News from the New Zealand Doctor newsroom

by Liane Topham-Kindley 02 May 2013

Botox, fillers, peels: NZ has tighter rein than UK

UK concerns about public health and safety of non-surgical cosmetic procedures need not be echoed in New Zealand, according to former GP Hans Raetz, president of the NZ Society of Cosmetic Medicine

It's not a simple process like buying a toothbrush
UK concerns about public health and safety of non-surgical cosmetic procedures need not be echoed in New Zealand, according to former GP Hans Raetz, President of the NZ Society of Cosmetic Medicine.

Industry regulation is tighter in New Zealand than the UK, Dr Raetz says

A review of the regulation of cosmetic interventions in the UK, released last week, highlights particular concerns about non-surgical cosmetic procedures such as dermal fillers, Botox, chemical peel and laser hair removal.

Under current regulations all of these procedures can legally be performed by anyone, despite the fact that, if performed incorrectly, they can result in complications such as burning, scarring, infection and even blindness.

"Given the known risks, it is not appropriate that the public has no more consumer rights when receiving a dermal filler injection, then when buying a toothbrush," the UK report says.

The review proposes much tighter and rigorous regulation for these types of non-surgical cosmetic procedures to ensure public safety.

Sector regulated in NZ

Dr Raetz, medical director of an appearance medicine clinic in Queenstown, says New Zealand has already carried out much of the work included in the UK review recommendations.
The Medical Council of New Zealand developed a statement of cosmetic procedures, recommending non-surgical cosmetic procedures be performed by a vocationally registered GP, dermatologist or surgeon.
The NZ Society of Cosmetic Medicine has also developed a training programme, which has been approved by the Medical Council, under the auspices of the RNZCGP.
The two colleges are also working together to establish appearance medicine as an extended scope of practice.

10 year campaign to clean up the industry

Dr Raetz says the college has done a lot of work cleaning up advertising and discount schemes run by some providers.
"NZSCM has run a 10 year campaign to get the field cleaned up and either get fly-by-nighters trained up, or out of business," Dr Raetz says.
"I think the relatively low level of complaints in New Zealand is credit to the general success of this strategy."

He admits there is still some work to be done in New Zealand, with cases of some nurses being given the go-ahead to carry out Botox injections under standing orders, when the doctor responsible does not know what they are doing.

"There's a bit of cleaning up still to do," Dr Raetz says.

Medical Council chair John Adams says there is still "a steady, but infrequent, trickle" of complaints about the adequacy of services and a lack of informed consent.

Boundaries still not always clear in NZ

Appearance medicine is a burgeoning business, and there are a number of areas in the industry where "the boundaries are not entirely clear", Dr Adams says.
"From the Medical Council's point of view, we are trying to ensure that patients get the safest and best services in this area."

UK report available here

Smooth using Botox to look the business

By Martin Johnston 5:30 AM Thursday Apr 12, 2012

Rather than going under the knife, many men are opting for Botox to delay the aging process.

Businessmen wanting that look of authority are helping to drive a big increase in the use of cosmetic therapies such as Botox.

The New Zealand College of Appearance Medicine estimates that clients spent more than $22 million on injections of Botox and dermal fillers in the year ending March 31.
This was 18 per cent more than in the preceding year - compared with the 15 per cent increase recorded in Australia for all non-surgical cosmetic treatments, including beauty therapies such as hair removal.

College president Dr Teresa Cattin, the owner of the FaceWorks clinic in Albany, Auckland, said yesterday the increasing demand for injections of Botox and dermal fillers, which had occurred without respite for several years and even during the economic downturn, was probably fuelled in part by patients who might otherwise have had surgery. It was also spurred by the effectiveness and good value of the products.

Dr Cattin said the patient group had extended beyond the traditional category of women aged 40 to 55, and now included older people and patients in their late 20s and an increasing number of men.
Botox is the standard treatment sought by men, although one clinic, which offers "boob jab" injections of a dermal filler gel to make women's breasts "look fuller and softer, instantly" says this treatment is also suitable for men.

"For men it could mean defining those chest muscles that many hours at the gym are unlikely to fully achieve!" Clinic 42, of Epsom, says on its website.

The clinic said yesterday that it had given this treatment, which was relatively new to New Zealand, to a few women, but not men - "they're not brave enough to come in".

Dr Cattin said businessmen were the main group among Botox patients.
"[They] are unhappy with lines that make them look irritable and it alters the way people respond to you. When you're in a management position it's important that your face backs up what you are saying because we tend to read faces rather than question what people are saying.

"The way people respond to us, especially in a position of authority, is very much influenced by what we look like. I wouldn't say it's vanity at all. I would say it's a practical issue reflecting work needs."
She said Botox injections were a straightforward treatment, effective and relatively cheap. A single treatment of frown lines cost $400 and needed to be done three or four times a year - "it works out as a cappuccino a day".

Botox style DIY shots disfigure women

By Nicholas Jones 5:30 AM Thursday May 19, 2011

An increasing number of New Zealand women are being disfigured - and risking death - by buying beauty products online to inject at home. New Zealand and Australian surgeons are warning people not to buy derma fillers, or fake products purporting to be Botox, on the internet.

