Looking back on the past 12 months, it has been an interesting year—to say the least—for aesthetics; there have been several steps forward within the sector, with regulations being introduced by the Nursing and Midwifery Council (NMC) to help overseas nurses join the NMC register (NMC, 2019), as well as several steps back, as Channel 4 announced its controversial reality TV show, The Surjury, which some say exploits the vulnerable, in October (Heritage, 2019).
In late November, the Metro published yet another aesthetic horror story, reporting the case of a young patient undergoing lip fillers with a non-medical professional, which resulted in a group A streptococcus infection (Brazell, 2019). When contacted, the beautician who administered the filler stated that she thought the patient's swollen lips were unrelated to the filler. A shiver went down my spine as I read this—any qualified and trained aesthetic practitioner knows it is crucial to possess an understanding of the anatomy, as well as the knowledge and confidence to prevent and manage such complications. Despite stories such as these hitting headlines far too regularly, aesthetic procedures are only growing in popularity, with the American Society for Aesthetic Plastic Surgery (ASAPS) reporting a 58% rise in hyaluronic acid injections and a 36% rise in botulinum toxin injections since 2014 (ASAPS, 2018). So, as patient numbers grow, as does the need to protect and educate them and chase a safer, regulated sector.
This year has also been a major one for myself, as I was appointed as the editor for the Journal of Aesthetic Nursing (JAN). I had no experience in the aesthetics sector, yet I was immediately immersed in and welcomed to an industry full of passionate nurses, eager to pave the way towards regulation, with a simple mission at the forefront of mind: patient safety and ethical practice.
When I sat down to write this editorial, I decided to look at what has been achieved during the past few years. In 2013, medical experts gathered to discuss the future of aesthetics, in particular, why dermal fillers are not prescription-only devices (which, as we know, means anyone can use them). In the resulting Keogh report, one sentence in particular stuck with me: ‘a person having a non-surgical cosmetic intervention has no more protection and redress than someone buying a ballpoint pen’ (Department of Health and Social Care, 2013). Dermal filling is an invasive and potentially dangerous procedure in the wrong hands, and yet, patients have no protection.
Fast forward to the present, as we prepare to enter a new decade, the roaring 2020s, it is sure to be just as eventful as the last. Despite the—perhaps—depressing focus above, I am hopeful that, in the coming decade, the road to regulation will take us further than ever before. One pillar holding up my optimistic stance is the introduction of the Medical Device Regulations. From May 2020, all dermal fillers, no matter their intended use, will be regulated as medical devices under Annex XVI of the Medical Device Regulations (EU/2017/745). I hope, as I'm sure you all do, that this new regulation will survive Brexit and continue to improve safety, ensure quality and increase the surveillance of these products to protect both patient and practitioner. While dermal fillers are still not classified as prescription-only devices, this is surely a step in the right direction. While driven nurses such as this journal's readers and publications such as JAN exist, the battle towards regulation is still being fought and victory is perhaps in sight. As awareness is raised and more brilliant and passionate nurses enter the aesthetics arena and pioneer the sector's evolution, practice standards can only progress.