You don’t need to be a doctor or a nurse, or indeed have any type of training at all.
Right now, you can go online and order a range of dermal fillers and other injectable cosmetics, plus other equipment including syringes and cannulas, from an Irish company and within days they will be delivered to your home.
If you wanted to, you could set up shop and start injecting fillers the very same day, with no training, no knowledge of anatomy, and no way of providing treatment if things went wrong.
And according to the Health Products Regulatory Authority (HPRA), some of these products may not even be being distributed legally.
This is what happened when I ordered a selection of fillers and other intradermal cosmetic products from an online store registered as an Irish company in 2018 and operating out of Dublin.
For €214 plus €49.99 Vat and a €9.99 postage fee, three different products were delivered to my home address within a week of me placing an order via a website.
A popular brand of filler used to plump the lips, pre-loaded into syringes, came with the warning that it should only be used “by an authorized medical practitioner".
Two other products, one promising to combat cellulite and one marketed as a “depigmentation solution,” arrived in ampules.
One had no safety information sheet or CE European safety mark on it, despite CE marking having become mandatory for dermal fillers under new EU regulations that came into effect in June, a month before the order was placed.
Top consultant plastic surgeon and chairman of the Irish Association of Plastic Surgeons (IAPS), Professor Seán M Carroll, said he was shocked that I was able to order fillers online with such ease.
“It’s absolutely shocking that as a private person, without any demands as to your experience, these companies will just send these out to you,” Prof Carroll said.
He said the IAPS had been calling for regulations around fillers to be “tightened up” for a long time, and that although he doesn’t offer fillers himself, his own practice was “very frequently” contacted by people seeking treatment when things go wrong having had fillers.
“I get requests to assess clients as to what injuries occurred when they have received treatment from non-licensed people,” he said.
Many have no medical or nursing experience in any way whatsoever, which is just absolutely shocking. The whole thing needs to be seriously tightened up.
The more serious potential impacts of having fillers and other injectable cosmetics done by people without training in anatomy included necrosis and nerve damage, he said.
“Someone gets fillers on a Thursday: By Saturday, they notice their lip is turning blue. On Sunday, they have a black area of their lip. That black area is due to necrosis of the lip tissue.”
“Necrosis can be caused by too much filler being injected and that causing pressure, but injecting into an artery or vein by accident, can cause necrosis but it can also cause nerve damage.
Once a nerve is damaged, there is nothing one can do to repair it. It would be very difficult to repair a nerve with surgery and nerve injuries can be life-changing, can have an impact on the way you talk.”
Injectable cosmetics were once the preserve of the wealthy in Ireland, and as a result were more likely to be used by middle-aged professional women with the resources to seek specialist care.
But as the cost and ease of purchase comes down, younger women with less cash to spend are seeking cheap treatments: A search through hashtags like LipFillersIreland on Instagram reveals this trend.
But Prof Carroll says this is resulting in a wave of DIY approaches: Recently he even heard of someone operating a business out of their garage. He also has serious concerns about the ever-decreasing age profile of the young people, mostly women, that he is seeing opting for fillers.
“Now that it’s cheaper, younger people can access it and I’m not even sure if anyone is checking if they are over 18 or not,” he said.
In the EU, as in the US, fillers are not regulated as medicines, so who can purchase them is not restricted. They are largely regulated as medical devices. This doesn’t apply to all intradermal cosmetics: Botox, for example, can only be administered by medically qualified people because it is a licensed medicine.
The EU Commission’s Medical Devices Regulation (MDR) was recently overhauled, with new requirements as of June 2023 that all medical devices come with CE marks and new labelling rules for manufacturers that must clearly state that dermal fillers “are not to be used in persons who are less than 18 years old” and that they should only be administered by appropriately-trained healthcare professionals.
The Irish authority responsible for monitoring the market is the HPRA. It works with Revenue’s Customs Service and An Garda Síochána to investigate illegal supply of medicines, including online sources, and actively enforces against suspected breaches of the law.
