Medics warn Skype-only consultations putting lives at risk
A woman whose lips were “disfigured” after a botched Botox injection at a Chadstone clinic says a lack of doctor supervision is to blame, as leading plastic surgeons say a legal “loophole” allowing video consultations is putting lives at risk.
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Cosmetic clinics using Skype-only discussions with a doctor before administering fillers or Botox injections are putting lives at risk, medics claim.
Technology-based patient consultations are legal in Victoria but leading doctors are pushing for the closure of the “loophole”, claiming it was never meant to be used this way.
A Leader investigation found beauty clinics at major shopping centres including Chadstone and Fountain Gate offering patients a brief Skype consultation with a doctor, who authorises a nurse to inject the Schedule 4 drug.
The Leader asked several workers at these parlours if they had a doctor on site, but all said they conducted Skype-only doctor consultations.
Leading plastic surgeon Professor Mark Ashton has slammed this use of the legislation saying patients were at risk of blindness and other serious complications.
He said Skype consultations had no place in the cosmetic realm, as they were originally designed for people living in rural and regional parts of Australia.
“The biggest problem with Skype consultations is that if something were to go wrong that doctor is not physically present.
“We know things can go wrong with cosmetic injections, so patients are putting themselves at real unnecessary risk.”
He said patients were unable to get the appropriate care if complications occurred in shopping centres as they would in a clinic with a doctor present.
“If something goes wrong such as skin necrosis or you start to go blind — the capacity of that clinic being able to treat you quickly and appropriately is significantly and severely compromised,” he said.
Prof Ashton warned of the “dangerous risks” when complications did occur.
“If you are injecting filler into the nose (liquid nose jobs) or the face it is possible to accidentally put the filler into the blood vessels of the face or the nose.
“This filler can end up in the soft tissue of the nose or the face or in the eye — if it ends up in the soft tissue cheek, nose or lip — it will lead the skin to progressively die and fall off.”
“If it ends up in the eye — instantaneously the person goes blind and that blindness is permanent and irreversible.”
‘I COULDN’T OPEN MY MOUTH’
A woman, 21, of Mt Waverley, who asked not to be named but provided photos of the shoddy work she received at a Chadstone beauty clinic, said her lips were left “disfigured” after having a Botox lip-flip treatment that offered a slight pout to the top lip.
“They injected the Botox into the wrong places and my lips became so swollen — I was terrified that something had gone seriously wrong,” she said.
“I couldn’t open my mouth and I panicked and went back to the clinic but they just injected more into the frown lines as they said it was uneven and assured me it would go down.”
She blamed her Skype consultation for things going “horribly wrong”.
“There needs to be doctors on-site at these clinics — I don’t feel it was appropriate to have a doctor consult me through a video call and I was left feeling destitute when something went wrong,” she said.
“I had to go elsewhere to get everything fixed as my lips were disfigured — but the whole experience was traumatising and I urge people to do their homework.”
Age Reduxion Clinic plastic surgeon Dr Alie Ajam, who specialises in cosmetic procedures such as injectables, said he had witnessed several complications in women who had gone to underqualified practitioners.
“I had to reverse permanent filler from a woman’s lips who had them done at another clinic, which had caused infections and constant seepage for about two years until it was removed,” he said.
“As we know, there’s been cases of blindness reported in Australia so there definitely needs to be a doctor on premises in case things do go wrong.”
COMPLAINTS TO HEALTH WATCHDOG
Health Complaints Commissioner Karen Cusack said from 2017-18 the office received 81 complaints about cosmetic treatments carried about by general health service providers (non-registered health practitioners not regulated by the Australian Health Practitioner Regulation Agency under the national law).
This included complaints about laser therapy services, face and skin treatments and cosmetic injectables provided by beauticians, laser therapists and beauty therapy clinics.
In 2018-19 the office finalised 66 complaints.
“Most cosmetic injectables, including Botox and dermal fillers, are prescription-only medicines, which legally can only be prescribed by a registered medical practitioner, and administered by a registered medical practitioner or a registered health practitioner, such as a nurse under the instruction of a registered medical practitioner,” Ms Cusack said.
“There is no legal impediment to consultations occurring via Skype.”
She said there were risks, side effects and possible complications with any cosmetic treatment.
“The administration of procedures without a face-to-face consultation with a doctor or specialist may increase the chance of something going wrong,” she said.
A Department of Health spokesman said AHPRA and national professional boards were responsible for the regulation health practitioners.
He said the Medical Board of Australia had released guidelines on technology-based patient consultation.
“These guidelines include directions on the consultation requirements for technology-based patient consultations that use any form of technology, including making a judgment about the appropriateness of a technology-based patient consultation and in particular, whether a direct physical examination is necessary,” he said.
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“Health Ministers are also currently considering increasing penalties for practitioners who falsely hold themselves out to be a registered practitioner, and for misleading or false advertising.”
A spokesman from the Department of Health and Human Services said the State Government was cracking down on dodgy cosmetic providers, and enacted new regulations last year to provide tougher powers to protect patients from unregistered providers and premises.
THINGS TO CONSIDER
Victorians considering any treatment by a medical practitioner should:
● Ensure the practitioner is registered with AHPRA;
● Check the facilities appear clean and hygienic;
● Make sure you have a face-to-face consultation;
● Do the research to see if your therapist has a good reputation;
● Check the medicines are labelled clearly in English;
● Understand there can be risks with any of these procedures; and
● Report poor services to the Health Complaints Commissioner.