How cosmetic fillers can destroy your looks: They can turn skin blue and lumpy, leave you blind, and experts warn they could be a bigger scandal than faulty breast implants
Like most brides-to-be, Mary Catchpole, 41, wanted to look perfect in her wedding photos.
The mother-of-two had already lost 2.5 stone in preparation for her big day last year and thought a simple, non-invasive cosmetic procedure to plump up her face would make her look fresher and more youthful.
But the dermal filler injected into both her cheeks caused a devastating chain of physical reactions. Not only was her wedding ruined, but she has been left with serious nerve damage, blurred vision, insomnia, depression and a £10,000 bill for private medical care.
Marie Adams, left, as she usually appears, and right, as she looked after the filler surgery
Like thousands of British women, Mary believed dermal fillers to be a safe and affordable way to improve her looks. The procedure involves injecting a gel substance under the skin which plumps out grooves.
Although dermal fillers were developed to treat deformities, cosmetic surgeons quickly realised they could also enhance people's looks.
Now, fillers are as popular as breast enhancements. Along with Botox, they command a market in non- surgical cosmetic procedures worth £775 million, which is expected to grow by 8.4 per cent in the next year.
Restylane, the most popular filler, has been used in 16 million treatments worldwide since it was launched 16 years ago. Unlike Botox, which reduces wrinkles by paralysing muscles, fillers add volume to skin thinned by ageing, giving a fuller, more youthful effect. But while Botox is legally regulated, the law treats fillers as harmless.
Marie Adams, left, had filler injected before her wedding but it didn't have the results she was expecting
In the U.S., they're regarded as medicines and only six types are approved for use by professionals - on prescription only. In Britain, there are more than 100 types, which can all be injected without prescription by anyone, anywhere - whether they have specialist training or not.
Now a host of problems are emerging. Medical evidence shows they can cause health issues including blindness, facial collapse, herpes, rheumatic disease and blue-tinged flesh.
SURGERY
Two-thirds of women are so unhappy with their body they would undergo plastic surgery, a survey suggests.
Last month, a survey by the British Association of Aesthetic Plastic Surgeons (BAAPS) revealed that in the past year around seven in ten surgeons had seen patients complaining of complications from dermal fillers, and over the past three years the number of problems with some fillers has tripled.
A staggering 98 per cent said fillers should be treated as a medicine.
Mary, who had never had any cosmetic procedures before, had her filler injected early in August last year, a fortnight before her wedding to Christopher, 38.
'Botox didn't appeal to me - I didn't like the idea of having a toxin injected into my face,' she says.
'Dermal fillers sounded safer and more natural, as they're made from hyaluronic acid.'
Fillers can be divided into two main groups; temporary ones made from hyaluronic acid, which is eventually absorbed into the body, and more permanent ones made from other materials that can remain in the body for many years
Hyaluronic acid is found naturally in the human body and many temporary fillers use a synthetic form. Mary chose a reputable clinic near her home in Romford, Essex, and saved £600 for the procedure.
It was when a cosmetic doctor at the Court House Clinic in Brentwood injected filler into her forehead, crow's feet and nose-to-mouth lines that the first hint of trouble emerged.
'While injecting filler around my right eye, I understood he'd hit a vein with the needle and that the area would bruise,' Mary says.
FACT UP TO IT
43,069 cosmetic procedures weer done by The British Association of Plastic Surgeons last year
She wasn't too worried, until she woke that night in agony. 'My face was burning - it felt like someone had thrown acid over it,' she says. 'Over the next 48 hours I also developed flu-like symptoms, vomiting and diarrhoea, felt disorientated and developed redness on my cheeks and neck.'
Horrified, she returned to the clinic where, she says, she was told the problem was probably a very rare allergic inflammatory reaction. She was given a course of steroids and antibiotics, but the symptoms persisted.
Then, only a week before her £6,000 wedding ceremony, the vision in her right eye became blurred and she rushed to her GP. The doctor suggested it might subside by the time she had completed the course of antibiotics and steroids in five further days.
But nothing improved. 'My longed-for wedding day was overshadowed by the fact I was so ill,' she says. 'The night after, my sister had booked us into a hotel as a gift, but instead my husband had to take me to Chelmsford A&E because I couldn't see properly out of my right eye.'
In November last year, experts reported that a female patient went permanently blind in her left eye after having filler injected because it blocked an artery feeding the eye
Her GP referred her to a dedicated eye treatment centre at Whipps Cross Hospital in East London. 'The specialist said it was possible that the fillers could have got into my system via my bloodstream,' says Mary.
There followed two stays in hospital and regular visits to the GP because the symptoms got worse.
'The burning sensation to my face was intense, I had constant diarrhoea, felt drowsy all the time and had impaired vision in my right eye,' she says. 'Medics at University College Hospital, London, told me they thought it was all a result of my body trying to expel toxins.'
'They diagnosed facial nerve damage with the likely cause being the dermal fillers since there was no other explanation'
Mary paid to see a neurologist in London in February, who referred her as an NHS patient to the National Hospital for Neurology and Neurosurgery in London, where she spent three-and-a-half weeks having tests.
'They diagnosed facial nerve damage with the likely cause being the dermal fillers since there was no other explanation,' says Mary. The consultant neurologist's opinion was that some of the nerves in Mary's brain were desensitised by the trauma.
To date, Mary has spent almost £10,000 on private medical care. The Court House Clinic refuses to accept any blame. 'Had I been fully warned that these sort of side-effects can occur, there's no way I'd have gone ahead with the fillers,' she says now.