It would not provide a representative for an interview for this article and only communicated via email through a PR firm.
The HPRA pointed out that where, how, and by whom fillers are used is not within its remit: It is responsible only for monitoring the compliance and safety of the products being sold in Ireland.
“With regards to sourcing dermal fillers, the HPRA discourages members of the public from ordering dermal fillers online for use in their own home,” it said.
The group of substances classed as medical devices are listed as products “without an intended medical purpose” in the MDR.
But all three of the products I ordered actually contained small quantities of active ingredients that are licensed as medicines in their own right: The lip filler, mostly consisting of hyaluronic acid, contained 3mg of the anaesthetic Lidocaine.
Another of the products, intended to improve the appearance of cellulite, contained Troxerutin, a drug licensed as a medicine for the treatment of varicose veins and haemorrhoids.
Another, marketed as a “depigmentation solution” contained tranexamic acid, which is also licensed as a medicine and use to control heavy bleeding.
Ellie O'Byrne. All three of the products I ordered actually contained small quantities of active ingredients that are licensed as medicines in their own right. Picture: David KeaneBoth also contained numerous other active ingredients including Melilot, a herb from the clover family that is supposed to reduce skin inflammation, vitamins, and the Alzheimer’s drug Idebenone.
Initially, the HPRA pointed to the responsibility of manufacturers when contacted by the Irish Examiner.
“With regards to devices which contain substances and are regulated under the MDR and interactions with other products or substances, manufacturers should consider risks associated with interactions with products likely to be used in conjunction with their product as part of their risk analysis,” the HPRA said through a press spokesperson.
“With regards to our market surveillance activities relating to dermal fillers, we are continuing to monitor the compliance and safety of such products and associated manufacturers.”
But the information on the products delivered to me made clear that the risks of interactions between the active ingredients in their products had not been studied. There is no way of knowing that if someone had had previous beauty treatments that there wouldn’t be an interaction between different cocktails of active ingredients in injectable cosmetics sold for different purposes.
“There is no clinical data available concerning tolerance to the injection of this product at a site that has been treated with another permanent or impermanent product,” one information sheet read, and “no forms of interaction with other medicines are known.”
So I sent the HPRA photos of the packaging and products I had bought.
“Regarding the image provided, the product does not seem to be a medical device, and from the photograph of the package, appears to contain ingredients available in authorised prescription medicines, and is presented as a medicinal product,” it responded.
So the HPRA was querying the legality of the products I had purchased. How was it going to proceed? It said it could not comment on individual cases.
“The HPRA monitors for illegal supply, both in the physical and digital sphere. It has taken action in a number of cases, including in some cases prosecutions in the District Court in relation to illegal supply/administration/advertising of illicit medicines and continues to engage in enforcement of the regulations,” its statement said.
Ellie O'Byrne with some of the injectable cosmetics she ordered online. A popular brand of filler used to plump the lips, pre-loaded into syringes, came with the warning that it should only be used “by an authorized medical practitioner". Picture: David Keane
“The HPRA earlier this year released its annual enforcement data for 2022 which shows that it detained some 940,000 dosage units* of falsified and other illegal medicines. In addition, 639 websites, e-commerce listings and/or social media pages were amended or shut down.”
With regard to the products I ordered, Prof Carroll said: “The bottom line is that anything that contains a true medicine should not be delivered to someone who is not a professional.”
To Prof Carroll and other members of the IAPS, safety concerns about the current state of regulation on fillers in Ireland are going nowhere. And he has concerns over whether the HPRA has adequate resources to deal with a world where ordering products online is so easy, so cheap and so difficult to monitor and regulate.
The European Commission told me there were no plans to overhaul the MDR soon, but that there will be an evaluation report on the new MDR regulations at the end of May 2027.
