This story is the second part of Young and injected: Electing to have a major cosmetic surgery by 17 and 18. Click here to return to the home page and introduction or click here to read part one of the story. 

Because regulations vary across provinces, experts say before choosing a surgeon or cosmetic medicine provider, you should know what their credentials are, ask questions, ensure you’ve been properly assessed, know the risks, and know what happens next. Here they are broken down for you.

1. Know their credentials

Checking out someone’s work on Instagram isn’t research enough. Kelly Eby with CPSA says their website can provide a lot of information, but not to be afraid to ask the physician for their credentials.

“They can say “I’d like to see your practice permit”, because their practice permit is like their licence, and it spells out what their qualifications are,” she says. “And, they’re required to provide it upon request.”

Dr. Brown echoes the call to research and says private citizens are protected in public facilities such as hospitals because they have standards to protect the private citizen. He says, “In freestanding surgical facilities that doesn’t exist in many cases.”

2. Get assessed

Sofia Azami says although she was assessed for her nose job, the assessment for her lips was more about being asymmetrical than being asked questions about why she was choosing to get this procedure done.

Dr. Brown says assessments for dermal fillers and Botox may not need to be as intensive as surgical procedures, but that questions should still be asked. Questions could include, “What are the reasons why you are here?” Or, “What do you want to achieve and why?”

The surgeon, who specializes in aesthetic and reconstructive breast surgery, body contouring and facial aesthetic surgery, says the vast majority of his clients are “very sensible, thoughtful and reasonable people” who generally have self-confidence and feel good about who they are and where they are in life.

However, he says sometimes people look to make changes for the wrong reasons, such as a relationship crisis or to become more successful in the workplace, and that is where counselling techniques are required of the provider.

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“Because in the end, changing a body feature can only change a body feature,” the surgeon says. “[It] doesn’t change who a person is.”

Both Azami and Burge say they were in a good place when they made their decisions to undergo the knife or needle. “I was in a great mindset and had no issues whatsoever,” Burge says.

However, Azami says after going in a second time for the bump on her nose, she second guessed her decision to do so after not seeing much difference from before the second surgery. “I shouldn’t have even went back in,” she says.

Dr. Brown also believes in being cautious about creating a society where every wrinkle is looked at as a problem. Rather than assuming wrinkles require Botox treatments, asking what your goals and objectives are will help determine if treatment will enhance your quality of life.

He says a lot of people look at wrinkles as something they have earned and earned well. “And aging gracefully is still a tremendous beauty,” he says.

3. Ask questions

DeLaet says clients shouldn’t feel rushed in deciding their injector. “It’s fine to go for a consult first and then make your decision later.” She goes on to say having a couple consultations with different providers will help in choosing the right person for every individual. “Everyone’s going to have a different eye.”

Eby says research is absolutely critical, but asking questions during the initial consultation is just as important. “Not just about a treatment, but what kind of processes are involved in the office?” She suggests asking about things like cleanliness, sterilization and equipment.

Even though their regulatory body does inspections, she says not everyone meets those standards all the time.

Azami says when she initially went in to get her lips done, she asked questions, even regarding where her anaesthesiologist got his product, and what would happen to the product over time in her body.

“I don’t think they have the patience or the time to sit and explain every little thing to all their clients,” She says. Being curious about what was going to happen was important for Azami during her initial consultation.

4. Know the risks

Dr. Brown says the mark of a good facility is one where the professional explicitly talks about both the benefits and risks of every procedure. Since regulations in Alberta vary depending on the regulatory body, it is in the client’s best interest to know as much about the risks as they do the benefits of having any procedure done.

Part of that process includes signing consent forms, something both Azami and Burge say they have signed for every surgery and procedure they have had done.

Burge says she has always been informed of risks to any procedure or surgery she has elected, but Azami says she was never told about any risks associated with getting lip injections.

Health Canada’s website does state however that dermal fillers can have adverse reactions that could last several months and may require additional treatment and or surgical removal to correct.

DeLaet says there are a variety of complications that can happen, but that “artery occlusion is the most feared.” She explains this is when a filler blocks a vein, which shuts off blood supply to that area of the face. It can be easily reversed if caught on time, but patients should be aware of the risk before the injection happens.

She also says bacterial infections can occur if patients don’t follow aftercare instructions, which typically include avoiding working out for a certain period of time to avoid bacterial infection at the injection site. She also suggests showing up to appointments with no makeup on. Although injectors will cleanse the face, she says, “the cleaner the better!”

5. Know what’s next

Knowing what happens after an aesthetic surgery or procedure is important too. For example, both Azami and Burge say they know if they don’t like their injected lips, they can either wait for the filler to be metabolized by their body, or, can go in for a hyaluronidase injection which will dissolve the filler in a short period of time.

DeLaet adds this injection is a last resort for most injectors as it does break down some of the body’s natural hyaluronic acid, but that it “isn’t the end of the world,” as the body will naturally build the acid up again over time.

Following their initial lip injections, both women say they experienced bruising. “I’ve had bruising go all the way down my chin,” Burge said. However, neither of the girls experienced other unwanted side effects from their injections.

DeLaet echos the potential of bruising and says it can get quite severe. However, “Anything that’s bigger than a quarter, I would definitely let whoever injected you know.” She says most practitioners will give emergency contact information if these side effects arise, but if anyone feels they are experiencing something abnormal, they should go to a hospital emergency room.

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“There’s always a dermatologist on call. I don’t think a lot of people know that,” she says.

Azami and Burge wondered if lip fillers would make their lips saggy, but Dr. Brown says if the injectable is reasonably done, tissues generally return to normal after injections. He says they typically have minimal long term effects, other than usual aging that occurs through life.

Although she was told recovery isn’t typically bad, Burge says hers was unusually painful following breast augmentation. A friend ended up staying with her since she required help to get to and from the bathroom – a process she says took 45 minutes every time.

“After the first week when I could get out of bed, somebody pulled me up, lifted me up to a 90 degree angle, lifted my legs off the bed and then I could stand up.”

As for implants, plastic surgeon Dr. Brown says it’s important in his own practice and in the industry to always tell patients that these are man-made devices, and aren’t meant to be once-in-a-lifetime products. Whether it is a cheek, chin, or breast implant, Dr. Brown says upkeep is required.

“They do require some level of maintenance,” he says, “And if you choose to have a breast implant, then you will almost certainly at some point in time or several points in time in your life have to have that implant changed or replaced.”

When it comes to being properly informed, DeLaet says the important thing to consider is individuality. “We don’t all age the same, and we don’t have the same makeup. All of our bone structures, all of our genetics make us unique, and it’s one of the beautiful things about every person.”

Dr. Brown says after a patient has been properly informed, there should be no judgement on people who make proactive decisions about the things they feel will improve their quality of life.

However, before surgical or nonsurgical procedures, he says patients need to “ensure that they feel they’re in an environment where they’re safe and protected, and that they’re with somebody who has the ability to help them not just when things go well, but also when there are complications and problems.”

Editor: Amber McLinden | amclinden@cjournal.ca 

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