PART 6: Why Some of the Most Qualified Doctors Refuse to Inject

Why doctors refuse to inject Botox and fillers.

I think it goes without saying on any topic where someone wants us to purchase something, the seller is certainly not the best person to ask whether something is safe. Right? What do we expect them to say? “NO, the thing I’m about to inject into your face is not safe”?

So why do some of the most qualified medical professionals decline to offer these treatments? Because they have ethical concerns about cosmetic injectables. 

Ethical physicians consider several factors before agreeing to inject:

Body Dysmorphic Disorder (BDD): Body Dysmorphic Disorder is an anxiety-related mental health condition characterized by a persistent obsession with body image, with sufferers becoming extremely distressed about their appearance and often resorting to behaviors such as repeatedly checking how they look in a mirror.

I think most women have at some point in their lives struggled with BDD. I know I have, and so have many of my female friends. Sadly, I think remnants of BDD live rent-free inside the brains of too many women. 

Individuals with BDD are more likely to turn to quick-fix procedures, even though these fixes do not actually address the underlying condition. Responsible practitioners are trained to recognize this — and to refer patients to mental health support rather than proceed with treatment.

Informed consent standards: Ethical providers understand that patients are entitled to full disclosure of risks, reversal options, and the limits of existing long-term safety data. Many conscientious doctors decline to inject because they feel they cannot in good conscience make promises the research does not support.

Contraindications: Medical professionals who review a patient's full health picture — medications, neurological history, blood clotting factors, skin conditions — will sometimes find clear reasons not to proceed, which a less thorough provider might miss.

The "do no harm" principle: Some physicians believe that for a healthy individual, injecting a neurotoxin or foreign substance into the face for cosmetic purposes carries risks that outweigh benefits, particularly given the lack of comprehensive long-term safety data.

How can licensed Estheticians help? Seeking out advanced Esthetician training and certification in non-invasive esthetics alternatives to injectables. And developing a great rapport with their clients. 

 ** More detail can be found in my book The Heart of Esthetics

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