Where is the Aesthetic Industry headed for 2020

Where is the Aesthetic Industry headed for 2020

The competition and rivalry in the aesthetics industry is no surprise to most veterans. Many surgeons, doctors, nurses will be overly friendly to your face and stab you in the back behind closed doors. This culture has instilled a “trust, no one” approach for most clinicians, distributors and of course media representatives. It is a negative outlook and sad way to approach an event or perceive others. If we believe everyone is out for free product, to sell advertising or find some gossip to undermine a competitor, we all become disheartened. This is something we have seen firsthand unfold over the last few years.

There have been significant traumas which have had a ripple on effect. In 2017 we had a woman die in Sydney from imported or off label filler injected into her breasts. In 2018 we had our first of now 3 cases of blindness due to filler. Whilst we have also seen a significant rise in opinions regarding who should or should not be injecting. This has had a devastating impact on the industry. By the end of 2018 the industry was fragmented, the various industry groups all preaching “patient safety” but no one addressing the practitioner’s safety. Practitioners in 2019 are in an extremely difficult position between the patients requests and expectations and that of the industry. If a patient requests a certain aesthetic look which is not consistent with a subtle natural look, that practitioner is labelled by the industry. If a practitioner refuses to work to what a patient desire’s, the practitioner is labelled by patients as too natural. Either instance the practitioner at no fault of their own is judged, labelled and potentially jeopardising their aesthetic business. Therefore, the question must be asked, who is driving the aesthetic industry, the patient or the doctor?

If we look online, the most popular and sought-after clinicians are not restricted to one specialty and are very authentically forthright in what their art is. This is a secret ingredient to their success, they are attracting the clients who resonate with their aesthetic eye, ethos and values. This is not easy for a new business or new clinician and we see this all the time. We have had new practitioners ask for our help and have had to decline the work. Sounds crazy, but if you don’t know who you are, what you stand for and who your ideal client is, we are going to fail. It is that simple and no one likes setting themselves up to fail. If you are an injector taking on work you are not proud of, you will only continue to attract the wrong clients. It is like asking an abstract artist to create a life like sculpture, or a portrait painter to design a building. It is true that in all forms of art, from marketing design to musicians and painters, if you are not true to your aesthetic eye you will lose your passion. When we lose our passion, we become complacent, aesthetics is no longer an art, it is a job. You are no longer a unique artist you are another person in the service industry performing a skill.

trusted surgeons

If we look at injectors as artists, as we do an aesthetic surgeon, the importance of finding an injector with your type of aesthetic eye is imperative. A young woman entering the porn industry would not see a surgeon who only performs conservative breasts for a breast enhancement procedure. We have surgeons who inserts eurosilicone 800cc implants and surgeons who only inserts motiva 300cc or less, both qualified, experienced and highly sought after. They are both reputable and honest. It is transparent the larger the implant, the bigger the risk but ultimately it is still the patient’s choice. With injectors if you choose an injector who may on average use 10 syringes and large volumes of filler, eyebrows raise. Many clinicians think, hmmm are you sure you want to see that injector. Or “I wouldn’t take on these patients as it is my reputation on the line”, these comments are perpetuating the great divide between practitioners. God forbid the duck lip injector is a nurse, immediately she is labelled as inexperienced and a poor injector. However, she may love her lips, her clients may very well love their lips and the problem is not the injector, it is society enforcing what “should” be rather then what “could” be. To further add to the debate is where does patient safety fit into this fragmented industry. If practitioners are all competing against each other, it is unlikely they will openly share their complications. Considering how successful our leading conferences are (Non-surgical symposium, Cosmedicon & Aesthetics 2019), I would like to believe the vast majority do love to collaborate and share their triumphs and tribulations. It is not rocket science the more patients you inject, the higher the risk of a complication. No one regardless of their title or years’ experience is free from complications. It is interesting when watching presentations on complications the vast majority are “patient from another practitioner”. It is very rare to see a practitioner on stage presenting their own complications, that they caused and how they managed. This information is incredibly valuable, and this is where fear and risk-taking behaviour truly does have a direct impact on patient safety. As Associate Professor Mark Magnusson stated words to the effect “There are no safe zones, there are only safer zones”. If we have no accrediting body for injecting, we have no mandatory training or conferences, how do new injectors learn the fundamentals? The big pharma companies most often provide training and that is fantastic, however who accredits their training? Who sets a benchmark? If the practitioner doing the product training is to then buy product, does anyone fail training? I dare say no.

