Opting for cheaper cosmetic treatments with unlicensed practitioners can come at a high cost, sometimes costing a patient his or her life. 

Last month, a 29-year-old housewife lost her life after undergoing a breast enhancement procedure with an unlicensed beautician operating out of a shophouse in Johor. Post-mortem results revealed that she succumbed to a bacterial infection due to unsanitary conditions during the procedure. In 2020, a 23-year-old model underwent liposuction at a beauty salon in preparation for her wedding day and tragically passed away.

Sadly, these are not isolated incidents. Despite the grave risks associated with receiving cosmetic treatments in non-medical establishments like beauty salons, these practices continue to lure patients by offering attractive discounts and low prices, while downplaying the risks and overpromising results.

Consultant Plastic and Reconstructive Surgeon, Dr. Somasundaram Sathappan, and Consultant Anesthetist, Dr. Gunalan Palari Aramugam from the Subang Jaya Medical Centre, share the dangers of visiting non-medical establishments and unlicensed practitioners for medical aesthetics procedures.

  1. Lack of medical knowledge and clinical experience

All medical procedures that penetrate the skin carry inherent risks, regardless of the invasiveness of the procedure. This is why medical practitioners undergo years of medical education, housemanship, and training. Plastic surgeons undergo postgraduate education in plastic surgery and supervised training under more experienced surgeons before they are qualified to deliver safe and effective surgical treatments.

“Individuals who are not medically trained simply lack in-depth knowledge about anatomy, surgical procedures, and how to manage complications on the operating table, should they arise. Even minimally-invasive procedures like injectables can result in complications if the person administering it hits the wrong nerve or tissue, or does not have the right techniques,” says Dr Soma, who often sees patients seeking corrective treatments after undergoing botched procedures.

One such patient came to him with abscesses across her face after undergoing non-sterile facial injectables with a beautician for a few hundred ringgit.

“The patient had contracted a non-tuberculous mycobacterium infection, and the cost to treat it came up to RM54,000 including six weeks of antibiotics and dressing, which doesn’t even account for the permanent disfigurement she will have to endure for the rest of her life,” he shares.

  1. Inadequate Facilities and Equipment

In Malaysia, all aesthetic procedures must be performed exclusively by qualified registered medical practitioners, at a premise registered or licensed under the Private Healthcare Facilities and Services Act 1998, to ensure that patient safety is maintained at all times.

“According to the regulations stipulated by the Ministry of Health (MOH), hospitals must ensure that operating rooms are not only sterile to prevent infections but also have proper lighting, adequate surgical staff, and suitable patient monitoring equipment. Even clinics must be equipped with an emergency call system, ventilation assistance equipment and emergency medical equipment to stabilise patients in the event of emergencies,” explains Dr Gunalan.

“Most unlicensed practitioners operate out of private residences, spas or beauty salons, which are not properly equipped for invasive procedures, and are not regulated by the MOH. This significantly increases the risk of infection, errors during surgery and adverse reactions to anaesthesia,” he says, adding that even something as innocuous as local anaesthesia could lead to complications and become lethal if administered improperly.

  1. Lack of Accountability

Registered medical doctors in Malaysia are held to high ethical and professional standards, holding them accountable for their actions. They can be subject to harsh disciplinary measures including lawsuits or revocation of their medical licenses in the event of malpractice or negligence.

Dr. Soma says, “In instances of medical negligence in registered medical facilities, established infrastructures are in place to protect and compensate patients. In such cases, not only are doctors and hospitals held liable, even product suppliers may be implicated if the medical product used results in complications.”

Conversely, unregistered practitioners often operate in the shadows, making it easier for them to dodge accountability and more challenging for patients to hold them responsible for any undesirable events.

“While patients can report these practitioners to the police, which can result in the practitioners being jailed, fined or both, there are limited options for monetary recourse. Many patients also choose not to file a police report due to fear of social repercussions,” adds Dr Soma.

From left: Consultant Plastic and Reconstructive Surgeon, Dr. Somasundaram Sathappan, and Consultant Anesthetist, Dr. Gunalan Palari Aramugam from the Subang Jaya Medical Centre

From left: Consultant Plastic and Reconstructive Surgeon, Dr. Somasundaram Sathappan, and Consultant Anesthetist, Dr. Gunalan Palari Aramugam from the Subang Jaya Medical Centre

How to ensure the legitimacy of your cosmetic doctors

In Malaysia, all cosmetic doctors who possess the Letter of Credentialing and Privileging (LCP)  are licensed to perform minimally-invasive procedures like injectables. Cosmetic surgeries such as liposuctions or breast enhancements are the sole domain of qualified plastic surgeons.

Patients are advised to verify if their chosen practitioner is properly licensed before undergoing any cosmetic procedure, by checking if the practitioner is listed in the National Specialist Register MeRITS website and MOH Registry respectively.

Featured photo by Dreamstime. Doctor photos courtesy of each respective doctor.