The Five Worst Practices of Bad Injectors – 5 Bad Habits of a Dodgy Cosmetic Injectors

It’s important to have confidence in your Injector. Firstly, because you are placing your one and only face under their care. Secondly, there’s extensive technical and clinical expertise required to do injections and fillers properly. And the third reason is that are dangers to being injected improperly or with fake injectable products. We know what makes for a good injector, but what makes for a less than desirable (or even bad’) Injector? Knowing What’s Bad About an Injector or Injecting Strategy Can Save Your Life. When you do decide to go ahead and use injectables as part of your anti-ageing program, it’s important to really observe what the nurse or doctor is doing during the procedure.

These are the five worst practices of a bad injector that you want to identify and stay away from at all times. The reason why is because these five practices could conceivably lead to disfigurement, pain, scarring, infections, or simply poor results. You also want to be sure you get what you deserve for your money, and understand why cheap injection options are not always your best option or a bargain. This is why you want to aim for a quality injecting service and avoid a dodgy injector or cheap and fake products.

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5 Worst Practices of a Bad Injector

Here are the five worst practices of what could be deemed a ‘bad injector.’

Bad Habit #1. Over-Diluting of the Injectable (or Dilution of a Filler)

Not Using the Injectable according to Recommended Specs or over-diluting an injectable often means it will be less effective.

Some injectables (muscle-relaxant products) come in a powder form, in a small sterile glass bottle. These DO need to be mixed with a saline-based solution before injecting. But there are specific ratios (Specs) that need to be followed.

Other injectables (such as fillers) are generally ready to go.

For example, fillers are typically a gel and dilution is not recommended. These should not be diluted, but some injectors DO dilute them – even though they’re not approved for dilution. The companies that make these products know how much will be needed to perform a treatment for a certain facial concern. A well-trained injector will have learned, directly from the manufacturer and in additional training sessions, how to inject the substances precisely so that a minimum amount will be used for the best effect (and also avoiding the pillowy or over-injected look).

What should you do if you spot your Clinician diluting (‘mixing or watering down’) your filler product with another solution? Or if you suspect the wrinkle injection is being OVER diluted?

Anti-Wrinkle injections have a manufacturer’s recommended dilution rate, but a bad injector might exceed this in order to attempt to cut product costs to offer a ‘cheaper injectables’ option. Ask your Injection Clinician what dilution specs they are following (but do your research first) and ask what the BRAND of product is and where they purchased it from. This could save your life because, unfortunately, counterfeit products are rampant in the cosmetic injectables market (read the blog on the Medical Dangers of Fake Injectables).

Questions to ask:

The questions to ask are what is the brand name and type of the injectable; what is the injectable being diluted with, why – and if it’s being over-diluted or diluted against recommendations, why does the injector believe it will be better for you than using it at full strength. Ideally, the filler solution used for your skin comes straight out of a fresh bottle, is not diluted, and the brand name is clearly visible on both the container and the jar. For wrinkle injections that must be mixed before injecting, the key is that they are diluted precisely and to manufacturer’s specifications (and not over-diluted).

It is also helpful to ask how the filler or muscle-relaxing product was stored. A quality-focused Clinic and top injecting team will follow protocols for safe storage at the product safety and effectiveness-tested temperatures.

Bad Habit #2. Not Using Quality Injectables Products

The products used for your injectables should be high-quality products and ones you can see the package of if you ask the doctor. Prior to your appointment, spend about an hour personally researching the products that your injecting clinician might use. Whilst the Australian injecting clinicians cannot print the brand names of injectables in advertising, you should have a solid idea of the top brands used in Australia. Then you can ask the Clinician by phone – or in-person – so you know what you’ll be getting.

If you call the office and find out the names of the possible products that could be used in your situation, you can then do some online research. Save the photos onto your smartphone so you can compare them with the photo of the products your Injecting Clinician uses.

Use your discerning mind to notice the details.

If you’re satisfied with the comparison, proceed to the second office visit. This step is an important step, as many fake injectors – ones posing as fake doctors and nurses – use fake injectables. These fake products are obviously low quality, and may even be contaminated.

Unfortunately, the number of women that are opting for the use of substandard injectable products is rising. Women and some men are not using their mind to discriminate wisely between those who are using high-quality products and those that are not. The results could be disastrous, causing pain, suffering and scarring.

Bad Habit #3. Injecting in a Non-Sterile Environment

Offering to meet you at an apartment, house, or hotel or even a hair or beauty salon is a bad injecting practice for several reasons. First of all, there’s no way that any of these locations can be considered sterile or sanitary. Thus, it increases the chances you’ll develop an infection from the injectables. Doctors are taught to never place their patients at risk so this practice is unacceptable.

