A young Toronto woman is warning others about the dangers of home lip augmentation and lip-filler parties after a complication left her temporarily disfigured, in excruciating pain and, a plastic surgeon says, at risk of losing her lip, nose and possibly even her eyesight had she not been treated in time.
A CBC News investigation has found the woman who allegedly performed the injections appears to have no medical qualifications, and wouldn't have the authority to legally access the injectable gels, much less provide medical care for a client if something were to go horribly wrong.
"It's just been so painful. I can't even describe it to people. I would never wish this upon anybody," says Jenna, who asked that her last name not be published.
Prior to the health scare, the 23-year-old hairstylist says she'd been to a couple of parties at a woman's home in her neighbourhood where she and others underwent lip augmentations.
It's a common cosmetic procedure that's become a hot trend, with more and more people wanting fuller, plumper lips like those of reality TV star Kylie Jenner and other celebrities.
The procedure involves using a needle to inject a dermal filler, either a fat injection, a collagen product or hyaluronic acid, a substance found in the body's connective tissues, into the area around the mouth to make the lips bigger.
Health Canada says hyaluronic acid products are the most commonly used dermal fillers. And there are more than 30 injectable dermal fillers containing hyaluronic acid legally for sale in Canada.
The products require a prescription and must be administered by an authorized health professional, so they can be expensive, with one Toronto clinic charging as much as $600 per injection. Multiple injections may be needed over many months.
Jenna went to her first lip-filler party three months ago and then a second one about a month later. She says the woman performing the injections at these parties was named Susan. She didn't give her last name.
Jenna says Susan told her she was a nurse and charged $200 per injection.
Jenna was pleased with the results of the first two injections, so last week she arranged to meet Susan at a friend's home and underwent the procedure for a third time.
"When I got done the appointment, I looked in the mirror and my entire bottom lip was pure white," she says.
Both Jenna's lips, but especially her bottom one, were extremely swollen.
"[Susan] put a little bit of a dissolvent in because she thought it was too much filler that was put into my lips.
"She said it would go away."
'Got worse and worse'
About an hour later, and in terrible pain, Jenna says she started noticing blue discolouration on her chin.
She got Susan's number from the host of the parties and called her.
"I didn't really know what to do. [Susan] hadn't explained to me that this could possibly happen. She didn't tell me where to go from here," Jenna says.
So Jenna went to a walk-in clinic but they sent her to a hospital emergency room.
"And they couldn't do anything for me because they don't usually deal with stuff like this," she says.
Jenna says she was told bruising is common with injections and would heal with time.
So she went home.
"I tried going to sleep that night; I couldn't sleep, it just got worse and worse. And then in the morning I noticed I was getting black spots on my lips."
She called Susan again, and this time Susan told her to call a plastic surgeon, Dr. Martin Jugenburg.
"It appears that she had a lip filler injected which went intra-vascular, so it was injected into a blood vessel," Jugenburg says.
"And this caused obstruction, so the lower lip, it was ischemic. It wasn't getting proper oxygen and nutrients."
The starved cells in her lip were in danger of dying.
"We treated her with a lot of hyaluronidase, tried to break up whatever was injected," he says. "I also gave her nitropaste, which opens up the circulation."
Jenna says the cure is nearly as painful as the condition.
"I had about, I'd say 80 needles put into my bottom lip and on my chin, inside my lip."
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Had she waited just a few more hours before treatment, Jenna could have lost her lower lip, the doctor says. And that's not even the worst possible outcome. The circulation blockage could have spread to her nose or even her eyes, he says.
"Blindness is a very rare complication," Jugenburg says, "but it can happen if a filler is injected into a blood vessel by someone who is not properly trained and they don't know what they're doing. This filler obstructs the blood flow to the eye and the eye suffers the same ischemic death like the lip would."
Who is 'Susan'?
Jugenburg says the woman who sent Jenna to his clinic is named Susan Szilasi. He says she was an esthetician when they worked at the same clinic years ago.
"So where does she get her injections? I have no idea," Jugenburg says.
There is no one named Susan Szilasi listed in the Ontario College of Nurses website directory.
CBC News found a listing for a Susan Szilasi at an address in north Toronto but there was no answer at the door. She didn't return calls and texts. A cosmetic clinic in Toronto's Yorkville neighbourhood where Susan Szilasi was listed as an employee says she no longer works there.
Jugenburg says the problem with lip-filler parties is you have "beauticians or estheticians or nurses doing things … but there is no physician in the vicinity."
"Patients don't realize that getting a good deal on a cosmetic treatment is not the same thing as a good deal on a haircut," he says. "If something goes wrong, you can't just grow your hair back and start over again."
Against the law?
The College of Physicians and Surgeons of Ontario says administering a substance by injection is a controlled act under the Regulated Health Professions Act, and controlled acts may only be performed by authorized and regulated health professionals.
In an email, the college said "patients should have such treatments where a physician is clearly involved in the assessment of the patient to ensure they are a good candidate and that any delegation of this treatment is occurring under the supervision of a physician."
Jugenburg says Jenna's pain will likely go away in about five days and her face should be back to normal within a few weeks.
Jenna says she is lucky the outcome wasn't worse.
"With time, I could have lost a lot of skin," Jenna says. "And they said if I had waited, I could be getting reconstructive surgery on the bottom half of my face."
Despite the ordeal, Jenna says she's not against lip augmentation and may even get lip-filler injections in the future. But if she does, she says, she'll get it done by a doctor. She says it would be worth the extra cost.