Business Irish

Thursday 18 July 2019

Booming cosmetic industry needs a bit of work

As cosmetic surgery goes mainstream, calls have grown to regulate the 'Russian roulette' of the unlicensed beautician sector, writes Michael Cogley

Health Minister Simon Harris is considering a ban on Botox and fillers which cost hundreds of euro for those aged under 18 as concern grows about the impact of untrained operators and cheap products. Stock photo
Health Minister Simon Harris is considering a ban on Botox and fillers which cost hundreds of euro for those aged under 18 as concern grows about the impact of untrained operators and cheap products. Stock photo

Michael Cogley

Beauty has always been big business but up until recently, cosmetic procedures were the domain of the rich and famous. That has all changed over the past decade. The rise of inexpensive anti-ageing procedures which take just a few minutes to perform - coupled with a growing desire for Instagram perfection - has transformed the cosmetic and beauty industry.

Now new clinics are popping up all across the country, offering everything from lip fillers to anti-wrinkle injections. It is little wonder that some big-name investors are injecting big money into the industry.

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As reported in the Sunday Independent last week, serial entrepreneur Pat Phelan is in talks to raise over €50m to fund a growth plan for his Sisu cosmetic treatment business.

Phelan is expanding rapidly in Ireland and wants to open at least 20 outlets in London, as well as other cities where he has identified a growing demand for treatments such as teeth whitening, dermal fillers, Botox, lip fillers and laser skin treatment.

Meanwhile, Therapie, one of the most-recognisable brands in the cosmetic industry in Ireland, is planning a massive buildout across the UK's struggling main streets.

The Irish-run business, which is headed up by siblings Philip and Katie McGlade, claims to have around 250,000 clients. The company is looking to invest £50m in the UK over the next three years, opening 100 new clinics and hiring 1,500 staff in the process.

It represents a significant expansion from its headcount of 500. It is also expanding rapidly in Ireland with clinics in Dundrum Town Centre and locations in towns across the country.

The popularity of cosmetic procedures is reflected in the success of Allergan. The Irish-headquartered Botox-maker is investing €65m into two of its four facilities in Ireland, which will lead to the creation of another 63 highly-skilled roles. When implemented it will bring Allergan's total employment in Ireland to over 2,000.

There may be an immense opportunity for business, but the highly lucrative industry is not without its problems.

Regulation of the industry is playing catchup.

While clinics such as a Therapie and Sisu bring best practice to the cosmetics procedures business, others are bringing the industry into disrepute.

"There are a couple of clinics using Instagram very attractively to lure young customers in," says Liz Dwyer, who is heading up the Future Beauty show in the RDS in September.

"Dermal fillers should be in the region of €300 to €400 per millilitre, but there are places doing it for much less than that. I know a lot of people are going on weekend courses and are suddenly qualified in administering fillers. It has become prolific because fillers are very lucrative."

Richard Hanson, plastic surgeon at the Blackrock Clinic, compared it to "Russian roulette".

"You're getting a filler in your lip, but it may not come from a reputable manufacturer and the people administering it may not have a licence to inject it," he says.

"Typically those putting in the fillers won't be able to deal with any of the complications, which can even rise to blindness. There are 149 cases of blindness reported as a result of the procedure all over the world."

Hanson said that he also works in the Mater hospital and that every few months he deals with people who have suffered "massive complications" from getting work done abroad and that it many cases it had destroyed the patient.

Horror stories of botched cases have led to demand for regulation in a fast-changing business. It can't come too soon for some industry experts.

"Regulation will kill the cheaper cowboys in Ireland," Dwyer says. "I think it will fade out as a section of the industry because people will be forced to use better products making it more expensive."

The rise in popularity of lip fillers, driven by the likes of reality star Kylie Jenner, has brought a whole new cohort to the market.

Teenagers and young adults have moved in their droves to recreate the famous Kardashian look by opting for the fillers, which work by injecting hyaluronic acid into the lips. However, the emergence of the trend has brought with it numerous problems not least botched, cheap procedures.