I am not an injector or an experienced aesthetic practitioner, so I asked some of the experts three simple questions which I believe are catalysts for the fragmented aesthetic industry:

Dr Naomi Cosmetic Doctor – The Manse Clinic (Sydney)

Dr Naomi The Manse Clinic

1. What qualifications do you believe an injector should have?

I think cosmetic doctors who perform injectables should have studied medicine and should be a Fellow of one of the cosmetic medical colleges ie

CPCA, ACAM or Faculty of Medicine, ACCS.

2. Do you believe there should be a benchmark for injectable training?


3. What would you recommend patients look for when searching for a cosmetic injector?

Go to the College Websites above and find the doctors who are Fellows of these Colleges.

I have given a long and more detailed answer to this question in my blog post about how to find the best injectable clinic

Dr Naveen Somia, President of the Australasian Society of Aesthetic Plastic Surgeons, said it is important to define injectable cosmetic procedures as an invasive medical procedure.

Dr Naveen Somia

"It is prudent upon cosmetic injectors that they work within the realm of safety by recognising and sticking to their level of competence and scope of practice as deemed by their accreditation with AHPRA.

"Injectable cosmetic procedures should only be administered in an environment that is set-up appropriately to manage emergencies, and if the cosmetic injector has the appropriate training, expertise, and experience to perform the procedure and deal with all routine aspects of care and any possible complications," Dr Somia said.

Dr Sean Arendse - Senior Emergency Consultant and Cosmetic Doctor (Melbourne)

DR Sean Arendse

1.What qualifications do you believe an injector should have?

Currently there is no recognised injector specific training to become an injector, but at the bare minimum they should be a registered Doctor or Nurse with AHPRA.

2. Do you believe there should be a benchmark for injectable training?

Yes, I do and it’s something that the CPCA is working towards offering to Cosmetic physicians

3. What would you recommend patients look for when searching for a cosmetic injector?

    ·Registration with AHPRA

    ·Membership of a organization which requires its members to adhere to standards such as CPCA, ASCD, ASAPS, ACCS

    ·Word of mouth from people who have seen that practitioner

    ·The setting where the treatment is taking place i.e. medical clinic vs hairdressers

    ·That the Injector has full medical backup from a doctor who can deal with and cosmetic or medical emergency immediately and in person

    ·Don't chase price, chase the skill of the injector

Dr Johnathan Brown Cosmetic Physician and General Practitioner

Dr Johnathan Brown

1. What qualifications do you believe an injector should have? I think a cosmetic injector should be a Registered Nurse or Doctor.

2. Do you believe there should be a benchmark for injectable training?

Absolutely. As a GP in the UK you must undergo mandatory training and pass your Royal College of GP exams before practising. In Australia as a GP we must achieve CPD points to keep our registration with the Royal College.

I think there should be one independent College for injecting Doctors and Nurses. The industry is too fragmented at the moment - there is the CPCA, ASAPS, ACAM to name a few. It is confusing for cosmetic injectors and the public and having an Independent College with mandatory training would be great for improving patient safety.

3. What would you recommend patients look for when searching for a cosmetic injector?

Patients should always check the AHPRA registration of the Practitioner to ensure they have current registration. Also - ask the practitioner to see how long they have been injecting and how many treatments they have performed.

It is clear from the responses more can be done by way of improving patient safety and minimising risk. The demand is high. Those from a low socio-economic demographic, care about their appearance just as much as those more affluent. This is why we see back room set ups with imported product and we hear of patients who purchased their own injectables online. The industry is extremely difficult for any professional body to govern. The only way moving forward, to truly put patients first is for one unified, government recognised benchmark. If the CPCA create a benchmark specific to Cosmetic Physicians, where will this leave the nurses? dentists? gynaecologists? Are we heading towards more divide or more collaboration?

We can learn a lot from the past and the industry experts. Is it possibly time that a panel is created to consult with federal government and all the mentioned organisations to join forces? CPCA, ASAPS, ACAM, ACCS – all unique entities within they own right, however they all share one goal in common: Patient safety first and always. If we are solely talking about non-surgical procedures, could this be a step in the right direction? If not, could we see a rivalry lasting years and effecting hundreds of patients as with the past 20+ years between Plastic and Cosmetic Surgeons. It would be a huge disservice to patients to see such a divide between cosmetic doctors and nurses.

What we do not want to see is patients hurt and harmed from an aesthetic procedure, which has a direct impact on everyone within the industry: