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  1. ITV Report

Unregulated and unsafe? Rise in botched cosmetic fillers sparks questions about beauty industry

  • By Natalia Jorquera and Lewis Denison

The cosmetic industry in the UK is largely unregulated, meaning anyone can legally provide injectable treatments.

But an ITV News investigation has found a huge number of these procedures are going wrong - and those carrying them out are often not able to correct mistakes.

The number of official complaints about non-surgical procedures has more than doubled to over 600 cases in the last three years, according to Save Face, a company running a government-recognised national register of accredited practitioners.

Rachael Knappier said she suffered unbearable pain as her lip ballooned. Credit: ITV News/Rachael Knappier

In a survey carried out for ITV News, it found lip filler errors made up almost 70% of all corrective work and 47% of procedures that led to complaints were carried out by beauticians.

The number of recorded complaints about filler treatments has nearly trebled in two years. Credit: ITV News
The vast majority of complaints are over botched lip fillers. Credit: ITV News
Almost half of the botched treatments recorded have been carried out by beauty therapists. Credit: ITV News

Yet because there is no legal requirement to report mistakes if things go wrong the exact number of errors may be far higher.

The issue of regulation is the subject of debate by MPs on Tuesday following a Commons intervention by Tory MP Alberto Costa.

His constituent Rachael Knappier, from Leicestershire, suffered a catastrophic injury after a lip augmentation treatment went wrong and filler was injected into an artery.

The filler was incorrectly injected into an artery in Rachael's lip, which left untreated could have cause necrosis. Credit: ITV News/Rachael Knappier

The treatment she was having falls under the bracket of 'dermal fillers', a cosmetic treatment to add volume to the face which has become one of the UK's most sought-after procedures.

UK law currently allows anyone - whether they're a medical professional such as a doctor or a non-medic such as a beautician - to administer injectable cosmetic products.

Ms Knappier, whose treatment was administered by a beauty therapist, told ITV News of the unbearable pain she suffered after having filler injected into her lip to even out a lump.

"My top lip was touching my nose and it was then that I started to realise just how much pain I was in," she said.

"It felt like a burning throbbing pulsating feeling and it was as if my lips were just seconds away from bursting."

She added: "The filler had been injected into an artery and it’s the artery that runs from the centre of your lip, from up here, so it was causing a mass blockage. Left untreated that leads to necrosis, which is the death of the soft tissue on your lip. That’s irreversible damage."

Ms Nappier followed guidance from the NHS and contacted the beautician who treated her to ask for the work to be corrected, but instead discovered she needed the help of a doctor.

Rachael Knappier was able to find a doctor willing to dissolve the filler in her lip. Credit: ITV News

Fortunately she was able to find a doctor willing to dissolve the filler in her lip, but says before having the work done she didn't "understand the difference between medic, non-medic, beauticians, dentists, dental nurses".

She added: "I didn’t really understand how it works and what you need to be qualified to do."

The British Association of Aesthetic Plastic Surgeons (BAAPS), a self-regulating body of medical professionals, is calling for much tighter regulation on who is legally allowed to inject in the UK.

Nora Nugent, a spokesperson for BAAPS and a plastic surgeon, told ITV News she thinks to "perform an invasive procedure, which any injectable treatment is, that person at the very least should have some medical training".

Nora Nugent from BAAPS believes non-medics should not be able to carry out invasive procedures. Credit: ITV News

She added: "Dermal fillers are not prescription items and are not tightly regulated. So we have non-medically trained people - people who do not work in the healthcare field at all - performing these treatments and I think that's simply wrong and dangerous."

Despite this, there are dozens of cosmetic training courses advertised online that claim to teach non-medics how to administer injectable treaments to a very high standard.

Maxine Hopley runs a training centre in Manchester called Cosmetic Couture. Non-medics make up around half her students.

Maxine Hopley, owner of training centre Cosmetic Couture, also wants standards in the cosmetic industry to be raised. Credit: ITV News

She says her courses teach all the appropriate knowledge and skills needed for injecting.

Her students receive three days of training and work on up to 15 models before they finish a course.

Ms Hopley said "adverse effects and complications is one of the biggest modules", adding: "We recognise that as a non-medic doing treatment that you need to be able to recognise if something serious happens. We actually include that in our training."

However, the Joint Council of Cosmetic Practitioners (JCCP), a self-regulating body for the non-surgical aesthetics industry in England, says the level of teaching carried out at training centres where non-medics attend is not high enough.

In 2018 the JCCP stopped beauty therapists from joining its register of practitioners.

Ms Hopley agrees there needs to be higher standards in the industry but says the JCCP decision to "pull away from beauty therapists" has left the industry "at crisis point".

Adverse effects and complications is one of the biggest modules of courses at Cosmetic Couture. Credit: ITV News

She said: "I've seen the industry change. I've seen more and more training companies open up. I see a lax in insurance, so that for instance, I see in the industry that people can train, they can go and do a course and literally within a couple of months they've opened up a training company.

"That's worrying when we're trying to raise standards for the beauty industry.

"Obviously there is always going to be a negative side to what people do and I think there does need to be regulation, there does need to be inspections and, like I said, the industry is at crisis point."

Cosmetic practitioners do not have to sign up to Save Face's register of accredited practioners, which is why they are not required legally to report mistakes if things go wrong.

Unlike in the medical field, there is no register to be struck off.

Ms Knappier's MP, Mr Costa told ITV News the idea anyone could set up a cosmetics business is "simply ridiculous".

Alberto Costa raised the issue of regulation in the cosmetics industry to MPs in the Commons after he was contacted by Rachael Knappier. Credit: ITV News

He said: "If you look at breast implants, only medics can undertake that because it involves an operation, it involves surgery to undertake that.

"The GMC (General Medical Council) number means that that individual is regulated and has to perform that treatment, that service, at a certain standard.

"But with the other treatments, the dermal fillers, the botoxes, there’s no requirement - anyone can do that. I could set up a business on the side to being an MP and administer botox and that’s clearly ridiculous."

Following Mr Costa's intervention in the Commons, the Government said: "We are currently exploring options to strengthen regulation of cosmetic procedures and improve the safety through better training, robust qualifications for practitioners, and better information so that people can make informed decisions about their care."

In the meantime, the best advice for anyone considering a cosmetic procedure is to find a reputable, safe, and qualified practitioner who is subject to statutory regulation, or on a voluntary register.