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Botox: beware rogue practitioners, bargain treatments and botched injections at parties

Posted: 10/11/2017

A bogus plastic surgeon is accused of leaving three women in agony and one permanently disfigured by giving 'dangerous' fake Botox injections. Mr Ozan Melin is alleged to have told three female patients that he was an American-trained cosmetic surgeon but the General Medical Council has not heard of him. During his trial in Bournemouth Crown Court, which is currently ongoing, evidence has been presented suggesting that Mr Melin ‘recklessly’ gave ‘dangerous’ injections with strong undiluted solutions that caused severe swelling and bruising. He is charged with grievous bodily harm and fraud. The Botox treatment Mr Melin administered has been described in court as an ‘unknown and extremely dangerous substance’.

The women consented to treatment from Mr Melin as they believed he was a qualified doctor and had no reason to question what he had told them. Mr Melin ran a mobile clinic called The Smooth Face Botox Company and carried out Botox treatments at beauty salons and in customers’ homes.

One of Mr Melin’s patients complained of swelling and burning in her face just an hour after seeing him, but he dismissed her concerns and told her to use a wet flannel. However the following day she suffered an anaphylactic shock and was admitted to hospital for treatment. The court has heard evidence that Mr Melin didn’t ask his patients for a full medical history and deliberately didn’t dilute the Botox solution as recommended so that it would work more quickly.

Many people have heard of Botox as a miraculous treatment for wrinkles and expression lines. It is actually the trade name for a substance injected into the skin which is known to inhibit muscle movement and prevent wrinkles developing or worsening. The name Botox or Botulinum toxin originates from the word “botulous” meaning sausage. This is because the substance is actually related to a naturally occurring poison, occasionally found at dangerous levels in bad meat products, which can paralyse and kill. It has been described as ‘the most poisonous substance known’ but certain varieties in minute purified doses have been discovered to actually perform a safe and useful function, hence its use in plastic surgery.

Botox injections are now one of the most popular cosmetic treatments in the world as a procedure for aesthetic purposes. Botox treatment works by blocking the nerve signals to the affected muscles around the injection site. The muscles become more relaxed and their activity is reduced, in turn reducing the effects on the skin such as lines. When injected into the problem area, Botox freezes muscle movement by blocking neuro-transmitters for a period of four to six months, so the treatment needs to be administered a few times a year to maintain the curative effects.

Despite Botox being a prescription only medicine, its use is not subject to statutory regulation which means virtually anyone can, in theory, set up shop and begin offering dermal fillers or Botox parties, even if they have no experience whatsoever and no qualifications. After a doctor has prescribed Botox, there is very little in the way of rules on who can then administer the injection.

While there is no statutory regulation for practitioners, the General Medical Council (GMC) has developed guidance for doctors on good medical practice when it comes to prescribing Botox to patients. The GMC stipulates that a doctor must carry out an assessment of a patient’s full medical history before issuing a prescription. The Nursing and Midwifery Council (NMC) has stated that nurses who issue Botox without a written and signed prescription form will be held in violation of standards and could face disciplinary action.

Although individuals who administer Botox are not legally obliged to do so, there are various professional organisations with which they can register. Entry requirements for membership will differ between organisations, but generally a high level of training and experience will be required, as will a pledge to abide by guidelines, codes of ethics and complaints procedures.

Treatments You Can Trust (TYCT) is a register of regulated cosmetic injectable providers that is backed by the Department of Health and run by the Independent Healthcare Advisory Service (IHAS). It provides consumers with information about treatments, and only lists treatment providers who have been checked and registered. Providers are fully qualified and insured and are obligated to deliver treatments that are compliant with the TYCT standards.

All members of the British Association of Aesthetic Plastic Surgeons (BAAPS) are fully trained plastic surgeons who are experienced within the industry. BAAPS is based at the Royal College of Surgeons, and its primary aim is ensuring high standards of practice within the aesthetic/cosmetic surgery industry.

Alison Johnson, associate director at Penningtons Manches LLP, represents men and women who have received a poor standard of plastic or cosmetic surgery care. She comments: “Botox treatment should only ever be undertaken by a qualified medical professional, preferably a plastic or cosmetic surgeon. Any patient undergoing Botox needs to be in safe hands, meaning someone experienced who knows how important it is to get the right amount of Botox in the right area to avoid asymmetrical results, muscle drooping, frozen expressions and potentially very dangerous consequences. It is hugely worrying to hear of Botox parties, where friends are dividing the cost of treatment by sharing the serum and all having injections done at the same time. They may well not be sufficiently advised of all the risks associated with Botox and the fact that party packages may be offered by under qualified practitioners.”

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