But in reality, “you can buy whatever you want—who’s going to come after you?” says Dr. Kontis. It’s more common for someone to want to inject filler at home than neuromodulator, she adds, because filler tends to be more expensive to get done professionally—so there’s more incentive to do it on your own—and it may seem less intimidating, since it’s not a toxin. “Neurotoxins, believe it or not, are not as dangerous,” says Dr. Kontis. “If you inject it in the wrong place, you just paralyze a muscle, it becomes inactive. Filler can embolize [obstruct] a blood vessel, and you lose tissues without blood vessels supply, including down the line—if you inject around the nose, the product can go backwards into the artery [that leads to] the heart.”
And a blocked coronary artery can cause a heart attack. In other cases, cutting off blood supply to tissues can “lead to disfiguring complications, including permanent blindness, necrosis (deadening of the skin), scarring, and potentially death,” says Shari Marchbein, MD, a board-certified dermatologist in New York City and clinical assistant professor at New York University School of Medicine.
“It is patently insane for a layperson to purchase a product off the ‘street’ and inject it into his or her face and expect the outcome to be anything other than a disaster,” says Min S. Ahn, double-board certified facial plastic and reconstructive surgeon in Boston.
Why would anyone risk it? And how did we get here? “TikTok and Instagram and YouTube,” posits Dr. Kontis. “There was a lady doing videos on YouTube of how she injects herself, basically [showing] this is how you could inject yourself. That video came down [shortly after] I notified the FDA.”
Along with these “injectable tutorials,” there’s the fact that we’re living in a time where medical procedures have, arguably, been demedicalized. Ours is a culture of med spa billboards, Botox parties, and filled faces everywhere from movie screens to the grocery store checkout lines. It’s perhaps no surprise that injectables can seem more like routine maintenance (akin to a facial or a new lip gloss) than the medical procedures they really are. We’ve come to a place where people are so desperate to look a certain way—and so unaware of the seriousness of injectables—that they’re willing to bring a syringe to their own lips and crow’s feet. Based on her own experience, Dr. Kontis certainly gets it. “I feel better when I have injectables—I just like the way I look,” she says. And when something makes you feel better, it can be hard to resist: “So if people can’t afford it, they’ll try to find it a different way.”
For now, Dr. Kontis and her colleagues are trying to get the word out to patients about the dangers of DIY injections. In a statement to Allure, the ASPS stresses that “while these treatments may be called minimally invasive, they are still real procedures with real risks” and “encourages patients to value their safety over any perceived savings.” The AAFPRS reminds patients on a daily basis to trust their faces to qualified plastic surgeons, and has a physician finder on their website. And AAD “strongly advises against people performing cosmetic injectable procedures themselves—these injections are medical procedures,” says Dr. Taylor, noting the AAD also has a physician search tool of “member dermatologists [who] have the most extensive medical training to avoid complications and provide patients with the best outcomes.”
