According to the latest survey by the International Society of Aesthetic Plastic Surgery (ISAPS), conducted in 2023, Brazil was the second country in the world with the most aesthetic procedures, behind only the United States. The total number of procedures was 3,381,551, representing an increase of almost 12% compared to 2022. Our country is also the third largest aesthetics market in the world, behind the USA and China. This data shows that we are people who value appearance and personal care.
On the other hand, the number of unregulated aesthetic procedures is also growing. ANESCO (National Association of Estheticians and Cosmetologists), created in 2018 to defend the interests of estheticians and cosmetologists in Brazil, also oversees professionals in the field, as does ANVISA (National Health Surveillance Agency). Both receive reports of illegal aesthetic procedures. To help consumers in this system, ANESCO issues the Esthetician Professional Card (CNEC), which serves to identify the professional throughout the national territory.
Dr. Giselle Mello, a doctor specialized in women’s health and advanced aesthetics, says that over the past decade she has seen the aesthetic market and the science produced and practiced in this segment of medicine and aesthetic dermatology transform. “What was practically safe and highly cautioned by the vast majority of professionals has become something insane, as we see daily on social networks and all online and printed media.” She points out that the search for personal care and health is welcome, but it is necessary to be careful. “As a doctor, I find it incredible this movement of people looking more at themselves and taking care of themselves with aesthetic procedures. Although generally safe, when performed by poorly qualified professionals they can have complications.”
Among the complications are allergic reactions, infections, bruising and swelling, scars and fibrosis, tissue necrosis, deep vein thrombosis and pulmonary embolism, asymmetrical or unsatisfactory results, eye complications, temporary or permanent paralysis, and psychosocial reactions.
Dr. Giselle, who also mentors and teaches courses, emphasizes that to minimize risks, it is essential to research the professional and seek recommendations from acquaintances who have already had procedures with the person. “I always recommend undergoing procedures with experienced and qualified professionals, following pre- and post-procedure instructions rigorously, and also being truthful in your consultation about everything you want, everything you have previously done to your face or body, about your lifestyle habits, and health condition,” she reinforces. She describes that she observes daily in her office patients who try to remedy or minimize information about their health to be able to undergo their procedures. “This is where one of the biggest dangers of exposure to complications from aesthetic procedures lies,” she reminds.
Esthetic procedures have gone wrong
Many cases of celebrities who have regretted their procedures have been recently disclosed, including singers Lucas Lucco and Gabi Marins, former Big Brother Brazil participants Eliézer and Rodrigo Mussi, influencers Gkay and Carlinhos Maia, as well as American actress Courteney Cox. However, several situations were not just reversible as they led to the person’s death. At the end of last year, two cases gained significant media coverage in Brazil, such as that of businesswoman Paloma Lopes, who died during an esthetic procedure in a clinic in the east zone of São Paulo. She paid for a “hydrolipo” and died during the intervention. The surgeon was Dr. Josias Caetano dos Santos, who has already faced at least 22 lawsuits for medical negligence in the São Paulo courts.
Another case is that of public servant Danielle Mendes Xavier de Brito Monteiro, who died after undergoing an esthetic procedure on her face in a clinic in Goiânia. The Goiás Civil Police (PC-GO) suspect the victim may have had a “severe allergic reaction” to a product not registered with the National Health Surveillance Agency (Anvisa).
“Today, the excess of esthetic procedures itself has become a problem. We see various complications daily on social media and in the news, even deaths. Many of them are related to facial or body fillers where the excess product or interventions can overload the body,” Mello says. For her, the combination of procedures with unregistered Anvisa products has taken over the headlines. “Even those approved by Anvisa, however, are done in a way to give a lot of volume to a region that anatomically is incompatible with positive results,” she reinforces.
In a period when people seek to modify their bodies and faces radically, like fitness muse and current Big Brother Brazil participant Gracyanne Barbosa, who has undergone everything from facial harmonization to eyebrow transplant, Dr. Giselle says she does not approve. “I am not in favor of large-volume fillers, whether on the face or the body, even with the wave of professionals making major transformations. Particularly, procedures that treat the skin and rejuvenate it are amazing, and medicine has advanced significantly in this fully regenerative area,” the specialist mentions. She notes that in these cases, venous applications and nano absorption are effective. “It is important for everyone to remember that anything highly invasive or minimally invasive surgeries are limited to medical practice.”
How to avoid complications
The specialist cites some causes of complications in esthetic procedures: lack of professional qualification, inadequate environments, low-quality or counterfeit products, excess procedures or poor indication, patient’s individual anatomy and response, wrong technique or mistakes during the procedure, lack of post-care, unassessed health conditions, social and esthetic pressure, and procedures performed on people with contraindications.
“Therefore, it is always good to emphasize that people should choose qualified and regulated professionals, perform the procedure in authorized and well-equipped clinics, conduct a detailed preliminary evaluation (exams and medical history), follow all preparation and post-procedure guidelines, and use only products approved by Anvisa (or local regulatory authority),” Dr. Giselle points out. Remembering that invasive procedures should be performed by doctors in the field, Mello warns that the price factor is significant. “Today, many do not seek only good care, but also prices. I attribute the search for other professionals to this explosive growth of low-cost procedures with cheap raw materials, or attractive prices with cheap raw materials, which often lead to unapproved procedures.”
The search for esthetic treatments goes beyond the quest for the perfect body or doll face, but also helps in postoperative care and emotional health and quality of life, with the recovery of self-esteem, self-love, and self-confidence. “In view of this, Brazil has understood how much self-esteem affects a person’s mind, how it affects a human being, and it is up to us, doctors, not to let this become an obsession. Many times, I have had to tell patients who come to my office that ‘it’s already good’ or ‘we won’t do more because it will exceed the necessary limit,'” she emphasizes.
“The lack of strict and specific legislation in Brazil is another factor to consider, as many councils related to the aesthetic area claim that the rules are not clear. But Dr. Giselle believes it goes beyond that. ‘I believe it is not just the council with liberal gaps, but nowadays many professionals have lost not only respect but also the fear of losing a life. For example, we know that a rhinoplasty is a hospital procedure performed by surgeons, but even so, it is done by non-doctors and for a much lower cost-benefit,’ she explains. And she adds, ‘The problem is the professional knowing that each area has its scope and that we need to constantly update and train ourselves, we need to know how to responsibly deal with complications and know how to stop a patient who thinks they need to do everything. The problem is the professional acceptance that the priority is the well-being of the patient.’
In a reality where the demand for procedures is increasing, we are a country of opportunities, and Dr. Giselle leaves a message to people: ‘Fall in love with yourselves and, thus, you will find the best professional to make it real.’ For professionals, she indicates that they should always learn and know new techniques, continuously training, improving, and bringing even more excellence to patients. ‘Have passion for what you do in your daily life, like an artist for their artwork, and you will achieve increasingly extraordinary results. The more impossible it seems, the more challenging it will be!'”.
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