Non-Surgical Vs Non-Medical


It’s a common misconception that non-surgical cosmetic treatments such as facial injectables are non-medical- and therefore do not carry the same protocol, risks or complications as surgical procedures. Dr Dehan Struwig debunks the myth…

Cosmetic procedures can be divided into two main groups: cosmetic surgery – requiring surgical intervention of some nature, and non-surgical or minimally invasive cosmetic surgery.

According to the latest statistics of the American Society of Plastic Surgeons, more patients are opting for cosmetic surgery every year, and it is safe to assume that this trend reflects in the South African market as well.

Furthermore, growth of non-surgical or minimally invasive cosmetic surgery, is exponentially higher than surgical options.

Sadly however (especially in South Africa) there is limited control over who may or may not perform non-surgical cosmetic treatments, nor where these treatments are performed. There is also no medical supervision for when things go wrong, and thus one has to question whether the necessary follow up is being done.

My office staff regularly complain about patients who phone in, requesting to be injected with anti-wrinkle injectables or dermal fillers without a consultation – and then slamming down the phone furiously when they explain that it is just not possible.

Non-surgical does not mean non-medical

I am very strict where this is concerned.  Non-surgical does not mean that there aren’t any risks or possible complications involved.  Non-surgical does not mean you visit me today and are gone tomorrow.  Non-surgical is still a journey we need to walk through together as an accredited medical practitioner and patient.

As far as I am concerned, these are the golden rules for non-surgical treatments, which should not be ignored:

  • Remember these are still medical treatments. A full medical history, including at least the last five years of medical conditions and surgeries should be taken, along with a full list of medications, homeopathic medications and supplements taken.
  • Patients suffering from certain medical conditions cannot undergo certain non-invasive cosmetic procedures.  If patients have suffered from food poisoning at some stage in their life, they could have antibodies that would prevent anti-wrinkle injectables from working – a waste of money if you were injected, without a proper medical history taken.  Meanwhile, patients who suffer from herpes might suffer an outbreak straight after injections if the necessary prophylactic steps have not been taken.
  1. Some medication, homeopathic medications and supplements, such as Omega 3 and 6 oils, evening primrose oil and aspirin cause bleeding, and therefore bruising – these should be stopped at least seven to 10 days prior to any treatment or surgery.
  2. The suitability of the treatment and alternate options should be discussed. I often find patients who are convinced that anti-wrinkles injectables will give them fuller lips, or that the grossly overly large lips they saw on the internet was because of these injectables. No, it was not!  You need to be properly advised.
  3. You should be fully informed. The risks, complications and benefits of the treatment should be properly discussed with yourself, and you should understand the limitations of the treatment. You should know which anti-wrinkle injectable (there are several brands on the market) and which filler would be injected, and what result you can expect from each.  There are different fillers available for different areas of the face – not all are suitable for the lips, for instance.
  4. The procedure should be performed in a sterile medical setting.  I still hear
    of parties at people’s homes or at beauty spas where injectables are freely given – and one has to question issues like patient-doctor confidentiality, sterility for some procedures, and appropriate preparation of the products and materials being used in the treatments.
  5. Who is doing the injections? In South Africa only medical doctors may perform cosmetic injections. However, this does not mean that your doctor has undergone the necessary training to do these injections. In order to inject, an in-depth knowledge of facial anatomy is needed – and very few doctors have in depth training of the facial anatomy, as it is not part of their field of specialization.  Make sure you make use of accredited, well-trained practitioners.
  6. What if there is an emergency? A surgical setting, even if in a doctor’s procedure room, allows for emergency treatment if necessary.  This is not always available in other settings.  Always ask yourself, what if: what if I sustain a deep dermal burn due to a chemical peel – is there a doctor on hand to ensure that the burn is treated correctly immediately, or do I have to travel to the emergency unit of a hospital for help?  What if: what if I develop an allergic reaction.  Is there someone that can administer emergency medicine?  These things happen infrequently, VERY infrequently in fact, but, what if?

Choose wisely.  Non-surgical is NOT non-medical.

A2 Disclaimer: This article is published for information purposes only, and should therefore not be taken as an endorsement or advertisement for any product or medical treatment –  nor should it be regarded as a replacement for sound medical advice. 

CURRENT Issue 19 – Sep 2016 (Spring)

Issue 19 – Sep 2016 (Spring)

This article was written by Dr Dehan Struwig and edited by the A2 team EXCLUSIVELY for the A2 Aesthetic & Anti-Ageing Magazine September Spring 2016 Edition (Issue 19). 

A2 Magazine prints only four magazines each year – reporting seasonally on everything you need and want to know about aesthetics, anti-ageing, integrative medicine, quality and medical skin care, cosmetic dentistry and cosmetic surgery in South Africa – where to go, who to see, what to expect, something new and so much more! Never miss an edition – click here for more info about where you can buy the print and/or digital copy of A2 Magazine (including back copies).

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About Author

Dr Dehan Struwig

Plastic and Reconstructive Surgeon, M.B.Ch.B; M.Med. (Plast&Reconstr) (Stell). Dr Dehan Struwig is a qualified and registered Specialist Plastic and Reconstructive Surgeon, with consulting rooms and operating privileges at Life Vincent Pallotti Hospital in Pinelands and Netcare Blaauwberg Hospital in Sunningdale, Cape Town. Dr Struwig's specific fields of interest are cosmetic surgery of the breast and face, including anti-wrinkle injectables and Dermal Fillers, breast reconstruction after breast cancer, ear reconstruction (microtia) and reconstruction for skin cancer. Dr Struwig underwent medical and surgical training at the University of Stellenbosch Medical School and the University of Cape Town Medical School in Cape Town. After completing his specialist medical and surgical studies and training, he completed a fellowship in Paris, France to obtain in depth experience and training in specialised cosmetic surgery techniques and to learn the unique skill of reconstructing deformities of the outer ear by utilising rib cartilage, from Dr Francois Firmin, a world leader in this area. Dr Struwig visited various medical institutions in England, Europe and the United States of America in an effort to learn more about professional patient care and practice management before committing to private practice in July 2001.

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