Dr Teresa Cattin, president of the New Zealand College of Appearance Medicine, said she saw women with injuries from DIY cosmetic procedures about once every six weeks. One patient was admitted to hospital for six weeks after a friend injected a substance bought online into her face." She had huge big abscesses. She went into kidney failure. We still don't know what the substance was."In one case they got it tested and it turned out to be cooking oil. "It really is scary. The products we use are prescription medicines, and they're prescription medicines for a reason - you only want to be injecting stuff that is tested." Dr Cattin said she would often refer patients to plastic surgeons to have affected areas of the face cut out.

This week photos were released by an Australian woman, who did not want to be named, showing the swollen lips and face blotches she suffered after a friend injected her with a product bought online.Her lips ballooned two weeks after being injected with supposed dermal filler, and abscesses showed on her face six weeks after the injection.She is now being treated with antibiotics and drainage, and asked for the photos to be released to alert the public to the danger.

Dr Garsing Wong, also a member of the NZCA, told the Herald the photos highlighted the dangers of buying such products online. "MedSafe do their best to stop all prescription medicines coming in, but sometimes they can slip through. "He said it was a great concern that websites claimed to offer products such as Botox, some of which marketed do-it-yourself application kits.

The Australian woman had bought a supposed dermal filler labelled "HA 40 mg/ml", which was now being analysed. "Judging by the photos, it's very unlikely she would have got a pure form ... The worst thing is you don't know what's in it." Dr Wong said that such products could cause outcomes much worse than permanent scarring. "You risk anaphylactic shock, which in the worst-case scenario could kill you instantly. That's because it could contain impurities."

Another reason for consulting a doctor was to check the prescription against the patient's medical history and allergies. "Not only that, you need to have the options explained. Maybe that's not the best treatment for you. Maybe no treatment is needed."

Both doctors said the dangerous importation of prescription drugs bought online extended to other medicines such as Viagra, weight-loss pills and steroids.

American woman Kerry Campbell recently caused global outrage when it was revealed she was injecting her 8-year-old daughter with Botox to help her win beauty pageants.

NZCAM Media Release

November 11 2009

NZ appearance medicine experts "world class"
Appearance medicine doctors in New Zealand are among the best in the world thanks to our rigorous training standards, says the new president of the New Zealand College of Appearance Medicine, Dr Teresa Cattin. "There are so many exciting developments in the field of appearance medicine and our members are right up to date with the latest techniques," she says. "New Zealand cosmetic physicians are respected internationally and our practices and training programmes are as good as anywhere in the world."

Dr Cattin says NZCAM's primary aim is to train physicians to treat patients safely and professionally, using safe, approved products and techniques. "We want to ensure that patients are getting the right treatment from well-trained professionals – and the result is that New Zealand has an excellent record in patient safety."

When NZCAM was established 15 years ago, appearance medicine was in its infancy. Now the college has 30 fully qualified members and another 12 doctors currently undergoing training. The Diploma in Appearance Medicine is open to doctors only.

NZCAM also holds annual conferences attracting leading overseas cosmetic specialists and researchers, and college members regularly attend international conferences and workshops. Retiring president Dr John Barrett, who headed NZCAM for 13 years, says the college has developed an excellent training and auditing system over the years. "NZCAM has set the gold standard in appearance medicine in this country. This is such a rapidly changing area of medicine that we constantly need to keep up with the latest trends."

Dr Cattin was elected president at NZCAM's annual conference in October.

The new executive members are:
Dr Sarah Hart (Palm Clinic, Auckland)
Dr Hans Raetz (Skin Institute, Queenstown)
Dr Garsing Wong (Sapphire Appearance Medicine Clinic, Auckland)
Dr Lynn Theron (Clinic 42, Auckland)

Dr Teresa Cattin (MSc, MBBCh, FRNZCGP, FNZCAM) is a highly experienced cosmetic physician and owner of FaceWorks Clinic in Albany, Auckland. As well as being president of the New Zealand College of Appearance Medicine, she is a national trainer in BOTOX® Cosmetic and Juvederm, training other doctors in NZ and Australia. Teresa is also a member of the BOTOX® Advisory Board and the Juvéderm® Advisory Board of Australasia. She has an interest in the therapeutic role of BOTOX® in breast surgery and has also developed the cosmeceutical FaceWorks® skin care range.

Media release

10 April 2013

New Zealand Society of Cosmetic Medicine (NZSCM) welcomes the introduction of regulations banning the use of sunbeds for people under the age of 18.

NZSCM president Dr Hans Raetz says it is well recognised that excessive exposure to ultraviolet radiation at a young age increases the risk of developing melanoma and other skin cancers.

"It is sensible and prudent that sunbed operators will have their machines strictly audited and are required by law to inform their customers about the risks inherent in sunbed usage," says Dr Raetz. "These measures will help to safeguard the New Zealand public against the rising risk of skin cancer."

The Government will amend the Health Act later this year to ban the use of sunbeds for people under 18. It is a key part of MP Paul Hutchison's Health (Skin Cancer and Trauma Prevention) Amendment Bill, which has been supported by NZSCM.

Dr Hutchison's private member's bill was designed to prevent avoidable harm from UV radiation through the use of solaria - sunlamps, sunbeds, or tanning units. The World Health Organisation reports the risk of skin cancer, particularly melanoma, increases by 75% when sunbeds are used before the age of 30.

NZSCM has also assisted Auckland Council to draft regulations in the proposed Health and Hygiene Bylaw regarding the use of commercial sunbeds and light-based therapies.

Dr Raetz says NZSCM will continue to be actively involved in measures that promote the health and safety of the public.