The fact that a physician with no experience in facelifts attempts to help their patient with filler methods, and the outcome harms the patient, if not medically, at least financially, actually stems from that physician's lack of experience in comparing the results that both methods would produce.

Ten years ago, when laser facial peeling emerged as a new method, all campaigns by the laser industry were based on the slogan "laser face lifting." The claim made about this method was that it created skin tissue that was taut, not sagging, free of wrinkles, and as firm as a baby's. Although we plastic surgeons with surgical experience in facelifts stated that laser skin peeling would not replace a facelift; that it could only be a supportive application, physicians without surgical experience continued to widely apply this method instead of facelifts during those years. However, today, long-term follow-up data show an increasing number of patients and physicians dissatisfied with the results of this procedure, and interest in this initially very popular method is decreasing over time.

Another issue I have reached and greatly value after thirty years of experience in aesthetic surgical applications is complications. It is, of course, very important for an aesthetic surgeon to have detailed knowledge and experience in the various methods they will apply. However, in addition to this, the same physician must possess knowledge of the complications and their frequency that these applications can bring, and have the experience to perform the necessary medical intervention, treat the complication, and achieve the initially targeted result when faced with a complication in their patient.

My philosophy, which I have made a rule in my professional life and primarily teach to the young plastic surgeons I train, is: "It is certainly important to know what you are capable of doing well, but do not treat your patient without considering what complications you might encounter and without carrying the concern of how much harm your patient might suffer from it..."

Even if the probability of a method causing a complication in aesthetic surgical applications is very low, if that complication leaves irreparable damage when it occurs, I absolutely avoid applying that method. This rule applies to any surgical method, as well as to the complications that a small filler procedure can bring.

Speaking of the complications of filler methods, I would like to give you a little more detailed information on this matter. Complications defined as minor usually occur in applications of permanent or reactive facial fillers. These can cause permanent deformities and significant psychological problems for the patient. Because even if the rate of such complications seems low, the resulting problem can push the patient into much greater unhappiness, as it will be greater than the complaints initially sought to be eliminated by aesthetic methods.

What needs to be done is to explain the probability and consequences of such complications to patients and leave the decision to the patient. I do not recall any patient I have spoken to in detail ever accepting a treatment method, knowing that in addition to its benefits, there is a small probability of harm that cannot be reversed.

Perhaps I think we haven't learned enough from the past. We should not forget the problems caused by free silicone injected as a facial filler. Even if the problem seems small at first, approaching the issue with the logic of "it can be eliminated immediately with a tiny needle," hastily made decisions, excessive use of the substance, superficial injections, and too frequent and misplaced applications lead to irreversible permanent problems. Surgical intervention is also required to clean these; this sometimes means removing these substances from the tissue, leading to unwanted surgical scars.

At the last meeting of EQUAM (European and International Committee for Quality Assurance, Medical Technologies and Devices in Plastic Surgery), consisting of plastic surgeons who meet every three months in Europe to discuss innovations and old problems in plastic surgery, a consensus (EQUAM consensus conference) was reached on these issues in Amsterdam.

For us plastic surgeons, evaluating patients harmed by treatment with permanent fillers has now become part of our daily life in the practice. As the type and number of these permanent fillers increase; the rate of complications such as foreign body reactions, and even redness covering the entire face, swelling, tissue hardening, and infection, is increasing every day. I must state that this situation is also being followed with great concern by EQUAM.

What I want to convey to you here is: "We must not forget that just as there are many methods and tools presented to us today as aesthetic miracles, there are also many patients who have been victimized by resorting to these methods with the aim of becoming more beautiful and younger."

Just as a physician is ethically required to clearly and explicitly inform their patient about all possible or currently unforeseeable complications before recommending new treatment methods, a conscious patient should not turn to temporary and yet unproven treatment methods without consulting specialist physicians trained in plastic surgery, making easy and quick decisions, and without questioning or researching the treatment method.

For my part, I want to see people who, as a result of aesthetic treatments, simply enjoy themselves, love and like themselves more...