Secondly, highly qualified doctors operate out of medical offices, not people’s shops, homes or hotels. Thus, the chances that the nurses or doctors partaking of this practice is unlicensed or not even a doctor at all are great.

Don’t take a chance with your injectables!

Bad Habit #4. Injecting Incorrectly

Spend some time online watching doctor training videos for how they should do the injectable procedure. You’re not watching them for the purpose of doing them yourself, but simply for the confidence that results when you watch your highly qualified Injector do the procedure correctly. You will notice a big difference between injectors in how fast they rush the treatment, how dedicated they are to minimising bruising (usually by going slowly and not rushing although some people will bruise no matter what), and how much thought they give to the injecting strategy (including facial markings in advance of injecting).

DIY Injecting Training?

A potentially fatal flaw. Some people wrongly believe that they can watch a video and then do the procedure themselves. This is very dangerous thinking. First of all, how can you be so sure that the video is complete training? No training company is going to put their complete training on the internet for other companies to snatch their training and use the information without paying them for it. This would be a serious business blunder.

Secondly, when you are watching a video on how to do the procedure for the dermal fillers or injectables, think hard. What are they not showing on the video? The answer would be all the years of pre-existing knowledge that went into becoming a Clinician (RN, Physician or Plastic Cosmetic Surgeon). Hundreds of hours about germs, infections, sanitation, hygiene and preventing infections are part of the training of a well-qualified injecting professional. Where are you going to get that knowledge from? Unless you enter medical school, you simply won’t…and even then, it takes many years to become a master injecting Clinician.

Our culture now seems to downplay the achievements that many have, saying it’s nothing to accomplish this or that and that most things we can do ourselves.

It may be a Do It Yourself (DIY) world, on some counts. But with medical or cosmetic treatments, please don’t fall for this type of delusional thinking…because it could be seriously damaging or even deadly.

Being an informed consumer of cosmetic injectables and fillers is great, but it doesn’t mean you’ll be able to do it yourself (DIY) or for someone else. It’s great to know the procedure of the cosmetic injectables for purposes of your confidence only, nothing more. You should definitely only trust a fully qualified and experienced Injecting Clinician (Division 1 Registered Nurse, Physician or Plastic Surgeon). With so many GPs now entering the cosmetic services & injectables treatments market, it’s also good to ask JUST how long they have been performing injections. You really want someone who has decades of expertise in anatomy, skincare and injections and fillers for the best possible outcomes and best value for your money.

Bad Habit #5. Decanting the Injectable

Decanting an injectable means pouring part of one syringe into another. This practice brings up a lot of questions such as:

Will the syringe be used for another patient after it’s used to break my skin?
Was the syringe used for another patient prior to using it for me?
If it’s rare that someone needs more than one syringe, why does the doctor offer a price for a half syringe?

An experienced and highly qualified injector never decants the injectable. – There’s also an issue with the amount of time that the injectable should not be ‘stored’ or remain unused, once the bottle or container is opened.

The Bitter Truth About Anti-Wrinkle Products when you go to an injector who cuts corners to offer discounts.

Most of us are finding ways to keep our skin looking younger than our biological age, especially those of us who want to remain competitive in a youth-oriented world where deep wrinkles, crows feet and ‘laugh lines’ aren’t necessarily in favour. When anti-aging home remedies begin to fail you and surgical procedures like a Facelift or Eyelid Lift seem too complicated or just above your current budget, you can always rely on anti-wrinkle treatments such as anti-wrinkle injections or dermal fillers to cater to your cosmetic enhancement needs. In the last few years, injectable cosmetic treatments have gained extensive popularity in Australia, and across the world, for women and men of many different ages. In fact, for some people, the cosmetic injections route is a preferred approach, because it is so minimally invasive compared to the plastic surgery procedures for facial rejuvenation.

Injection treatments can help reduce wrinkles, fight atrophy of the skin and other facial structures (bone atrophy) and deter other signs of ageing.

They also tend to have minimal risks of unwanted effects, whilst offering a low cost of effective rejuvenation therapy. In fact, some people are getting them in what’s called “prevention” – a way of using injectables to stall the typical signs of ageing on the face, such as vertical forehead lines between the brows (the elevens), crows feet or lip lines.