In the meantime, in the absence of any action to ensure that only medical professionals can get their hands on and use fillers and other injectables, Prof Carroll said there’s another approach he’d like to see taken, and one where the Government could be pro-active.
He’d like to see a public health awareness campaign targeted to young people warning of the potentially life-altering risks of getting fillers and other injectable beauty treatments by untrained personnel.
“Right now, I think we need warnings online, specifically on channels favoured by young people such as TikTok and Instagram where the information would go to the people who are having this done,” he said.
“No-one could argue that was an unreasonable step and the IAPS would be in favour of that.”
Dermal fillers are a popular non-surgical treatment option that can help reduce the appearance of wrinkles, fine lines, and other signs of aging. These gel-like products restore volume and shape to the treated area, giving patients a more youthful and refreshed appearance.
Dermal fillers are administered as injections. When you buy dermal fillers online, you’ll receive a box of pre-filled syringes ready for administering to your patients.
Depending on the manufacturer and type of dermal filler, a package may contain one or multiple syringes. The syringes can contain 1-3 ml of the product, which also depends on the strength of the product.
Dermal fillers have become a popular cosmetic procedure, as they can help revitalize a person’s appearance by adding volume and fullness to the face, enhancing facial contours, and diminishing the unsightly appearance of wrinkles, lines, and folds. They can address a wide range of concerns, including:
That being said, each product in this category has different indications. It’s important to check the recommended usage of each product before you buy fillers online, then adjust your order accordingly.
However, not everyone is a candidate for dermal fillers. Patients with certain medical conditions, such as autoimmune diseases, may not be suitable for treatment. Pregnant or breastfeeding patients should avoid dermal fillers, as there is limited research on their safety in these populations.
Patients with a history of severe allergies or hypersensitivity reactions should also avoid dermal fillers, as there is a risk of an allergic reaction.
It’s important for patients to note that following laser treatments, chemical peels, or other cosmetic procedures, they may need to wait until their skin has properly healed before receiving dermal fillers.
This will ensure the best possible results and help patients look and feel their best.
Patients must discuss their medical history with their healthcare provider before undergoing any cosmetic treatment to ensure their safety and well-being.
Each type of dermal filler has its own distinct benefits and uses. Medical professionals must carefully select the most suitable filler for each patient’s unique requirements, considering critical factors such as the desired results, the patient’s age, and skin type.
This selection process is crucial to achieve optimal outcomes and ensure patient satisfaction.
When you decide to buy dermal fillers, you’ll encounter several options:
Dermal fillers based on hyaluronic acid are the most common type of these injectables right now. Hyaluronic acid is a naturally occurring substance in human bodies, making it an ideal filler material, as it doesn’t cause the patient’s body to reject it. It’s also one of the safest injectables, with little to no possible side effects.
These fillers are available from the following brands:
Besides treating signs of aging around the face, hyaluronic-based fillers can be used for treating scars and can even be injected into the knees, providing relief to patients suffering from osteoarthritis.
These fillers are made of calcium microspheres suspended in a gel. They are thicker and more robust than hyaluronic acid fillers, making them ideal for deeper wrinkles and folds.
Calcium hydroxylapatite fillers are commonly used to treat nasolabial folds and marionette lines, add volume to the cheeks and correct facial asymmetry.
One advantage of calcium fillers is that they use no animal products in production, reducing the risk of allergic reactions to a minimum. Radiesse is the most common brand available through the dermal filler supplier.
A synthetic filler that helps stimulate collagen production in the skin. They are commonly used to treat deep facial wrinkles and folds, as well as to add volume to the cheeks and smile lines.
Unlike other fillers, injections containing this substance provide gradual results that become more apparent over time. For some patients, this means waiting up to six weeks and repeating treatments to achieve the desired results.
Sculptra is the most well-known brand of these fillers.
PMMA is often used as an alternative to collagen-based fillers. These fillers are most commonly used to treat deep wrinkles, folds, and scars, but have also proved effective for lip augmentation.