Medicines such as Botox are subject to prescription control and can only be administered by a medical practitioner or by a dentist, but fillers are listed as medical devices. This essentially means that they are free from regulation across Europe. Dermal fillers, collagen injections, hyaluronic acid, are all more likely to cause complications than Botox.

"If you're going to drive a bus or operate something for the public you need a licence," Dwyer says. "But in the beautician realm no one is accountable because there's no one to be accountable to. Unlike doctors and dentists they're not going to be struck off because there is no council to do so."

The debate around the need for regulation has intensified in recent years, culminating in Health Minister Simon Harris saying last week that he was considering a ban on Botox and fillers for those aged under 18.

Harris has instructed his officials to look at the public health risks and examine the need for further regulation. His department is also seeking to reclassify fillers under new laws that are due to be enacted by 2020.

"It is important to distinguish between dermal fillers and medicines containing botulinum toxin (Botox)," the department said in a statement.

"Medicines containing botulinum toxin are subject to prescription control and may only be legally administered by an appropriately qualified and trained registered medical doctor or registered dentist acting within their practice of medicine or dentistry and within the regulations."

On procedures outside of dermal fillers and other medical devices more normal rules apply. Both the medical and dental professions are subject to codes of conduct for cosmetic procedures. Elsewhere the Medical Council monitors registered practitioners and can conduct inquiries where needed.

"The department is currently progressing a number of pieces of legislation that seek to enhance the safety and provision of health care services," it said in a statement.

"This includes the Patient Safety (Licensing) Bill, which will ensure public and private hospitals undertaking high-risk healthcare activities, including certain cosmetic procedures, will require a licence to operate."

As it stands, registered medical professionals need to be able to back up any advertising around their products or services in the aesthetic sector, according to the Medical Council.

"The sector definitely needs to be more regulated and that's just to protect the patient," says Aisling Cleary of Dublin-based River Medical, which carries out surgical and non-surgical procedures.

"There has been a lot of talk about it and I'm sure it will come in eventually. Most professional operators would hope to see it brought in, the cream always rises to the top and the introduction of proper regulation will force out those that aren't operating properly."

Cleary said that the average spend of one of her patients is around €6,000 with solutions for cellulite dimples topping the list. Predominantly, she says, because it's approved by the US Food and Drug Administration (FDA).

"We're seeing clinics popping up everywhere and I do think it's important that people make sure their clinician is qualified before letting them near their face with a needle," Cleary said.

"We want people to leave here happy and we will go through everything with a patient, but if something is not right for them we will let them know. We turn away one in five for various reasons because they're not suited to the procedure they're looking for."

Cleary said that she has seen a surge in men coming through the doors at River Medical, with a lot of it being down to chest reductions.

"A lot of men don't talk about it unfortunately," she says. "They develop breast issues and are just as conscious about their chests as women are."

While Cleary says the improvement of the economy has led to an increase in procedures, certain jobs have remained consistent. She says that breast augmentation remained a constant right through the economic downturn.

Hanson adds that a wide range of people are now seeking some cosmetic work.

"Our clientele is very diverse. Typically 'reclaimers' will have much more disposable income. These are women whose kids are grown up and they're happy to spend on themselves. Sometimes you just have ladies coming in for an event to get a touch up or young professionals who are coming in for their own maintenance."

Younger people are driving much of the new demand, however.

"Millennials are very well-researched and they're much happier to spend money on themselves," Hanson says.

"They may never be as rich as their parents or grandparents, but they're much happier to spend their disposable income and they don't mind spending on luxury items.

"Then there's also the incredible rise of social media, so they're much more aware of their appearance."

Demand for cosmetic procedures seems sure to grow, especially when it comes to affordable and relatively painless procedures. But with significant investment coming into the lucrative sector, pressure will only mount on those giving the business a bad name.

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