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  • Writer's pictureDr. Chuck Lortie MD, FRCPC, FAAD

Are Cosmetic Procedures Safe?

Updated: Sep 16, 2023

Cosmetic procedures have become very popular with Botox and filler injections being two of the most common. Currently, there is also great enthusiasm for newer energy-based procedures such as laser resurfacing, RF microneedling (skin tightening) and RF-based nonsurgical fat reduction as well.

What does the data say?

Research looking into the most popular cosmetic procedures has confirmed that these they are "exceedingly safe" when performed properly with "essentially no risk of serious adverse events".(1)

As a dermatologist and a fellowship trained cosmetic dermasurgeon, however, I am sometimes asked to see patients who have undergone procedures that appear to have gone wrong.

Case study:

One such patient related to me that she had undergone an RF-based nonsurgical fat reduction to her back at a local cosmetic facility. She initially trusted that her experience would be straightforward. As her treatment session went on, however, she began to experience an intolerable degree of discomfort beneath the device pads placed over her back. She describes that the technician initially reassured her that such discomfort was not uncommon. The procedure was allowed to continue for a further period of time. Following the treatment, however, the pain persisted and the patient contacted our office.

She was gracious enough to share these photos of her back demonstrating the progression of her skin changes noted over the course of the week that followed. As evident in the photos, she had clearly suffered a significant injury to her skin during this procedure.

Proper medical oversight is key

To help understand how this can occur it is useful to explore the regulation of energy-based devices in Canada. Oversight of energy-based products is generally a federal responsibility to ensure that systems sold here are safe and effective when used for their licenced medical purposes by trained professionals according to directions of the manufacturer.

Since healthcare is under provincial authority, however, regulation over who the "trained professionals" are that supervise these devices in Alberta may be less certain. As an example, the College of Physicians and Surgeons of Alberta (CPSA) regulates and provides guidance for physicians. It also regulates energy-based devices, such as medical lasers, which are required to undergo inspection of their energy output as well as updated registration annually.

Though government has granted the CPSA the power to enforce regulation over doctors in Alberta, it has little or no authority over other practitioners who may purchase or lease these devices, but are not medical physicians. Thus, cosmetic devices in facilities that do not have a physician as their "owner/director" may not undergo the same degree of oversight as that provided by the CPSA, or possibly no oversight at all. As a consequence, such facilities may also not be required to up hold the same standards of care.

Our best advice regarding cosmetic procedures...

So then, how can a consumer of cosmetic services be more reassured that they will receive safe and effective care? These are our recommendations:

  • Attend a facility with an on-site physician supervising all care as a dedicated medical director.

  • Be sure you have a proper medical assessment, including documentation of your condition, a mutually agreeable treatment plan and a discussion of your expectations as well as the expected outcomes.

  • Inquire as to the degree of specialized training the medical director has in regards to knowledge of the skin (dermatology) and/or, cutaneous surgery (dermasurgery or plastic surgery) as well as their years of experience providing cosmetic treatments. Physicians with specialist training in Canada will have the designation FRCPC (Fellow of the Royal College of Physician of Canada) following their name.

  • Be sure to inquire regarding any possible complications prior to the procedure being initiated. A formal Medical Consent Form that you are required to sign should also be part of this process.

  • Finally, cosmetic procedures are never emergencies. If you feel you are being pressured to undergo any procedure, you may wish to hit the pause button and seek a second opinion.

Again, it is worth restating that most popular cosmetic procedures are exceedingly safe. Though complications are always possible, they should be a rare occurrence. Most complications are avoidable with proper precautions. Attention to the expertise of the provider, the regulation that governs their care and the equipment they use should help to prevent any of these concerns from affecting you.

1- Safest cosmetic surgery procedures: National study offers broad evidence of safety for minimally invasive procedures (Northwestern University). Science Daily; Nov. 4, 2014.

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