Dangers with unqualified cosmetic injectors and illegal substances on the rise

The increased popularity of cosmetic injectable fillers has also resulted in a rise in illegal injections with dangerous substances by unlicensed or unqualified injectors, cautions the Physician’s Coalition for Injectable Safety (PCIS). This announcement was made in response to a report published online by the newjerseynewsroom.com (11/23/10) announcing that an Essex County, New Jersey Grand Jury returned a three-count indictment (#10-11-2686-I) charging Anivia Cruz-Dilworth, 28, of New Brunswick with practicing medicine without a license.

According to the report, “In March, six women showed up in the emergency rooms of Essex County area hospitals complaining of problems after having received buttocks-enhancement injections. An investigation revealed Cruz-Dilworth had [allegedly] injected women with what she described as hydrogel. Several of the women sustained serious bacterial infections requiring them to undergo surgeries.”

“Disturbing stories like this tell us that there is an unsafe climate for patients looking to enhance their appearance with non-invasive procedures in the current economy. We are responding to a growing need for physicians to be properly trained to respond to adverse events,” explained Coalition Chair and plastic surgeon, John E. Gross, MD of Pasadena, CA. 

Like many experienced physicians, Coalition leader Dr. Roger A. Dailey, an Ophthalmic Plastic Surgeon in Portland, OR, has treated patients who have had injections elsewhere. “Even if we’ve never encountered the complication in our own practice, we have to be ready to diagnose it and ensure the best possible treatment for patients.” 

 Dr. Jonathan M. Sykes, President of the American Academy of Facial Plastic and Reconstructive Surgery reminds patients that any cosmetic procedure comes with risks. “Many of these products work very well for people, but they should be used appropriately by qualified injectors who understand the intricacies of injectables and how to combat complications that may arise,” he adds. 

State regulations on injectors vary across the nation leaving open interpretation to exactly who is qualified to inject fillers and neurotoxins. Immediate Past President of the American Society for Dermatologic Surgery, Dr. Jeffrey S. Dover warns, “Patients need to be vigilant about having an experienced, board-certified dermatologist or plastic surgeon directly overseeing their injections. You can greatly minimize the chance of complications, or worse, by doing some research.”

 Dr. Claudio L. Delorenzi, a Past President of the Canadian Society of Aesthetic Plastic Surgeons has seen some of the worse complications through his research. “I would be suspicious of extremely low prices.  Unlike fake purses, fake injectables can really hurt you, or worse.  Ask questions, check credentials, and do your homework.  Real specialists have nothing to hide and will welcome your questions.” 

In an effort to raise patient safety standards, these Coalition leaders banded together to increase educational levels within the medical community in a multi-societal webinar on Managing Adverse Events with Injectable Fillers. This hot topic presentation was highly-attended and discussed recognizing complications, prevention and management. 

The Coalition, charged with educating consumers on safe choices in cosmetic injections and eradicating the use of counterfeit and illegally imported cosmetic injectables, suggests all consumers follow these steps to ensure safe and effective treatment:

  • Doctor: Ask your doctor or injector for qualifications. Choose a doctor who specializes in treating all cosmetic concerns of the face, such as a board certified plastic surgeon, facial plastic surgeon, oculoplastic surgeon or dermatologist. Examinations and procedures should take place in a licensed and properly equipped medical facility. Establish a positive and on-going relationship with your doctor and follow-up as directed. A nurse or physician’s assistant may perform your injection if you elect, but a licensed physician must prescribe the treatment.
  • Brand: Ask specifically for the brand name of the injectable recommended for you, the approval status of regulatory agencies in the country where you will be treated (the FDA in the United States) and about any potential outcomes and the likelihood of adverse events. If your doctor does not offer, ask specifically to see the packaging and identifying marks that can verify authenticity, including identifying holograms and logos for the brand, the serial and lot number (which as a matter of proper procedure must be recorded in your medical chart). For reference, images of all US FDA approved brand logos and packaging are available at: http://www.injectablesafety.org/consumers
  • Safety: If you suspect your injector is not properly trained, is not following proper procedure or is injecting you with a non-branded, non-approved or unsafe substance, do not accept treatment. Follow-up by anonymously reporting suspected illegal activity to your local FDA field office that can be found at http://www.fda.gov/consumer/updates/oci072307.html.

To learn more about the benefits of cosmetic injections, the uses for approved cosmetic injectables, to plan for your treatment, see video of live, appropriately administered injectables and more, visit http://www.injectablesafety.org and http://www.realself.com/injectable-safety-campaign.

About Us
The Physicians Coalition for Injectable Safety is an alliance of specialty physician organizations including the American Society for Aesthetic Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, the American Society of Ophthalmic Plastic and Reconstructive Surgery, the American Society of Plastic Surgeons, the American Society for Dermatologic Surgery, the American Academy of Dermatology, the International Society for Aesthetic Plastic Surgery, the International Society for Facial Plastic and Reconstructive Surgery and the Canadian Society for Aesthetic Plastic Surgery. The mission of the Coalition is to provide the public with unbiased and necessary information on injectable cosmetic treatments, appropriate injectors and where to safely access cosmetic medical procedures. Our goal is to promote treatment supervised by properly qualified and trained, board-certified doctors and to promote only the use of U.S. FDA-approved, appropriately administered product. More information can be found at http://www.injectablesafety.org.


The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world's leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of over 2,600 Plastic Surgeons; Active Members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and nonsurgical aesthetic procedures. International Active Members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.


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