How to avoid ‘cosmetic cowboys’ and find the right Botox practitioner
A guide by Dr Rekha Tailor
The popularity of Botox means that there are multiple clinics and practitioners offering the treatment and all too often we hear of cases of malpractice by unqualified providers that put reputable practitioners and the industry as a whole in jeopardy.
The main reason for these issues is that there has been a lack of regulation in the industry, which has allowed ‘cosmetic cowboys’ to practice unchecked.
The government is now taking action to impose greater controls and restrictions on individuals and clinics, but this takes time to fully take effect.
It’s our responsibility as credible practitioners to ensure we uphold the very best standards of practice and clinical excellence when offering Botox. You wouldn’t trust an unqualified person to carry out any medical procedures on you, so the same should be true for cosmetic procedures. With this in mind, the following guide will help you to know what to look for in a safe and reputable practitioner (clinic) and some of the key questions to ask them before investing in your treatment.
Research is absolutely paramount when searching for a Botox practitioner and I would urge everyone considering treatment to investigate a potential practitioner thoroughly and to only undergo treatment by a medically qualified professional at a Care Quality Commission (CQC) registered clinic.
Qualifications and experience
For a practitioner to inject Botox safely and legally, they will need to be fully trained and hold the appropriate qualifications. Unfortunately, Botox is still available everywhere from hair salons to ‘Botox parties’ at home.
Botox is a prescription only medication in the UK. This means it can only be prescribed by a doctor, dentist, pharmacist prescriber or nurse prescriber. A prescriber can give the Botox to someone else to administer, but the prescriber is ultimately responsible for ensuring it’s injected correctly.
When choosing a practitioner, it is advisable to choose a doctor-led clinic with experienced staff. If a nurse is administering your treatment, check that they are registered with the Nursing and Midwifery Council. If a dermatologist or skincare professional is administering your treatment, check how much experience they have. Also, ask to meet the doctor who will be prescribing the Botox for them and don’t be afraid to ask to see proof of qualifications.
When you are considering using a particular clinic, look for signs that the clinic is in regular use and regularly administers Botox. Check whether it offers complementary treatments such as dermal fillers as this will be a good indicator of the specialism of the clinic.
When choosing a practitioner, as a minimum look for someone who is registered with the General Medical Council (GMC), an organisation set up to protect patients and enhance medical education and practice in the UK. General Medical Council (GMC) released updated guidance directed at doctors who perform cosmetic procedures in the UK to ensure patient safety in surgical and non-surgical procedures on1st June 2016.
It is also worth checking to see if the clinic adheres to Care Quality Commission (CQC) regulations. The Care Quality Commission (CQC) is an independent regulator of health and social care in England and specifically all providers of surgical cosmetic procedures.
As a doctor-led clinic that is committed to providing the best in clinical excellence that our industry has to offer, we at Health & Aesthetics follow all the latest guidelines set out by organisations such as the GMC and CQC stringently.
As Medical Director of Health & Aesthetics I am registered with the GMC and am a full member of the British College of Aesthetic Medicine(MBCAM), an organisation dedicated to advancing safe and ethical aesthetic medicine. I also have a Bachelor of Medicine, Bachelor of Surgery (MBChB) and am a Member of the Royal College of General Practitioners (MRCGP).
The Consultation Process
A full and thorough consultation with any prospective practitioner before treatment (even if you have had Botox previously) is highly recommended. Injectables inevitably come with some form of risk, and there is no standardised approach to Botox which is why it’s incredibly important to make that initial consultation count.
During a consultation, a practitioner can assess your medical history, discuss the treatment process in detail, listen to your expected outcomes and manage your expectations accordingly, ensure that you are suited to the treatment and develop a plan tailored to your individual needs.
Be honest with your potential practitioner (especially when it comes to your medical history) and expect them to be the same with you. This includes them reserving the right to refuse treatment if they feel that it isn’t the best route of treatment for you to take. At Health & Aesthetics, as part of the consultation process we offer the VISIA 3D imaging system to fully analyse patient’s skin. This allows us to look at the skin in close detail and develop a skin care plan that is bespoke to their specific needs. The results may reveal for example that treatments such as chemical skin peels or laser treatments, to complement Botox treatment.
Your practitioner should also explain the potential risks and side effects of any suggested treatment and offer aftercare advice so that you know what to do to ensure the treatment is as effective as possible, both immediately and also a couple of weeks post-treatment.
One of the most important parts of any consultation is that you are given ample opportunity to ask any questions and share any concerns you may have. Make sure you take this opportunity and ask as many questions as you feel appropriate to help you decide whether proceeding with treatment is the right choice for you. You might want to ask the following:
- How much experience do you have administering Botox? Find out how much experience the person who will actually be administering your Botox treatment has. Remember, the person who prescribes the Botox may not be the person who actually administers it, so ensure you find out exactly who will be treating you.
- Which brand of botulinum toxin do you use? Although Botox is commonly used to describe wrinkle relaxing treatments, it is actually a brand name of botulinum toxin. There are three different botulinum toxin brands available: Botox, Azzalure and Bocouture. At Health & Aesthetics we use Botox and sometimes Azzalure branded botulinum toxin for our procedures as patients find these give lasting results.
- Will I receive a follow-up appointment? Ask your practitioner what their follow-up policy is. Reputable clinics will offer a follow-up call or appointment to check you are happy with your results. I would recommend a thorough follow-up appointment 2-3 weeks after a patient has undergone treatment to confirm that they are happy with their results, to check for any signs of side effects and to have a little touch up treatment if required.
- Does your practitioner have medical indemnity insurance? Botox is not without risks and in the unlikely event that the procedure should go wrong, your practitioner should be covered by medical indemnity insurance so you are protected should the worst happen.
- Why is your treatment so cheap? As the saying goes, if something looks too good to be true, it probably is. Be very wary of clinics providing special offers, for example, Groupon vouchers promoting cheap Botox. Often these clinics won’t offer an in-depth consultation as part of the treatment. In some cases, special offers can mean that the Botox is over-diluted. Diluting Botox with saline is standard practice. But diluting it too much means that you may not see any results at all from your treatment.
- Do you have before and after images and testimonials from previous patients? A reputable clinic will be able to show you before and after pictures of patients who have previously had treatment. Also ask for testimonials from previous patients. Video testimonials in particular can give you a better idea of a patient’s true experience of using the clinic. ‘Good’ Botox shouldn’t be noticeable, and the patient should just look like a more rested version of themselves and maintain natural features as opposed to making them look young. On the contrary, too much Botox, or Botox that has been administered incorrectly, can cause a patient to have a frozen expression. It can make them look unnatural, or cause an ‘unbalanced’ look on their face.
After the consultation process, you should be given enough time to digest the information you’ve been given. You need to make a considered decision about whether the treatment is right for you. At Health & Aesthetics we give you as much time as you need. After your consultation we recommend you take time to consider all the pros and cons before making a decision and booking a treatment appointment. After your consultation you will be given an information pack (including a brochure, relevant leaflets and a form with possible outcomes and contraindications) to further help you make a decision.
The last step before going ahead with treatment is to sign a consent form. The practice treating you will should talk you though the consent form and give you time to read it through before the treatment. When all forms are filled out and consent forms signed, the treatment can then take place.
Whether or not a clinic or practitioner has won any industry awards is a good indication of how authentic they are, particularly if they have consistently won or been a finalist over a number of years. The MyFaceMyBody Awards and Aesthetic Awards are a good example of an award to look out for and is a globally recognised award that celebrates innovation and patient excellence within the aesthetics industry.