While these fillers are a good choice if you’re looking to buy lip fillers, they don’t provide immediate results, and the treatment can take up to three months. Additionally, PMMA fillers require a different injection technique compared to the previously mentioned ones.
This is especially important, as improper technique can lead to visible bumps under the skin.
The longevity of dermal fillers is influenced by several factors, such as the type of filler employed, the injection site, and the patient’s unique metabolism.
Factors such as these reflect the variation observed in the longevity of dermal fillers. However, most dermal fillers last anywhere from 6 to 18 months before needing to be re-injected.
Hyaluronic acid fillers, which are one of the most frequently used fillers, usually have 6 and 12 months lifespan. Calcium hydroxylapatite fillers and poly-L-lactic acid fillers can last up to 12 to 18 months, while PMMA fillers provide longer-lasting results that can last several years.
Dermal fillers are gaining immense popularity due to their quick and easy procedure, which takes only under 30 minutes.
Patients can resume their daily activities soon after receiving the injections. But, there’s still some aftercare required to ensure the best possible results with any fillers purchased from your dermal fillers’ distributor of choice.
After dermal filler treatment, patients should avoid touching or massaging the treated area for at least 24 hours, including putting on makeup. This is because the filler material is still settling into place, and manipulating the area can cause it to shift or become uneven.
Patients should also avoid strenuous exercise and alcohol consumption for 24–48 hours after treatment. These activities can increase blood flow and lead to bruising and swelling.
Hydration is essential to minimize swelling. Limiting sun exposure and extreme heat following treatment is vital to ensure optimal results. In the event of swelling, applying an ice pack for no more than 10 minutes at a time can provide relief.
Dermal fillers are sold pre-packaged, and in boxes containing one or several doses. Because of their packaging and the quantities typically used in each treatment, it’s possible to either purchase them individually or in bulk.
At Medica Depot, you can find top-quality fillers at competitive wholesale prices. Depending on the quantity, you can place large orders and save on your purchase. Discounts start when you order over five packs of a single product.
Frequently Asked Questions:
What is a dermal filler?
A dermal filler is a cosmetic substance injected into the skin to restore volume, smooth lines, and enhance facial contours. Various materials like hyaluronic acid, collagen, or synthetic compounds are used. These fillers aim to address signs of aging and provide a rejuvenated appearance. The choice of filler material depends on the specific needs of the individual. The treatment is commonly used to reduce wrinkles, plump lips, and improve overall skin texture.
What do dermal fillers do?
Dermal fillers add volume to specific areas of the face, effectively reducing the appearance of wrinkles and fine lines. They can also be used to enhance facial features such as lips and cheeks, providing a more youthful and revitalized look. The non-surgical procedure typically involves minimal downtime, making it a popular choice for those seeking a quick and effective cosmetic enhancement.
Are dermal fillers Better than BOTOX®?
Dermal fillers and BOTOX® serve different purposes in the realm of cosmetic procedures. While BOTOX® works by temporarily paralyzing muscles to reduce the appearance of wrinkles, dermal fillers add volume to specific areas, smoothing out lines and wrinkles. The choice between the two depends on individual preferences and desired outcomes. Some individuals may opt to combine both treatments to achieve comprehensive facial rejuvenation.
What are the side effects of fillers?
Common side effects of dermal fillers include temporary swelling, redness, and bruising at the injection site. These effects usually subside within a few days. More severe reactions like lumps, asymmetry, or infection may occur in rare cases. It’s essential to know that more serious complications, such as allergic reactions, can arise.
Is it safe to buy dermal fillers online?
Buying dermal fillers wholesale on Medica Depot is completely safe.
If you cannot guarantee the authenticity and safety of the products, then it poses a significant risk. Counterfeit or improperly stored fillers may lead to serious health complications. However, the same can happen to you in a brick-and-mortar store, so the only thing that matters is the seller’s reputation, not the place of purchase.