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When you set up your own Medical Aesthetics practise, you will quickly find a Ghost that haunts you. You will particularly experience her looming shadow if you decide to offer Lip Filler treatments. But we can pretty much guarantee that her name will crop up over and over regardless. “I don’t want to end up looking like Leslie Ash!”: it is a plea from your clients that will become all-too familiar.

The Leslie Ash “Look” is certainly not high on most people’s aesthetic wish-list. You have most probably seen the recurrent pictures in the media of her now infamous “trout pout”. The unfortunate woman has been hauled over the coals as an example of Cosmetic Surgery Gone Wrong in every woman’s mag. article of that theme ever since her Lip Body treatment in 2002.

Ash originally claimed she had collagen Lip Implants to correct her disappearing top lip (an unfortunate but common side-effect of ageing) and maintain her image in the public eye. Ironically, the treatment had the opposite effect, bringing her notoriety for all the wrong reasons. Back in 2003, the actress typically told the Press that her permanently swollen, upwards-curled top lip was a terrible accident and the result of a reaction to the collagen in the implant. By 2010 she had conceded that it was not an implant at all, but an injection of liquid silicone (the same lethal cocktail responsible for the recent death of Claudia Aderotimi) which had caused the ridiculous effect.

“The Curse of Leslie Ash” is therefore that hundreds of women who would otherwise have considered lip-enhancing treatment have now been put off completely. And of those that do approach you for procedures, a large number will need reassurance that they will not leave your Clinic looking similarly over-the-top or caricatured.

In his talks to delegates attending Medical Aesthetic courses at the Cosmetic Courses National Training Centre, Mr Adrian Richards (Consultant Plastic Surgeon) is always keen to set the facts straight. For starters, there should be broader awareness of precisely which treatment Leslie Ash underwent: it seems very wrong that by initially shielding the truth, she has created mistrust and fear of both Lip Fillers and Lip Implants. Prospective clients do not realise that Dermal Fillers are not the same as the injections which she had, and can give lovely subtle enhancement to both the lip body and border (in the hands of a qualified, trained medical professional). Nor do they always understand that she did not have a Lip Implant at all and that it is therefore well worth investigating the potential of Permalip implants. In fact, Mr Richards highly recommends the Permalip implant as a method of augmenting the lip body: these implants come in a huge variety of sizes and shapes, are sculptable, safe and above all can be removed if necessary.

In contrast, Liquid Silicone injections, like Ash had injected into her lips by a plastic surgeon whilst at a friend’s house, is permanent. And as Mr Richards warns all his trainee Aesthetic Practitioners, ‘Permanent fillers cause Permanent problems’. In Leslie Ash’s case, the silicone set around the muscles in her lips and it is now impossible for surgeons to remove it.

So there you have it: of course, however silly the actress may have been, she is also incredibly unfortunate. She is certainly not alone, but possibly receives more publicity about the matter than most and will almost certainly be one of the names you come to regard as a bug-bear. Instead of getting irritated by this, however, try to see your role as educating your clients, so that others do not make the mistakes of Ash and others. With this knowledge, you can ensure that you offer only the best and most suitable treatments and therefore provide genuine reassurance that your clients will not walk out of your Treatment Room and straight into the Gossip Columns!

For the first time ever, an attempt has been made to monitor and control places that provide Botox treatments and “filler” injections. With 5,000 clinics performing approximately 200,000 Botox treatments for wrinkles and filler treatments designed to plump lips and sagging skin each year in the United Kingdom, the industry is in dire need of regulation. Although there are plenty of legitimate practitioners working in the industry, there are also far too many rogue practitioners administering treatments they are not qualified to give. To combat this, only doctors, dentists and nurses will be invited to participate in this attempt at regulation, along with organizations that provide Botox and filler injections. Once accepted, these practitioners will receive certificates of approval proving the quality and safety of their service.

The main problem with this proposed system is that it is voluntary. The charity Action Against Medical Accidents declared that if the Government does not make this system statutory, many people will be left at risk because an industry cannot be trusted to regulate itself properly – especially an industry that is as large and prosperous as the cosmetic industry. The Government requires any major cosmetic surgery to be regulated, but as Botox and filler injections are relatively minor non-surgical procedures, they can be offered by just about any business. Peter Walsh, the chief executive of Action Against Medical Accidents declares that his charity will continue “using our experience and influence to make this scheme as robust as it can be.”

One of the best reasons to create a regulated cosmetic industry is to help reduce the amount of botched cosmetic procedures. The most high profile examples of cosmetic treatments gone wrong are usually celebrities. For example, in 2003, Leslie Ash, the star of the television show Men Behaving Badly, had filler injections on her lips. The procedure went wrong, resulting in a look known as the “trout pout.” It is hard to determine exactly how many people have suffered from cosmetic treatments gone wrong or adverse side effects since many people are extremely embarrassed as to what has happened to them and would prefer to keep it quiet rather than raise a national ruckus. Also, without strict guidelines, many practitioners may turn to shady and dangerous treatments. For instance, in 2005, two government reports were published detailing how several practitioners supplying filler injections were using material from both animal and human corpses – material that could have been infected with hepatitis and other deadly diseases.