Cosmetic procedures: don’t fall into traps! – GOOD SHAPE

How far would you go to achieve your ideal of beauty? The issue was once again on the agenda at the end of last year, when the model Andressa Urach, 27 years old, was hospitalized with a very serious infection, which almost cost her life. The reason? Complications arising from the application of a substance known as hydrogel, which was used to enhance the thighs. About a month earlier, there was a similar case. Auction assistant Maria José Brandão, 39, died in Goiânia, hours after applying the same substance to her buttocks. The procedure would have been performed by a fake biomedical doctor, in a hotel room rented for that purpose. Cases like this are not uncommon. In the eagerness to conform to standards, basic safety and hygiene issues are left aside – and this non-compliance can be costly!

There is no 100% safe procedure in the universe of aesthetic medicine. Therefore, the order is to equip yourself with information. At the top of concerns should be the careful choice of the professional. Look for a plastic surgeon or dermatologist who specializes in the technique. “He must have knowledge about anatomy, be able to recognize clinical signs, such as allergic reactions, pressure drop, hypoglycemia and even deal with a cardiac arrest”, lists dermatologist Mônica Linhares, from Rio de Janeiro. “He also needs detailed guidance on the risks”, says dermatologist Juliana Carnevale, also from Rio de Janeiro. Consult the sites of the Brazilian Societies of Plastic Surgery (www.cirurgiaplastica.org.br), of Dermatology (www.sbd.org.br) and the Federal Council of Medicine (portal.cfm.org.br) and seek recommendations from friends that had good results.

trap smell

Another important measure is to visit the establishment where the procedure will be done. Assess the conditions of the environment and avoid rented rooms in hotels, private homes, beauty salons and clinics with no name on the facade. Do a price search, calling renowned doctors, and if you find any offers far below average – such as those offered by group buying sites – be suspicious. If you use an injectable product, ask the doctor for the product’s packaging and photograph its expiration date and registration. “This can be useful if there is any complication”, explains dermatologist Helena Costa, from Rio de Janeiro. Below, we list, in order of safety, the treatments that offer the most risks. Be smart: not everything goes in the name of beauty!

Warning: don’t go there!

polyamide hydrogel

WHAT IS IT: It is a substance made up of polyamide (synthetic product) and saline solution, with a consistency similar to hair gel and which is reabsorbed by the body after four or five years. Under the commercial name of Aqualift, it does not have a valid registration with Anvisa – it expired in March 2014 and, until the closing of this report, it had not yet been renewed. This means that new batches cannot be imported or sold in Brazil. However, the product sold before that date is in legal status.

WHAT IT IS FOR: Only to fill small corrections, such as reducing the appearance of cellulite and leveling out depressions in the skin caused by scarring. It is not recommended for large areas – in this case, increasing the volume of the buttocks and thighs.

SCRATCHS: Substance rejection, deformity, inflammation or infection. “There are no long-term studies that guarantee the safety, biocompatibility and stability of the substance”, says plastic surgeon Eduardo Sucupira, from Rio de Janeiro, a member of the Brazilian Society of Plastic Surgery.

ALTERNATIVES: Practically unanimity among doctors for small corrections, the gel based on hyaluronic acid it is considered much safer, in addition to being widely studied. “However, when it comes to larger fillings, the best options are undoubtedly highly cohesive silicone gel implants, that is, plastic surgery such as breast augmentation. Lipoenxertia, which is the use of fat obtained through liposuction, is also a possible alternative, especially for buttock augmentation”, says Eduardo Sucupira.

To increase the volume of the thighs, an amount of hydrogel up to 20 times greater than what would be safe is used. The risk of infection increases proportionally.

PMMA

WHAT IS IT: A compound of gel and microspheres of a plastic-like material, polymethylmethacrylate. O PMMA it is not absorbed by the body and, therefore, has a definitive effect. What it is used for “PMMA is indicated only in small amounts and in very specific situations, such as HIV carriers, who may have body and face deformities due to medication”, says dermatologist Helena Costa. The substance, however, is also contraindicated for smoothing medium to deep wrinkles and furrows,
like the Chinese mustache, fill in thin lips and add volume to the buttocks, thighs and calves.

SCRATCHS: Stains, deformity, permanent redness, formation of granules, infection or nodules that can pull on the skin, causing pain, necrosis (tissue death), pulmonary embolism and expulsion of material through the skin. “When it appeared, PMMA was a fever and there was indiscriminate use of the product. What we are seeing now in some cases, after a decade, is hardening in the region, migration of the product and an incurable cyclic inflammatory reaction, very difficult to treat”, says Helena.

