Australians at risk of chronic infections from cosmetic injection contamination

 abc.net.au  9/16/2017 8:15:22 PM   the National Reporting Team's Rebecca Armitage

Updated September 17, 2017 06:32:57

Last year, Leila decided to try a new cosmetic procedure known as the vampire facial.

Key points:

  • Poor sanitation during cosmetic injections can result in infections, skin necrosis and blindness
  • Experts are calling for an online filler 'passport' to keep track of cosmetic injections

Her Sydney-based cosmetic surgeon promised the platelet rich plasma injections — made popular by Kim Kardashian — would rejuvenate her skin and make her look younger.

Her blood was drawn, then treated to separate the platelets, which were injected back into her face.

But several weeks after the procedure, Leila woke up with sore pink spots on her left cheek.

"The spots got bigger and my face started swelling, so I went to the GP. He told me I had to go straight to the emergency room, because the infection was so close to my eyes and my brain," she said.

Leila (not her real name) was given a course of antibiotics, and she underwent surgery to drain the infection from her face.

"It was a severe infection. And it was scary because my face became infected again and again. The doctors couldn't control it. I had to have three draining surgeries done in three months to get rid of it," Leila said.

In the past few months, Leila has undergone multiple fat transfer procedures, a face lift and laser treatments to reconstruct her face.

"I look about 95 per cent like my old self," she said.

Melissa from Canberra endured a decade of infection after a doctor talked her into getting cosmetic fillers in the lines around her mouth.

"Three months later, I had these long straw-like lumps running under the skin from my nose to my mouth. I went back to the doctor, and he was so unhelpful," she said.

The doctor said he could remove the lumps, but it would probably leave scarring on her face, so Melissa decided to live with it for 10 years.

In 2013, she finally found a surgeon who told her the dermal filler she had received was notorious for infections and complications.

"I'm just so ashamed of myself for not questioning the doctor about complications at the time. I had just broken up with my partner, and I was probably a bit emotional, and I just didn't think," Melissa said.

'At first the injections look good, but then nodules appear'

Australians spend roughly $1 billion a year on non-invasive cosmetic procedures, according to the Cosmetic Physicians College of Australasia (CPCA).

The industry is so lucrative that some Australian dentists are offering cosmetic injections.

But as the industry grows, so does the number of people getting bacterial infections.

Many end up in the office of Professor Anand Deva, the head of Plastic and Reconstructive Surgery at Macquarie University's MQ Health in Sydney.

"It takes a few years for some of these problems and complications to start to occur. At first the injections look good, but then nodules start to appear. They look awful. You can't hide them," Professor Deva said.

Professor Deva said many people are unaware that injections are performed in a dangerously unregulated industry.

The Australian Medical Board has ruled that only a doctor can prescribe cosmetic injections, and they must consult with a patient beforehand.

But these consultations can occur over Skype and the injections can be made by a nurse under the doctor's supervision.

"There are these nurse-run clinics opening up in shopping malls, where there is never a doctor on site. They are simply rubber-stamping procedures over Skype. I really believe that is wrong," said Dr Mary Dingley, a cosmetic practitioner and CPCA fellow.

Professor Deva and his colleagues at MQ Health have analysed how easily bacteria can thrive under the skin when cosmetic injections are performed with poor infection controls.

"Once these bacteria gain access, they just grumble away, they grow, they invite their friends, they multiply and then after a period of time, the body starts to react to this infection and then you have a big problem," he said.

Some cosmetic injectors will push the same needle through the skin multiple times, increasing the risk of infection by a factor of 10,000.

"It's very difficult to treat. Because the fillers spread across the tissue, you might flare up the infection in one section, and you can get rid of that bit. But then it comes back in another spot and you're always chasing your tail," he said.

Professor Deva's research found that chronic infection following cosmetic injections could be occurring in almost one-fifth of patients in Australia.

Calls for filler 'passport' to track cosmetic injections

Professor Deva is seeking industry funding for a secure online database which records exactly what, with whom and where a patient's fillers were placed.

"It's the first step to actually finding out what's happening in the industry. Because right now, we've got no idea," he said.

Dr Dingley from the CPCA likes the idea of a passport, but says it would not cover illicit injectors who are operating in back rooms and garages.

"They would not be party to this sort of thing and could not be compelled to do so," she said.

"It wouldn't really capture the people who are creating most of the issues, which is those people who are doing it off the grid."

However, Professor Deva believes the passport is a good start.

"Is it easy to enforce a level of transparency and standards and quality across an industry that has never really had to? No, it's not. But we have to do it. Because the consequence of not doing it could be lethal," he said.

Topics: health, womens-health, doctors-and-medical-professionals, diseases-and-disorders, australia

First posted September 17, 2017 06:15:22

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