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To recap…complications and injectors


I do some skyping for some  injectors on a weekly basis in addition to my own clinics.

When I began doing this about a year ago, it was as a temporary favour for a friend.

In the process though, it’s become an eye opening and educational process for me.

See, in Medicine, we are taught to “First, do no harm.”.

As doctors, we spend a huge chunk of the first year of medical school studying anatomy in detail on cadavers (dead bodies donated to research and learning). In subsequent years, as we rotate through the various specialities, anatomy comes up again and again.

As interns, very junior doctors, surgical rotations (usually general surgery and orthopedics, ie bones) are mandatory before we can obtain general registration- in my case, I trained in surgery, specifically, Obstetrics and Gynecology, the science and art of delivering babies and caring for women, between 2001-2011 when I left with 2 years to go, for  General Practice.

Those years of 50-60 hours each week, of working, suturing women after childbirth who were awake  (and not), developed an intimate knowledge of and respect for, anatomy, muscle memory and what to do if things go wrong (and things WILL go wrong despite the best effort and intentions.)

What is my point? Not all injectors are the same. Injecting the face isn’t colour by numbers.

With knowledge, comes a healthy respect for what can go wrong

This week, I had someone I work with, ask for a script for filler to the forehead area. I asked if her patient had been educated on the risks. “Yes, I have told them about vessel blockage and the need to use hyalase to dissolve it.” She seemed unaware that filler to that area is associated with the highest risk of sudden, permanent and irreversible blindness.

In this case, I declined to write the script- as the scripting doctor, I am ultimately responsible for scripts and doses I write, and even if I wasn’t, I’d feel terrible if someone went blind due to something I contributed to, remotely.

I posted about this on my Facebook page and a young woman wrote to say “surely that can’t be true/real!” Another said “Oh relax!”

filler necrosis







So I am reprinting the link to my article from January this year.

‘I understand that cost is a factor in these decisions, and I support everyone’s right to see the injector of their choice. At the same time, you get what you pay for. And while I don’t price match, and my prices ARE more than chain clinics and salons, I recognise the fact that:

– I am ultimately responsible for any complications that occur as a result of my injecting.

– I give all my patients 24/7/365 access to me for any complaints, or concerns they have.

– the fee isn’t just for the products but is part of a service I offer and is reflective of over a decade of surgical experience.

Many will still go to chain clinics, and when they do, it’s my job to ensure that the injectors that I script for,  are competent, safe and don’t bite off more than they can chew Because “first, do no harm” still applies, even via Skype.

Pls, inform yourself before you choose the cheapest place around. I am not writing this because I want you to come to me; I am writing this because any medical procedure needs to be carried out ethically, with due care and attention and accountability. So if by doing so, some of you will ask your injector about risks, side effects and their experience, I shall be very happy.

So many injectors- what’s the difference anyway?




  • Dr Imaan Joshi has been working as a doctor since graduation from the University of Sydney in 2001. She spent years between 2004-2011 as a surgical trainee before switching to a different speciality program for work-life balance. She is passionate about her work in Medicine and especially about procedural Medicine, and loves her work as a Cosmetic Physician. When she isn't working, she is busy focusing on an active life with her family, which includes 4 active children! Dr S Imaan Joshi BSc, MBBS, FRACGP


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