Buyer Beware: Fixing Botched Cosmetic Procedures

When you make an appointment for a cosmetic treatment that’s supposed to leave you looking better than before, the last thing you expect is to walk out looking worse. But that’s exactly what happens when someone who is not properly trained, experienced, and qualified performs the procedure. And it happens all too often. Treatments such as Botox, dermal fillers, laser skin resurfacing, and even laser hair removal, all carry small, but potentially significant, risks. When you put yourself in the wrong hands, that risk increases.

Experience counts, and it shows up in the results you receive. “I have been injecting Botox for 20 years, but there are practitioners who took a weekend class to learn to inject it,” says Debra Jaliman, MD, a board-certified dermatologist and assistant clinical professor of dermatology, Mount Sinai School of Medicine. “Who would you rather trust your face to?”

What could possibly go wrong?

Horror stories of cosmetic procedures gone wrong often make the news. There's coverage especially when it’s something as devastating as someone dying from botched liposuction. But a treatment doesn’t need to be fatal to have life-altering affects.

Laser treatments—including those to correct dark spots, erase blood vessels and even those used for hair removal—are frequently offered in spas and operated by practitioners who aren't medically trained. Not surprisingly, they also have the highest incidence of injury. “When an incorrect setting is used on a laser, there is a chance of burning the skin,” says Gervaise Gerstner, MD, a board-certified dermatologist in NYC and assistant clinical professor of dermatology, Mount Sinai Medical School. “I’ve seen permanent white patches on dark skin, residual redness, and even depressions and scarring from lasers that weren’t used correctly,” she adds.

And when the needle is in inexperienced hands, injections can also carry risks of unintended results. “If dermal fillers are injected into the wrong spot, the face can look unbalanced, there can be bruises or scarring, or the product can cause visible lumps under the skin,” says Doris Day, MD, a board-certified dermatologist and clinical associate professor of dermatology, New York University Medical Center. “And improperly placed Botox can cause uneven or drooping brows,” she cautions.

How can you fix a botched job?

Dermatologists are reporting seeing more and more patients who come in for repairs. They want the doctor to fix a problem that occurred during a procedure they thought would help make them look better. “I just saw a woman who had a laser treatment to erase broken blood vessels,” says Dr. Day. “The blood vessels are gone, but now she has permanent brown lines where the vessels used to be.”

It can end up costing many thousands of dollars more to repair burns, discoloration, and scarring. And that's in addition to the time and discomfort of having several treatments. And even after all that, the end result will most likely not be perfect.

Injections gone wrong can sometimes be quickly fixed—for example, a misplaced injection of a hyaluronic acid based dermal filler such as Belotero, Juvederm, Restalyne, or Perlane, can be instantly neutralized with an injection of the enzyme hyaluronidase. But with dermal fillers such as Radiesse and Sculptra, your only choice is to wait for it to be metabolized by your body and gradually disappear, which can take up to a year. Same goes for Botox, which wears off in 3 to 6 months. And if it’s a permanent filler (such as Artefill), you're pretty much stuck with the results unless you have it surgically removed.

Of course, even with the most skilled physician, things can—and sometimes do—go wrong. The difference is that someone with the proper knowledge, training and experience can respond quickly to rectify a problem. “A person who knows what they’re doing will recognize right away if something doesn’t go well. And they can address it immediately to minimize any damage,” says Day.

The Bottom Line:

Follow the same guidelines we do when selecting cosmetic doctors to included in our expertly curated directory, The Book. Dermatologists should be certified by the American Board of Dermatology (ABD). Plastic Surgeons should be certified by the American Board of Plastic Surgery (ABPS). Both of those boards are part of the American Board of Medical Specialties (ABMS), a non-profit organization that is considered the gold standard of physician certification. For more information about how we choose our providers, please read Credentials We Abide By.