By Sarah Shafer
For reasons I Kardashian explain, trying to look “marvelous” is a big deal. In 2018, non-invasive cosmetic procedures, like botulinum injections, cosmetic fillers, chemical peels, and laser hair removal, were performed almost 16 million times. This, vastly outnumbered invasive procedures, such as breast augmentation and liposuction.
With most things associated with wealth and status, aspirational consumerism drives a “knock-off” market where people can fashion themselves with a facsimile of the product that they desire. Non-invasive cosmetic procedures are no different. When one can’t afford $1000 for botulinum injections or $500 for lip fillers, it turns out that a cousin of a co-worker knows of someone that can do it for $200. “Seems too good to be true,” you wisely think to yourself, “there’s got to be a catch.”
Clearly, there are strong societal forces taking effect when a person decides to pursue illegal cosmetic procedures. The world-wide beauty industry is a behemoth made up of $532 billion of revenue in 2017. Just to put that number into context, it would take you 16,846 years to count out 532 billion seconds. If you were given $10,000 every day, it would take you roughly 147,000 years to save up $532 billion. To put it more simply, $532 billion is approximately 3.7 Bezos units (BUs).1
Approximately 73% of people are unhappy with their appearance.
With money, comes power, and the beauty industry wields its power thusly. Approximately 73% of people are unhappy with their appearance. This translates to the average American spending $3,300/year on their appearance.2 In 2017, the beauty industry spent approximately $10 billion on advertising alone, not to mention the undercurrent of messaging that permeates every facet of marketing and media.
So what are the risks associated with illegal cosmetic fillers? One major problem is that the people who are offering these services may have little to no medical training. They are often unlicensed practitioners who offer their services out of locations that are not appropriate for medical services, such as hotels or private homes. There is also no guarantee that the products they are using are safe. Medical-grade injectables are produced under a highly regulated environment to ensure sterility. In addition, these agents undergo scrutiny by the FDA before they’re cleared for use in human bodies. Almost all facial fillers are made up of biodegradable products, which is why their effects are temporary. Autologous fat injection provides a more permanent result, but this requires a two-step procedure where fat is “harvested” through some sort of liposuction before it is injected into a different location. Any kind of silicone implant is surrounded by some kind of membrane designed to prevent leakage/migration. The FDA has not approved any kind of injectable silicone except for use in ophthalmic surgery since the 1992 ban that came after the Dow breast implant controversy.3
Patients may be under the impression that they are receiving medical-grade silicone when they receive treatment from illegal practitioners, but instead, they may be receiving anything from industrial silicone, Fix-A-Tire sealant, Super Glue, cement, animal fat, to whatever else is being used by the illegal practitioner. Illegal practitioners are also more likely to inject large volumes of silicone, with some people receiving as much as 8 liters in an attempt to sculpt their bodies.4 Some physicians advocate for the use of injectable silicone, but even then, they support the use of micro-injections given the risk of significant complications of large-volumes of silicone. Whether injected in small or large volumes, silicone injections lead to two major groups of complications: local adverse effects and embolization.
One of the reasons the FDA banned injectable silicone is because it can spread from its original injection site. These silicone emboli can travel in the bloodstream as a tiny plug embedding themselves somewhere they don’t belong. Emboli themselves are not dangerous. What makes them dangerous is that they can block blood flow to sensitive tissues. Emboli that travel to the brain cause stroke symptoms. Silicone injected near the eye can cause blindness by blocking blood flow to the retina. The most common place for silicone embolic phenomenon to occur is in the lung tissue. There, they can cause anything from local hemorrhage/inflammation to a deadly respiratory condition called acute respiratory disease syndrome (ARDS).5 Media reports of sudden death after illegal silicone injection is likely due to embolization causing multiple organ failure.6 Injected silicone can also migrate away from the original injection site, causing disfigurement, along with the risk of local inflammatory effects at the new site.4 There are no real treatments for these conditions except supportive care.
Liquid silicone was originally thought to be the ideal substance for body augmentation because it was thought to be long-lasting and insert. However, experience has taught us that while silicone is relatively inert when compared to other long-lasting injectables, it can still cause local reactions. One of the more common reactions is local granuloma formation, which is a local inflammatory reaction that causes swelling and redness.7 In the grand scheme of illness, this is not that big of a deal except that it can be disfiguring, and since silicone injections are often applied for cosmetic reasons, this can be particularly difficult for the patient. Aside from granuloma reactions, local reactions to the injected silicone can be very dramatic and disfiguring, especially when the silicone injected is contaminated. Irritating chemicals can lead to massive soft tissue reactions, causing necrosis and sloughing of the injected silicone. Because the silicone is not sterile, it can also introduce serious infections. Sometimes the only treatment is to have surgery to scrape out the injected silicone, which can become a massive endeavor since it is not contained within a membrane-like FDA-approved silicone implant.
Check out these links to see some additional complications:
The scariest thing about silicone injections is that these reactions can happen at any time; adverse reactions have occurred upwards of 20 years after injection.4 Embolization can also occur during any manipulation/procedures involving the injected sites.8 With all the risks involved with illegal injectable, why would anybody take the risk to do this? It seems like such an obviously bad idea on its face, but there are very powerful influences that guide a person’s decision to pursue illegal medical procedures. It sounds like a bad idea to get illegal injections. Then again, the results in front of you are undeniable. Your co-worker looks great with their newly modified physical attribute. Maybe it’s not so bad? What if you work in a tip-based industry where a boost in your physical assets might pay out in the form of bigger tips? Then the decision also becomes economic as much as it is aesthetic. If you’re a transgender patient, illegal injections may be your best chance at living in a body that is more authentic to your gender identity. With this kind of pressure, it’s disingenuous to brush off the problem of illegal fillers as silly vanity. Beauty is a huge industry, and the pressure to conform to aesthetic appeal is strong. However, the dangers of illegal injectables are very real, and at the end of the day, the question is whether it’s worth dying to get the right look.
Peach by Charles 🇵🇭