ALTERNATIVES: The same for the polyamide hydrogel: hyaluronic acid gel for small areas, patient’s own fat graft and silicone prosthesis for larger areas. “The risks and rejection are minimal with this type of material. In addition, if there are any complications, it is possible to remove the prosthesis”, says the doctor.

Be very careful: not every doctor recommends

carboxytherapy

WHAT IS IT: Injections of carbon dioxide into the skin through a very fine needle. What it’s for ′′ The gas improves blood circulation and stimulates the production of new collagen. If introduced more deeply, it can help break down fat cells”, explains dermatologist Flávia Ravelli, from São Paulo. It is indicated to treat cellulite, stretch marks and sagging, in addition to softening wrinkles. It is, however, a procedure that is not endorsed by all dermatologists.

SCRATCHS: Bruises, swelling and pain at the application site, spots and skin necrosis. Furthermore, if there is not proper hygiene, a bacterial infection can occur (and even generalized infection if not treated in time). “It is a procedure that still lacks more robust scientific evidence”, says Flávia. For the Brazilian Society of Dermatology, this is an experimental treatment, which requires further studies to prove the benefits for aesthetic purposes. The Federal Council of Medicine (CFM) does not recommend performing
of this procedure by professionals other than physicians, such as nurses, physiotherapists and occupational therapists.

ALTERNATIVES: Radiofrequency, infrared and ultrasound devices to treat cellulite, localized fat and flaccidity. Non-ablative laser and peeling improve the appearance of stretch marks.

Mesotherapy

WHAT IS IT: Also known as intradermotherapya, is the injection of a mixture of substances (called mixtures) into the dermis, the second layer of the skin. The composition of this mixture varies according to what you want to treat: from cellulite to baldness. Some carry acids, vitamins and enzymes. There was already the fever of lipostabil, a substance prohibited by Anvisa, which would melt fat, and of artichoke extract, illegally applied even in beauty salons.

WHAT IT IS FOR: Localized fat, cellulite, stretch marks and even hair loss.

SCRATCHS: Ecchymosis (purple areas on the skin), redness, tissue necrosis, infection, spots, allergic reactions and anaphylactic shock. “Many professionals stopped using the method due to the risk of complications”, says dermatologist Luciana Labouriau, from Rio de Janeiro.

ALTERNATIVES: Cryolipolysis, ultrasound and radiofrequency to fight localized fat. CO₂ laser and peeling for stretch marks and phototherapy with red light to treat hair loss.

Approved, but in moderation

ablative CO₂ laser

WHAT IS IT: Laser that destroys the first layer of the skin. It is the most aggressive aesthetic treatmentsbut if well used, it has excellent results.

WHAT IT IS FOR: Rejuvenation (wrinkles, stains and sagging), high scars, stretch marks and body sagging.

SCRATCHS: Burns and stains. “Not everyone can do it, especially women with dark and tanned skin. It is also necessary to check whether the patient heals well, how she responds to anesthesia, whether she has diabetes or high blood pressure, for example”, lists dermatologist Carolina Marcon, from São Paulo.

ALTERNATIVES: Non-ablative fractional lasers, such as Fraxel and Pixel, among other brands, do not destroy the first layer of the skin and, therefore, are less aggressive. They work for wrinkles, blemishes and sagging. The intense pulsed light treats stains and apparent vessels.

permanent depilation

WHAT IS IT: Depilation done with laser or with intense pulsed light.

WHAT IT IS FOR: Eliminate hair.

SCRATCHS: Burns and stains. The laser is attracted to melanin, a pigment present in the hair follicle, where hair is born. Through heat, it destroys the follicle, causing the fur not to grow anymore. However, those who are very tanned, brunette or black have a
large concentration of melanin in the skin. The light then misses the mark and burns the skin. “The diode laser is the one that offers the greatest risk. ND:Yag can even be used on dark skin, but it has to be handled by a very well trained professional”, says Carolina. And that’s where the problem lies: in most beauty clinics, laser hair removal is done by a technician, not a doctor. In black skin, for example, carelessness can end in irreversible white spots. Another common disadvantage of lack of acuity when handling devices: getting the opposite effect and gaining more hair. “This happens when, for fear of burning the client, the professional uses too low an energy. In this case, it ends up stimulating hair growth”, explains the dermatologist.

ALTERNATIVES: Here, it is not worth an exchange of methods, but a good research before closing the depilation package. Clinics that use intense pulsed light usually offer great prices, but beware: the technique requires more sessions – which, in the end, can be as expensive as laser treatment in a dermatological office.

When a so-called “good” substance goes wrong

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