Cosmetic treatments are in demand: people go for flawless skins and full lips. The “ideal images” on social media. These include lip filling with a hyaluronic pen or plasma energy treatment to tighten the skin. Treatments with these and other devices, however, are surgical treatments that should only be performed by cosmetic physicians who are qualified and skilled for this purpose. After all, this technique can cause damage to the skin and this takes time to repair.

From our survey in collaboration with the Dutch Association for Cosmetic Medicine(NVCG), 71 percent of participants (55 of 77 participating physicians) indicated that they knew of a patient who had experiences with a complication following cosmetic treatment with medical devices by non-authorized persons.

It also shows that of the 55 cosmetic doctors who see patients with complications passing, 95 percent indicated that the treatment that led to the complication was performed by a cosmetologist. Among these doctors alone, more than 400 cases are involved. 33 percent of doctors have experience (in addition) with complications that have occurred after someone has undergone cosmetic treatment at a dentist’s office. Also, 13 percent indicated that treatments were performed by a(BIG-registered) physician, who also has the competence to use these specific devices.

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Easily available online

On websites such as AliExpress and Marketplace, the devices to perform cosmetic procedures are plentiful. Anyone can purchase these with ease. Prices range widely from 10 to 200 euros. ‘The cosmetic surgery market is a tremendously growing market. When you don’t have guidelines, some people just do whatever. That’s dangerous! We should come up with something that would prevent that equipment from being sold and purchased by everyone. Just like medication. You need a recipe for that, too. Based on current legislation, there is nothing we can do about this,” said Catharina Meijer, cosmetic physician and president of the Dutch Society for Cosmetic Medicine.

Hyaluronic pen

The hyaluronic pen is another way to enlarge your lips instead of an injection of a filler. The pen squeezes hyaluronic acid into the skin at a speed of about 800 km per hour. For 100 to 150 euros thicker lips. In clinic, a filler treatment easily costs 300 to 500 euros. Hyaluronic acid is a soluble body substance that keeps the skin supple and elastic. With age, the substance decreases and the skin slackens. The result is wrinkles. The effect of a hyaluronic acid filler is said to last between 3 to 15 months. “You insert the hyaluronic acid under the skin, and because you insert the acid into the skin you get a slight irritation reaction, which also causes the lips to swell.

Not knowing what to do if treatment goes wrong

Sietske of the online platform wiemooiwilzijn sees past the cases where things go wrong. ‘Devices like a hyaluronic pen can be dangerous. Even if a doctor uses the device, all sorts of things can still go wrong. But as a licensed and skilled cosmetic doctor, you have the ability to correct and notice a complication, should one occur. And unauthorized people cannot. A hyaluronic pen is a device where you have to be accurate and is not really suitable for cosmetic treatments on the face.’

Major concerns

The Dutch Cosmetic Medicine Association (NVCG) is very concerned about the use of medical techniques and medical equipment by unauthorized people. ‘Unauthorized persons, including beauticians, may not perform medical procedures. Inserting a filler with compressed air as with the hyaluronic pen or whether it is done with a needle: it is still injecting. Under the BIG Act, only doctors are authorized to perform this type of treatment,” Meijer says.

Competent and competent?

A doctor is always registered in the BIG register. ‘In this registry, you can see if a doctor is licensed. You have to be a doctor to do medical operations. To determine whether a physician is competent, education and experience are considered. ‘Ideally, the NVCG would like to see a separate registry created in the Netherlands where you can see exactly what operations a doctor is skilled in,’ Meijer says. As of July 1, 2019, cosmetic physician KNMG is a protected title. You must be officially competent. On Nov. 12, the Cosmetic Care Quality Framework was issued. This states what is meant by good cosmetic care and the competency requirements for performing cosmetic procedures, including injecting botox and fillers. Joba van den Berg, Member of Parliament (CDA): ‘Doctors may understand what is being said, but consumers know far too little about what to expect where and who is or is not qualified and competent. More oversight is essential.

Hotline

The NVCG has set up a hotline for those duped by cosmetic treatments. ‘It is important to report a complication performed by unauthorized persons. Did it happen to you or someone close to you? Then report that. Ultimately, this allows us to report to the government how many reports are involved,” Meijer says.

Joba van den Berg: “When a patient comes to a cosmetic doctor to “fix” what has gone wrong, it is necessary for the doctor who sees the complication to report it. You can do that at the Health and Human Services Inspectorate.

Age limit

Joba van den Berg feels there is not enough enforcement. ‘People need to be much more aware of what treatment they choose and where they want to have this treatment, young people do not know if someone is competent. Therefore, raise the age limit for such treatments to 21 and that a comprehensive education/awareness campaign be launched from the government.

Tips

Check if the practitioner is a cosmetic doctor. On the BIG register you can see if a doctor is licensed.
Inquire with the practitioner: Is the person also competent to perform the treatment? What is the experience and training of the doctor in question?
Do thorough research and take the time to determine where and by whom you will have treatment performed. Look online for reviews if necessary.
Don’t settle for scheduling treatment right away. Take the initiative to attend a preliminary interview/consultation prior to treatment to see who you are dealing with and if you are comfortable with it.