Society’s cosmetic science obsession: aesthetic medicine and injectables

Do we really know what doctors are putting into our bodies? By Demi Ball

Cosmetic Medicine is a broad discipline involving surgical and non-surgical procedures to enhance aesthetic features on the face and body. As the technologies that address common cosmetic concerns are advancing, these procedures are providing temporary and long-term solutions to the signs of ageing and overall aesthetic appearance. While there are a range of medical grade procedures available, specific treatments are gaining popularity for their intended aesthetic outcomes, particularly Botox, dermal fillers, platelet-rich plasma and autologous fat transfer. Botox injections are a form of medical treatment used for the purpose of cosmetic enhancement. Widely used in the treatment of facial wrinkles, Botox works to inhibit the movement of repetitive expression that causes lines to form. Produced by the bacterium Clostridium botulinum, Botox is a neurotoxin (a substance that causes damage to neural tissue) and inhibits muscle movement in administered areas by blocking the release of the main neurotransmitter, acetylcholine. The concept of preventative Botox focuses on reducing the occurrence of repetitive facial movements that result in wrinkles over time. By preventing their formation through regular injections, lines will never be able to form (or to the degree they would with natural ageing) and therefore will not need to be intensively treated later on. Botox is also utilised in clinical practices, by neurologists and other medical specialists, to assist in the treatment of headaches, teeth grinding and hyperhidrosis (excessive sweating). Of the eight antigenic toxins present within the Clostridium botulinum bacterium, Type A is the most potent and the most widely used in medicine. Botox is only one of these substances, as neurotoxins Dysport and Xeomin are also used for similar purposes. Injecting dermal filler is another method used to plump and fill in lines or indentations in the skin. It is also used to shape the face, particularly when administered to the cheeks, jaw and temples. Many soft-tissue filler products contain substances such as collagen or hyaluronic acid, which is naturally produced in the body. While dermal fillers are becoming popular due to their ability to quickly smooth skin texture and enlarge the appearance of the lips, there are risks involved in the administration of filler. One of the most severe complications that can occur is necrosis (tissue death) and blindness if injected incorrectly. Necrosis is the accidental death of cells; it can be due to a lack of blood and oxygen supply caused by the obstruction or compression of vessels or tissue damage. According to the ‘Journal of Clinical and Aesthetic Dermatology,’ the incidence of necrosis by injection of collagen has been seen in 9 out of 100,000 reported cases. However, swelling and bruising at the injection site are common side effects of fillers and usually subside within a few days to weeks, or as informed by the injector. The vampire facial is another cosmetic procedure used for skin rejuvenation. Known as PRP (platelet-rich plasma), this treatment induces and accelerates the natural healing processes occurring in the body. Blood is drawn from a patient and spun in a centrifuge to extract the platelet-rich plasma. The liquid is injected or rubbed into specific areas of the skin to stimulate growth factors and promote healing, and therefore is able to address superficial concerns such as scarring, lines and volume loss. The procedure is often referred to as the vampire facial due to combining the PRP with micro-needling, a technique involving the injection of fine needles via a pen or stamp device to puncture the skin, producing micro wounds that induce collagen. Treatments that are targeted to enhance areas of the body can involve injecting substances into the skin to produce desired results. Autologous fat transfer (or fat grafting), is the relocation of fat from one area of the body to another. This procedure is mainly involved in reconstructive surgery, particularly breast enlargement, as an alternative to implants; there is no scarring, minimal downtime and the avoidance of placing foreign materials into the body. The removal of fat tissue from a specific area (often the thighs, buttocks or stomach) is done via liposuction, filtered and inserted into the breasts through a syringe. Over time the injected fat can be reabsorbed by the body and result in a loss of volume, although specialists may insert extra fat cells to account for this. While these medically-developed solutions are gaining popularity, due to society’s increased awareness of ageing, consulting with a trained medical practitioner is advised before undergoing any treatment protocols.

From Issue 19