Marie, who had filler injections, said: 'All I'd wanted was a little confidence boost, but ended up with the opposite because I was too embarrassed to go out'
The Court House Clinic, however, believes it highly unlikely they are responsible for what happened to Mary. Dr Patrick Bowler, its medical director, says: 'Our medical directors and independent medical experts agree the patient's clinical symptoms are highly unlikely to be related to her treatment at the clinic.'
But he does call for tighter regulation of fillers and Mary's case has been reported to the Medicines and Healthcare products Regulatory Agency (MHRA).
Mary is trying to pursue a legal case against the clinic but such cases can be extremely difficult to judge because there is often no definitive medical evidence either way
The makers of the filler, Juvederm, also deny responsibility, but say: 'As with any medical procedure, there is always a risk of unwanted side-effects. Adverse effects with hyaluronic acid-based dermal fillers are normally short-lived and often relate to the injection procedure.'
Mary is trying to pursue a legal case against the clinic but such cases can be extremely difficult to judge because there is often no definitive medical evidence either way. It is scientifically reasonable to assume some people may have rare and unexpected allergic reactions to fillers through no one's clinical fault.
Doctors in Warwickshire once discovered that a transparent permanent filler gel injected into a woman's eyebrows a decade earlier had migrated across her head
All dermal fillers, no matter how carefully manufactured and administered, must inevitably carry some risk. 'All dermal fillers can induce serious and potentially long-lasting adverse effects,' says Dr Erin Gilbert, a professor of dermatology at the State University of New York.
Marie Adams, 34, is only too aware of the serious problems that can be caused by cheap injections from practitioners with questionable qualifications. A full-time mum to daughters Alice, 16 months, and Emma, 12, Marie went for the injections in her nose-to-mouth lines and top lip seven months ago.
'All dermal fillers can induce serious and potentially long-lasting adverse effects,' says Dr Erin Gilbert, a professor of dermatology at the State University of New York
'I'd seen other women who'd had great results,' says Marie, from Essex, whose partner Sean, 36, works in a fitness centre.
Marie booked in to a local beauty salon, where dermal fillers cost £150 a time. The salon assured her the practitioner was a nurse and 'very good', but two days after the injections her face was swollen and her lips lumpy. 'My nose to mouth lines were also uneven and one looked more puffed out than the other,' she says.
A fortnight later, Marie went for a check-up with the woman who administered the injections. But she failed to arrive. 'All I'd wanted was a little confidence boost, but ended up with the opposite because I was too embarrassed to go out,' she says.
Marie paid for Dr Mervyn Patterson, a qualified cosmetic doctor, to use more filler to even out her top lip and nose-to-mouth lines.
Pressure is increasing for tighter regulation so only properly qualified, trained and accredited professionals can administer the treatment and the fillers are properly tested
Far more serious complications have been recorded. In November last year, experts reported that a female patient went permanently blind in her left eye after having filler injected because it blocked an artery feeding the eye. Similar cases have also been reported, where injected filler has put pressure on blood vessels feeding the retina, starving it of oxygen, causing visual problems and blindness.
Doctors saw a woman complaining of a swelling on her forehead - the filler she'd had injected in her eyebrows a decade earlier had migrated across her head
Fillers can be divided into two main groups; temporary ones made from hyaluronic acid, which is eventually absorbed into the body, and more permanent ones made from other materials that can remain in the body for many years.
Temporary ones are less dangerous, but with most the effects last between three months and a year. Experts warn that all dermal fillers can induce serious and potentially long-lasting adverse effects.
Permanent filler can shift from its injection site to other parts of the body. Doctors at the University Hospital Coventry and Warwickshire NHS Trust described a case earlier this year where a woman was sent to them complaining of a swelling on her forehead.
Doctors discovered that a transparent permanent filler gel she'd had injected between her eyebrows a decade ago had migrated across her head.
Some patients can develop a chronic 'foreign body' reaction where the skin attempts to seal off the filler in a fibrous capsule causing lumps.
Stephen Hamilton, a London-based consultant plastic surgeon, has witnessed disfiguring damage caused by wrongly injected fillers.
Fillers can be divided into two main groups; temporary ones made from hyaluronic acid, which is eventually absorbed into the body, and more permanent ones made from other materials that can remain in the body for many years
'I have seen a 40-year-old woman patient who suddenly lost the skin between her eyebrows because an unqualified person had injected dermal filler into her frown lines, accidentally blocking an artery,' he says.
A less damaging, but still upsetting, result is the Tyndall Effect. It happens when temporary hyaluronic acid fillers, which reflect light on a particular spectrum, are injected too close to the surface of the skin, producing a translucent blue discolouration.
'Every kind of procedure intended to alter your appearance needs careful thinking about - it should not be something you do during lunchtime, or because you are lured by discounts'
Pressure is increasing for tighter regulation so only properly qualified, trained and accredited professionals can administer the treatment and the fillers are properly tested.
In January, Andrew Lansley, then Health Secretary, promised a review of the cosmetics industry and it was launched in August by Sir Bruce Keogh, the medical director of the NHS. The recommendations are expected in March.
'Every kind of procedure intended to alter your appearance needs careful thinking about - it should not be something you do during lunchtime, or because you are lured by discounts,' says Dr Alex Clarke, of Royal Free Hospital's department of plastic and reconstructive surgery.
Some experts are claiming fillers could cause a healthcare crisis bigger than the faulty PIP breast implants in 2010.
Yet, sadly for women like Mary and Marie, the call for regulation has come too late.
