says the results are brilliant. “I would recommend it to anybody. Overnight you look ten years younger.”

Others, however, are not so keen.

York GP Dr Sarah Bottom says she does not know a great deal about either collagen or Botox treatments. “But I wouldn’t have it done, and I would discourage people, I really would,” she says. “I don’t think we know enough about it.”

At the very least, she says, if you are considering having such a treatment, you ought to expect a proper consultation first, and ask for information about the practitioner’s success and failure rates, the complications experienced and how often.

“It’s not the kind of thing you should just pop out for on the spur of the moment over lunchtime.”

She says if you are really serious about it you should think about paying a bit more and see a consultant plastic surgeon.

Julie Clarke, who runs Julie Clarke Health and Beauty at The Mount Royale Hotel in York, also has reservations. She did offer the treatments at her clinic briefly, she says, but then stopped. “I didn’t like them at all,” she reveals.

Botox, she points out, is a toxin – even though the amounts used are tiny. She also worries that some people having the treatments won’t benefit from them and are just wasting their money when they could be considering alternatives.

She swears by microcurrent treatments – tiny electric charges – to smooth out the face, or else Vitamin A creams.

So what do the experts say?

Consultant plastic surgeon Waseem Saeed offers both collagen and Botox treatments at the BUPA Hospital in Leeds.

He says the most important thing for anyone considering such a treatment is that they have a full consultation first – and that they go to someone who is properly qualified to administer them.

“You should not undergo any procedure without having a consultation with a person who is appropriately trained,” he says.

“That consultation involves a medical history, examination of the patient, and a discussion about what they are trying to achieve. It is good if a patient can have some time to think about the information they have been given. Often, they may have questions arising from the discussion they only think about a couple of days later.”

It is important, too, that prospective patients are made aware of the limitations of their chosen treatment, he says.

“The patient should be aware of other options available so they are not wasting money on treatment that is not going to work.”

Once they have had a full consultation, and a chance to think things over, the procedure itself can be quite quick, he agrees. “But that is after a consultation.”

Any responsible practitioner must point out the possible side-effects of treatment, says Mr Saeed. They will depend on the treatment.

Botox (the brand name for a form of botulism toxin) is injected into facial muscles, usually frown lines and crow’sfeet, where it blocks nerve impulses, thus paralysing and relaxing the muscles.

If the practitioner doesn’t know what he or she is doing, says Mr Saeed, the Botox can “drift into muscles that you are not trying to reach.” That can leave you with a drooping eyelid or, in the most extreme cases (though this is extremely rare) problems with closing your eye. These effects should wear off after ten to 14 days.

“Filler” treatments such as collagen or restylane – a clear, non-animal gel – are injected into lines and wrinkles to “fill them out” and “plump them up”.

Here, the possible side effects are different – bruising, swelling, skin irritation and even lumpiness. These can usually be quite easily managed, says Mr Saeed – but they are not what you want if you have gone for a treatment to make you look better.

Stephanie McGrath, managing director of Collagenics Ltd, which provides collagen and Botox treatments at about 120 clinics around the country, agrees with Mr Saeed that all such treatments should be provided only by fully qualified medical professionals – either doctors or nurses – and that patients should be given a comprehensive consultation first.

She says she welcomed the Which? report because it highlighted a genuine problem.

“There are many people out there, whom I would call lone practitioners, who have not really prepared themselves properly,” she says.

This makes it all the more important that you should do your own homework first.

The BUPA hospital in Leeds can be contacted on 0113 269 3939. Collagenics Ltd, which is hoping to set up a new franchise in York soon, can be contacted on 0845 3303077.


What it does: Botox is the brand name for a form of botulism toxin used to smooth out fine lines and wrinkles

How it works: It is injected into the facial muscles, usually frown lines and crow’s feet, blocking nerve impulses and so paralysing and relaxing muscles

How long does it last?: It takes effect after three to seven days, and lasts three to six months.

The risks: Possible side effects can include soreness, bruising, headaches, or temporary drooping of the eyebrow. In extremely rare cases there can be problems closing the eye. If they occur, these side effects generally disappear after ten to 14 days.

Who should provide treatment?: Despite its popularity in the beauty treatment world, says the Which? report, Botox is a prescription-only. The injection should be performed only by well-trained doctors, or nurses under a doctor’s supervision.

Cost: Between £175 to £300 a treatment.

Filler treatments

What it does: Fills out and plumps up lines and wrinkles.

How it works: There are different types of filler, such as collagen or restylane. The substance is usually injected into several points near the edge of the area being treated.

How long does it last?: Usually between four and nine months.

The risks: Possible side effects include blistering, soreness, lumpiness and allergic reactions such as rashes.

Who should provide treatment?: Doctors and nurses.

Cost: from about £150 up to £750 a treatment, depending on the amount of filler used.