Unqualified people are performing cosmetic procedures and importing unregistered medicines, a professional body for the country's cosmetic medicine practitioners warns.
In one case which has caused alarm in cosmetic medicine circles, an Auckland woman is advertising surgeries on social media, including eye lifts and liposuction; sources in the industry, who want to stay anonymous, say she is not properly qualified to be doing the procedures and they are not being carried out in a proper sterile environment.
The New Zealand Society of Cosmetic Medicine is crying foul on the unlicensed operators, and the government regulatory body Medsafe is investigating the importation and use of unregistered medicines and medical devices.
Two sources in the cosmetic medicine field said that the Auckland woman had claimed to be a doctor but had no medical training, and had been operating behind a hair salon in central Auckland. She has since moved her work to a private home.
"There are quite a few backstreet clinics, but she is the only one doing surgery," said one source, who believed there were at least 20 operators in Auckland using unregistered products.
Sydney woman Jean Huang died after a botched breast procedure at her beauty clinic in August.
Dr Hans Raetz, the president of the New Zealand Society of Cosmetic Medicine, has shared concerns about unqualified people doing medical procedures with the Ministry of Health.
"I know there are backstreet injectors out there," he said. "There are eyelid lifts being done in a beauty therapy clinic."
He likens the services to choosing a scrapyard mechanic rather than a licensed mechanic. "I don't understand why anybody would go for these guys," said Dr Raetz. "You can always buy yourself a new car, but no such luck with a new body if your old one is falling to bits."
Ruth Nicholson, who runs NZ Laser Training - which specialises in training around the use of lasers in cosmetic procedures - said she was also aware of underground operators.
" Its a whole secretive underground industry. It does scare me, what's going on. I do think there are a lot of women out there working from garages and their homes who are not registered doing god knows what."
Sydney woman Jean Huang died after a botched breast procedure at her beauty clinic in Chippendale in August. A Chinese visitor claiming to be a doctor administered anaesthetic and breast fillers. The Australasian College of Cosmetic Surgery issued a warning about such procedures being done outside a medical setting.
The Auckland woman has reportedly been performing cosmetic procedures for the past two years. Her services as advertised include facial threading (a non-surgical facelift procedure), fat transfer (from one part of the body to another) and nose reshaping. Some of the procedures would entail use of anaesthetics, and it is unclear whether she is qualified to administer these.
Attempts to contact the woman, including via the WeChat social media app which she has advertised on, and at her last-known premises in central Auckland, have been fruitless.
Screenshots of posts apparently written by her on WeChat promote the anti-ageing properties of products she says come from Switzerland, Germany, Italy and Korea. The screenshots suggest she is importing dermal fillers and botox-like products that are unregistered in New Zealand.
In one WeChat post she says she has clients coming from Wellington to get their noses reshaped.
Another example of WeChat being used to promote questionable cosmetic procedures featured another New Zealand-based woman who touted cosmetic products which are not registered for use here.
Derek Fitzgerald, manager of compliance management for Medsafe, said the regulator was aware of Raetz's concerns and complaints from other people around unregistered medical products.
"Actions in relation to the importation and use of medicines and medical devices are under investigation, including the roles played by those involved," said Fitzgerald. "Medsafe has also had a discussion with Dr Raetz about topics of concern."
However, Medsafe was unable to confirm if reports of illegal cosmetic operations were under investigation.
If members of the public were concerned about the use of medicines or medical devices in relation to a cosmetic treatment, they could complain to the Ministry of Health, he said.
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."
Smooth operators...men 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".