Beauty Clinics and Dermal Filler Injections: Beauty’s New Normal Episode on ABC’s Four Corners

On 13 August 2018, ABC’s Four Corners covered a media story by Reporter Louise Milligan (@Milliganreports) on the risks of cosmetic injection treatments. The segment, “Beauty’s new normal,” focuses on concerns with cosmetic injections and other invasive procedures being performed by less trained doctors and non-monitored Beauty Clinicians who lack medical training. Additionally, the story covers the fact that many Surgeons in Australia offering cheap Cosmetic procedures may not actually be genuine, FRACS Qualified Plastic Surgeons, but instead – GPs, dentists or other doctors that have limited training in complex surgery they offer at a discount.

The August 2018 Beauty’s New Normal episode on ABC’s Four Corners also had expert commentary from several Australian Plastic Surgeons about dangers of ‘cowboy cosmetic practitioners’ or untrained injectors.

The program on cosmetic injections and mainstream cosmetic surgery on ABC’s Four Corners also focused on cosmetic injections risks with inadequately-trained practitioners.

There is a risk in cosmetic injections given to vulnerable patients who are unaware of the risks of dermal fillers and of using less-trained doctors – or worse yet, beauticians and others without any medical training or medical qualifications who are injecting patients in clinics and in private homes, with no medical staff present to handle emergency situations.

RISKS of Dermal Fillers and Less-Trained Injectors and Beauty Clinics offering ‘mainstream’ invasive cosmetic treatments such as prescription only “Schedule 4” medications delivered with needles or cannulas:

There are many people entering the cosmetic injecting and cosmetic surgery industry with very different skill sets and backgrounds.
Not all Cosmetic Injectors have the right training to offer cosmetic injections.
Some Clinicians who offer injections may have no medical qualifications and/or very limited training in facial anatomy and injecting techniques.
Some clinics that perform injections DON’T HAVE DOCTORS on-hand and sterility isn’t as much of a concern to them.

The Public is not yet aware enough of the differences in Cosmetic Injecting clinics and may shop on price, only to recognise – too late – they’ve chosen an untrained or unskilled clinician. Plus, not everyone really understands the risks of dermal fillers.

Dermal fillers and cosmetic injections ARE invasive and they DO have risks. The risks are even greater in unskilled hands, or when someone who has little experience administers the injections. There’s also a greater risk when someone uses non-sterile equipment.
In Australia, there is also a risk of counterfeit injectable solutions or “fake injectables” as well as ‘fake doctors’

Cosmetic Injections – including dermal filler injections – are very popular. But popularity does not mean they are suitable for every patient, or that every clinician can learn to use them.

Many people now consider dermal fillers to be a mainstream beautification treatment. However, they are invasive and there are risks.
And this is one of the featured stories in the Four Corners report on ABC airing on 13th August 2018.

Some risks of dermal fillers are very serious. You should inform yourself about:

patient selection criteria and its importance in prescribing these medications
the differences in skill levels – 10 years experience compared to a few months (“learner injectors” or “new injectors”)
permanent dermal fillers vs temporary dermal filler solutions – risks and dangers
how to prepare for cosmetic injections
the dangers of flying too soon after facial injections/dermal filler injections
you need to know about other risks, as well as how to reduce the ones you can reduce. You can’t avoid all risks, but there are some sterility measures that will reduce some infection risks.
injecting danger zones for dermal fillers/facial injections – areas of the face where complication risks may be elevated (that noted, every patient has unique anatomy and ANY and ALL injection treatments carry risks)
risk counter-measures and treatments should a complication occur
how to assess your Clinician or Medical Clinic before you consent to having these invasive treatments

And as seen in the news recently, dermal fillers or anti-wrinkle solutions injected into the wrong place, can lead to permanent blindness or other vision impairment.

So, whilst serious risks including blindness are rare in view of a large number of individuals having cosmetic injections by qualified practitioners, you DO need to consider these risks very carefully.
Do your research before you consent to one of these procedures – and choose your injecting clinician VERY carefully.
Even then, some complications – even serious or life-threatening ones – may occur despite your Injector’s knowledge of anatomy, their skill level and their focus on sterility.

Summary: Be an Informed Consumer of Cosmetic Injections and recognise they are a Schedule 4 Prescription Medication/Drug.

If you ARE having cosmetic injections, as hundreds of Australians do every day, a medical clinic or surgical clinic may offer a more sterility-focused and patient-safety minded environment than a beauty clinic or home-based ‘cosmetic injecting party’ environment.
But DO your homework before having injections and be sure you DO UNDERSTAND the risks of Dermal fillers.

Don’t increase your risks by choosing:

Unskilled practitioners
Inexperienced doctors, dentists, or pharmacists with little training
Places where cosmetic practitioners and beauticians offer dermal filler injections in clinics where there is NO doctor present and no medical assessment taken before the treatments.

