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  • Chris Thiagarajah MD

Who is injecting your Botox and Filler in Denver



Botox and Fillers are one of fastest rising nonsurgical cosmetic treatments for patients. It is a procedure that takes 10 to 15 minutes. There may be misconceptions that patients have about the dangers of fillers and botox. They are no risk free. Botox has the risk for example of a drooping eyelid or double vision. Filler can be inadvertently injected into a blood vessel and cause skin necrosis (the skin to die) or even blindness. In Denver there are a myriad of injectors who claim “expertise” in filler injection. As a non-physician to gain “expertise” one needs only to take a weekend course on fillers and botox. Additionally, there are non trained individuals who are injecting botox and filler into patients.

Man without license

Recently in Denver a man was identified as an unlicensed injector who was injecting patients with botox and filler. link to article

There is a growing trend of this in the city. What was once a physician only procedure has now be watered down to anyone who gets a certificate and medical director. The medical director is generally a physician who “oversees” the injectors practice. This person may never have met the injector. There is little to no oversight when this happens.

I have had a patient who had 100 units of botox injected into the lip. When the mistake was found the patient was asked to “find a doctor to help you:. Through her frantic search she came to our office. The “medical director” for the injector was a radiologist who was at a loss of how to even begin to treat the patient. With experience with the CDC and research plastic surgeon injectors have the highest knowledge concerning fillers and botox. It is critically to imagine “what would happen if something goes wrong” when getting filler.

Filler injectors without dissolving agents

One of the most tragic things that occurs is when a filler is injected and inadvertently gets into a blood vessel. When this occurs, it is critical for the patient to have the dissolving agent for filler injected immediately. Some non-physician injectors do not have the dissolving agent and send the patient to “find a doctor” once that happens. When a procedure is being done it is best if these things are with the injector.

Unknown "fake" botox

In 2016 the FDA sent warning letters to injectors (mostly med-spas and non-physicians) in Denver who were purchasing “fake” Botox not from Allergan. The idea of using fake medicine to treat patients is nauseating to most physicians. That being said it is in my opinion that a business person may view using that medicine as a “calculated risk” to save costs and increase profits. These are things to consider when choosing an injector.

Finally, sharing needles or tubes of fillers between patients increases the risk for transmission of HIV and Hepatitis C even if the injections are under the skin. There have been reported cases. If you attend a clinic in Denver where tubes of filler or needles are being shared between patients it is critical to contact the medical board.

As a physician and surgeon injector, the highest regard for safety is pursued. It is critical to think about that when getting cosmetic procedure treatments and not solely look at cost. If you could have your hairdresser perform heart surgery for $50 would it be worth it?


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