Words by Dr. Selena Langdo


The popularity of non-surgical cosmetic treatments is growing with the number of people offering them. In the right hands non-surgical treatments can deliver fantastic results, restoring a more youthful appearance and enhancing your natural beauty. 

As a doctor I have spent many years training, initially in Plastic Surgery and then in General Practice before moving into Aesthetic Medicine. When I first learned about the Aesthetics industry I was shocked to learn that anyone, regardless of their training or experience, is allowed to inject products like Botox® (a common brand name for anti-wrinkle injections which is a prescription-only medicine) and dermal fillers or operate medical devices such as lasers and cryolipolysis machines.  


The lack of regulation has resulted in a growing number of untrained and unscrupulous people providing non-surgical treatments. These individuals are enticing people to have treatments by offering huge discounts or making claims that are at best misleading or simply untrue. The real danger however lies in the fact that without the proper training or medical oversight, these treatments provided by unqualified practitioners can have disastrous results. 



There are a growing number of non-surgical treatments available with a lot of exciting innovations, the most popular include:


Anti-Wrinkle Injections  

Most often referred to by the brand name Botox® (Botulinum toxin), this treatment is one of the most well-known and popular. Anti-wrinkle injections are used to smooth dynamic lines (lines which are visible when you change expression) and the results will last between three to four months. Botulinum toxin is a prescription-only medication and should only be administered following a consultation with a medical professional as a prescription for the treatment is a requirement.


Derma Fillers

Are most commonly made of hyaluronic acid which is a naturally occurring sugar chain molecule found in all skin and soft tissues throughout the body. Dermal fillers are a multi-functioning treatment and can be used to reduce deep lines and wrinkles, fill hollows and smooth the contours, as well as adding or restoring volume to areas of the face such as lips or cheeks. Dermal fillers are considered to be medical devices and often contain Lidocaine (a local anaesthetic) which is also a prescription-only medication.


Chemical Skin Peels

Chemical peels remove layers of skin (how many depend on the type and strength of the chemical used). They can be used to reduce the appearance of uneven pigmentation, acne and other skin problems and can rejuvenate sun-damaged skin, stimulating the growth of new skin cells making your skin appear healthier and younger.  



First licensed for use in 2010 by Zeltiq under the brand name CoolSculpting, this treatment removes fat cells by freezing them until they die. This treatment is extremely popular in the United States and used by plastic surgeons as an alternative to liposuction. CoolSculpting is the only FDA cleared device for cryolipolysis that has undergone rigorous testing for safety and effectiveness, however there are many copycat devices which are untested for their effectiveness or safety that claim to be Coolsculpting. 



What can go wrong?

Recently publicised cases of non-surgical treatments going wrong have included cases of blindness and disfigurement. One such case involved a woman whose face has been left scarred by a clinician performing a chemical peel without adequate training. While facials and peels might seem safe, many involve the use of potent chemicals which should only be used by doctors with the necessary training and experience in a controlled way. 

Another, more worrying issue, is the use of dermal fillers which if accidentally injected into one of the blood vessels in the face can cause blindness and tissue necrosis (skin death) if not treated quickly. As a doctor, I have studied facial anatomy extensively so understand where it is safe to inject. To ensure patient safety I also have in place protocols and procedures to treat complications if they arise which is another reason it is important to only choose a medical professional. Always bare in mind that the only way to treat many complications is to use prescription only medications such as adrenaline or hyaluronidase – only a medical professional can do this. 



What is being done to regulate the industry? 

In short, nothing. In 2013, the UK Government commissioned a review into cosmetic procedures, and concluded that dermal fillers were ‘a crisis waiting to happen’. But very little has been done since then to curb unsafe practices. While there are many doctors lobbying the government to improve the situation by introducing the same oversight as for other medical procedures, in the short term the onus will remain on the public to protect themselves. 



How can you stay safe? 

Without legislation in place to protect consumers it is up to individuals to educate themselves and make informed decisions when choosing a clinic to have their treatments performed. Here are some things you should consider before having non-surgical treatments: 

  • Qualifications – Is the person a registered medical professional and which professional body are they are member of? Find out who your practitioner is by checking the GMC, GDC or NMC register. A medical professional must be registered with one of these regulatory bodies. 
  • Price – this is usually the biggest giveaway. Anti-wrinkle injections usually start at £200 to £250 and the price reflects not only the quality of the product being used but many of the other costs incurred in running a reputable and safe clinic such as training and insurance. 
  • Premises – The treatment should be performed in a medical setting – not someone’s dining room, kitchen or hair salon. 
  • Products – ask from where do they source their products and which brands do they use? Ask to see the products they are using and check that these are new, unopened and a brand which is reputable (examples include Allegan, Merz and Teoxane). 
  • Promotions – be wary of them, the GMC discourages doctors from offering promotions for medical treatments. Unregulated and rogue practitioners will often use promotions on social media offering specials which can appear too good to be true. 

A responsible practitioner always consults with you prior to carrying out any treatments and will take a medical history (e.g. medications, allergies, drinking and smoking habits etc), provide you with an opportunity to ask questions and ask you to sign a consent form. It is very important they also explain any possible side effects and provide a follow-up consultation free of charge, particularly if it is the first time you are having a treatment.  



I encourage you to do your research before having any treatments, ask a lot of questions and if you are unsure then do not proceed with the treatment. 



Dr Selena Langdon is the founder and medical director of Berkshire Aesthetics ( and specialises in non-surgical aesthetic treatments including facial aesthetics, body contouring and advanced skincare. Prior to founding Berkshire Aesthetics Dr Langdon trained in Plastic Surgery and General Practice in London.