It is not uncommon for physicians to encounter patients, who suffer the ill effects of having injection treatments for “enhancement” purposes, using substances that may or may not have been represented to the patient as medical grade or drug regulatory approved “silicone”, “collagen” or “botox”. These patients receive injections for “breast augmentation”, “nose-lift”, “buttocks-lift”, or “anti-wrinkle” treatments and unwittingly, expose themselves to clinical complications.
In my own surgical practice I have seen women who have had “silicone” or “collagen” injections to the breast for augmentation purposes. It must be pointed out that this practice is ethically questionable, as it is not an accepted medical procedure. However, the lure of advertisements and the fact that the injection treatments are presented as “cheaper” alternatives, in combination with a person’s poor body image or a desire to physically enhance one’s self, are enough to attract clients for these procedures and potentially create undesirable sequelae.
These patients who’ve had breast injections usually present with one of two problems, or a combination of both. Infection is one presenting problem. There have been instances when these injected substances are non-medical grade and cause infections in the breast, requiring surgical drainage and debridement. The consequence of such a problem is oftentimes seen in the unfortunate patient’s eyes --- a sadness which is an indelible reflection of how their self-esteem has been diminished by both physical and emotional scarring, when an attempt at enhancement turns into disfigurement.
The other problem I have encountered is breast lumpiness, or the sensation of having multiple breast masses (occurring at the multiple puncture injection sites). These masses are usually felt by the patient herself and are clinically evident to the physician as well, upon a physical examination of the breast. The haunting question that this problem creates in the minds of these patients is, “Is this mass a cancer?” It is possible that in the presence of a lumpy breast due to these injections, a cancer growth can arise from the breast glandular tissue making it indistinguishable from the other lumps by physical examination alone. In this situation, unless a biopsy is done on each and every lump, the tool that will be useful to screen for cancer, is magnetic resonance imaging (MRI) --- an expensive diagnostic procedure. Thus, a patient who at the start was looking for a “bargain”, is later on saddled with an expensive proposition to do annual MRI screening for cancer surveillance, otherwise the specter of undetected cancer threateningly hangs over their heads.
Problems similar to those just cited occur not only in Manila but also in the United States. A recent press release by the American Society for Aesthetic Plastic Surgery (ASAPS) states that, “…four seriously ill people were hospitalized following injections of an unidentified substance at a Fort Lauderdale clinic and could be the latest victims of what has become an increasingly common problem --- illegal and unsafe drugs administered as cosmetic treatments by practitioners without appropriate training and credentials.” It states further, “Early in the investigation, reports had suggested a possible association with BOTOX, the popular wrinkle treatment that contains a very small, and proven safe, dose of botulinum toxin type A. However, later reports on the case have suggested that the individuals may have been injected with an unapproved substance, perhaps containing botulinum toxin or some other agent and caused symptoms similar to botulism.” Botulism, according to infectious disease experts, is a rare systemic illness that is contracted only by ingesting or being intravenously inoculated with living spores from the botulinum bacteria, and is potentially fatal.
According to statistics from the ASAPS, nearly 2.3 million BOTOX procedures were performed in 2003, making it the nation's most popular non-surgical procedure. "More than 15 years of experience with therapeutic applications of botulinum toxin type A to millions of patients worldwide, has never produced this type of response when used at the doses recommended in the product labeling and administered in clinical practice." says ASAPS President Dr. Peter Fodor, when asked to comment on the Fort Lauderdale case.
Dr. Fodor says further, “The popularity of injectable treatments including BOTOX and a host of soft tissue fillers, has encouraged their promotion by inadequately trained or non-medical practitioners, some of whom may obtain illegal substances and perform procedures under non-sterile conditions.” He says furthermore, “Unfortunately, patients sometimes are lured by promises of less expensive treatments, or they simply fail to check the qualifications of the person administering the treatments, unnecessarily risking their health and safety."
Clearly then, choosing to have “bargain” injection treatments without doing a background check on the qualifications of the person administering them, may not be the economical thing to do and may cost a patient additional expense, their health and even their lives. Beverly Hills 6750’s plastic surgeon, Dr. Francisco Manalo warns, “Patients these days have to be informed patients. They should do their homework when planning to undergo certain procedures. If they eventually decide to have a procedure done, they should be sure that they’re done in appropriate facilities by a properly qualified physician who has received specific training in the particular procedure.”
To do otherwise, would be putting your health, and maybe even your life, in jeopardy.