What are the MOST Popular Cosmetic Injectables in Australia?

Some of the therapies that clinicians use to battle wrinkles are “micro-inasive procedures. Clinicians use muscle relaxant substances or dermal fillers for these procedures. They deliver the substances into the skin with injections using either a micro-fine needle or a cannula. The injections help to revitalize your skin and reduce lines or wrinkles. This gives you a fresher, tighter, younger look. Dermal fillers also recontour the face in order to improve overall facial appearance. Clinicians use them sometimes to combat facial asymmetry or uneven, gummy smiles.

1. Muscle Relaxing Injecting Treatments

Clinicians use a type of muscle-relaxing toxin in a controlled way for cosmetic procedures. The solution that they use can reduce wrinkles, of course. However, the effects of the injections may take a few weeks to fully appear. You’ll need to repeat these procedures overtime to ensure the best outcome. You need to remember their effects aren’t permanent.

Your clinician will put the substance that reduces or relaxes facial lines and wrinkles into your skin with micro-fine needles or cannulas.

The process is usually not uncomfortable as long as you have a good injector and follow protocols (there are some methods to increase comfort during injections also, as sometimes there’s a tiny stinging sensation which is quickly passing – but using ice packs can also help, and a good Injector finds ways of making the cosmetic injection treatments as comfortable as possible.

How Cosmetic Anti Wrinkle Injections actually Work

Clinicians inject a muscle-relaxing substance in very small amounts. These small amounts are what your clinician will charge for (the volume or amount that they inject you with). Clinicians measure these amounts in UNITS.

Clinicians consider the brands that work to be the best quality brands of wrinkle reducers. These brands relax tense muscles that cause facial expressions, which eventually also cause wrinkles. They also reduce frown lines and fine lines due to ageing.

How long anti-wrinkle injections last depends on a number of factors. You could see the effects that last from a few weeks to a few months. But, this depends on the dose and brand used. Patient factors play a role, as well, such as age, tissue mass, collagen, the depth of wrinkles, and the site of the anti-wrinkle injections.

The anti-wrinkle product comes in a powdered form and is diluted before use, but there are SPECS you hope your injector follows protocols

Our Team is adamant at providing quality injections and follows all recommended standards to offer long-lasting results, read our blog on the “Medical Dangers from Counterfeit Products“.

Alternatively, if you have a cheap injection place diluting the product beyond recommended specs – to offer deep discounts on anti-wrinkle facial injections by saving on product use – or if you have some injectors using other product brands without the quality reputation some brands have – then you may not be getting the most bang for your buck.

2. Dermal Fillers – Cosmetic Injections to the Face

The very first dermal fillers were of animal origin and were introduced in the mid 80s, however, these are not really used these days. Because of having an animal origin, these cosmetic injectables products had a tendency to induce some allergic reactions in sensitive patients. Before starting the actual procedure using those types of fillers, a patch test was mandatory.

However, fillers have changed and not the main content of a dermal filler is an approved temporary-filler-solution ((temporary)) based solution, with (temporary) also found naturally in your own body.

Lidocaine as part of the Filler Solution helps make facial injections more comfortable

Historically, around 2000, dermal filler formulations were first modified with the addition of lidocaine to improve the comfort levels of the injecting experience.

In fact, many doctors are now using cannula instead of needles to reduce the pain and local discomfort. The main content of dermal fillers is collagen protein (which is also a major component of skin and all connective tissues).

Are YOU getting the Injectables you are paying for and how do you tell if you are?

According to numerous resources, it appears that a lot of smaller clinics and beauty centers may be thinning out (or over-diluting) the wrinkle injection powders by adding too much of the saline solution.
Some also use less quality brands which may not have as strong or as lasting an effect on the wrinkles you are wanting to reduce with injection treatments

Sometimes clinics do these things in order to offer cheaper injections by using less actual ingredients. But this practice skimps on the ingredients that give injections their wrinkle-reducing effects.

Unfortunately, people fall for these non-reputable clinics over reputed ones because:

The difference in the cost of therapy can be huge.
Sometimes smaller clinics and beauty salons charge less for therapies from a reputed clinic. Coco Ruby, for instance, refuses to use brands that are low-quality, and we’re adamant about proper dilution. We measure, we don’t skimp and we never over-dilute. It would be against outpatient care ethos if we did.

Some recent data indicates that over 32% of candidates who opt for cheap injection therapies appear unaware of the fact that only a highly trained Doctor, Surgeon or Registered Nurse should carry out injectable therapies.

The actual dynamics of the procedure (i.e. dilution, recommended dosage, quantity in each unit etc.) is unknown to a common person.
Most people who get injection therapies don’t do much research. Therefore, they don’t know what’s in wrinkle prevention injections or dermal fillers.
Read our blog for other articles on this topic including the dangers of fake injectable products in Australia

What are some of the Pros and Cons of Injectable Therapies?

As the name indicates, “injectable cosmetic procedures” work by either one of the three common mechanisms:

Filling up lines or wrinkles on your face
Puffing up the areas which have sagged down due to loss of subcutaneous fat as part of ageing process
Relaxation of tight or taut muscles
Relaxing the muscles which cause the expressions that deepen lines and wrinkles once they start to form

Like all cosmetic treatments, injectable treatments also have some strengths and weaknesses which you should know before opting for it.

Injection treatments are popular for men and women who want to look their best or younger. They can help you look your best by reducing signs of ageing. They can also reduce effects that leave you looking angry, tired, worried or concerned.

Here is why patients consider opting for injectable cosmetic procedures:

As compared to the traditional surgical approaches (such as face lifting); injectable cosmetic procedures are far more economical and less time consuming.
Most people achieve their desired cosmetic results quickly.
Many people who are concerned with their appearance will be unhappy with the signs of facial ageing. These people can get some pretty strong anti-ageing effects from injectables. However, injectables treatments are not superficial cosmetic treatment. You should not take injectables treatments lightly.

It is noteworthy that the effectiveness of injection therapy also depends on a number of other factors.

For example, people who are in their 50s or above may not see a dramatic improvement with fillers. This is because of skin laxity and draping. All such individuals are a better candidate for face lifting.

Summary

People who have bleeding disorders, pimples, skin infection or inflammation, rashes, cysts and history of severe allergies should ask about their suitable for injectable cosmetic procedures, as they may not suit patients with these health conditions or sensitivities. Be sure you’re honest during your consultation with an injecting nurse.

Be sure that you find a Certified Medical Professional to perform the procedure (RN, doctor or surgeon). You’ll want someone who has extensive experience, and not someone who’s just taken a weekend course.

Ask about all of the possible risks and side effects of injecting treatments.

You should also discuss your medical history thoroughly. This will let your clinician help determine the best type of approach for your ageing or wrinkle concerns.

Doing your research BEFORE opting for a particular cosmetic procedure, whether facial surgery (facelift, eyelid lift) or injection therapy (dermal/ lip fillers or wrinkle relaxers) – to help you make an informed decision about which procedure is going to be right for you. You may find that a combination of procedures will get you the best outcomes, in comparison to just one approach.

For more information or to ask our Clinicians about getting good quality injection treatments, phone us on (03) 8849 1400 today.

Medical References:

Carruthers, J. D., Glogau, R. G., & Blitzer, A. (2008). Advances in Facial Rejuvenation: Approved injectables solution Type Approved temporary-filler-solution Dermal Fillers, and Combination Therapies–-Consensus Recommendations. Plastic and reconstructive surgery, 121(5), 5S-30S.
Lowe, N. J., Maxwell, C. A., & Patnaik, R. (2005). Adverse reactions to dermal fillers: review. Dermatologic Surgery, 31(s4), 1626-1633.
Sinha, A., Hurakadli, M., & Yadav, P. (2015). Approved muscle relaxant solution and derma fillers: The twin-face of cosmetic dentistry. International Journal of Contemporary Dental and Medical Reviews, 2015.
Curi, M. M., Cardoso, C. L., Curra, C., Koga, D., & Benini, M. B. (2015). Late-Onset Adverse Reactions Related to an Approved temporary-filler-solution Dermal Filler for Aesthetic Soft Tissue Augmentation. Journal of Craniofacial Surgery, 26(3), 782-784.
Bellomo, R., & Harrington, L. K. (2016). Neurotoxins and Dermal Fillers. Physician Assistant Clinics, 1(2), 333-345.

But if you have had a bad experience with an injector who used the wrong products or the wrong injecting strategy and you either need Tension Headache treatments using injectables, we can help on both counts.

Please call today if you are considering Cosmetic Injectables. We’ll do them correctly and help set your mind at ease. Plus, if you’ve had prior injecting experiences, you’ll soon learn why the Coco Ruby Injecting team is sought after. We provide high-quality, precision injections and other leading skincare treatments including Fraxel, DOT therapy and Dermapen.

Worst Practices of Dodgy Injectors – 5 Bad Habits to avoid