You are putting your health, looks and money at risk by buying fillers online or going to an untrained beautician instead of a medical professional.

We speak to a user of TEOSYAL® Hyaluronic Acid Dermal Fillers range and TEOSYAL® PEN, Dr Hew Yin Keat  from The MAC Clinic in Kuala Lumpur about the circulation of fake fillers in Malaysia.

(Q) There has been a concern of fake fillers in the market. How rampant is it?

Portrait of Dr Hew Yin Keat, taken from the

Portrait of Dr Hew Yin Keat, courtesy of

(A) Fillers are classified and registered as medical devices which means they are meant to be used only by suitably trained medical professionals such as plastic surgeons, dermatologists and aesthetic practitioners. Fillers are used to correct facial and body contour deformities, replace volume loss that occurs with ageing and to enhance or augment certain facial and body features such as the nose, chin, breasts and buttocks.

There has been an explosion of fake and unregistered fillers in the past few years which are used by fake doctors and fly-by-night surgeons operating from hotel rooms or business premises which are not registered medical facilities.

Counterfeit fillers claiming to be produced by well-known brands are making an appearance at beauty expos in Kuala Lumpur where they are usually sold at prices far below what the originals cost.

There have also been advertisements for sale of such counterfeit products on Facebook and Instagram pages and other social media platforms.

Personally I have had patients asking me to inject them with what they claimed to be genuine products bought off the internet. There is no such thing; no legitimate pharmaceutical company manufacturing medical devices would sell their products on the internet unless they would like their licence revoked.

(Q) How can consumers tell if a product is likely to be a fake? Why it is important to put a stop to the fake aesthetic product/treatment market?

(A) There are some clues to look out for when trying to determine if a product is a fake. As fake products are much cheaper, they are usually offered at a much lower price than what one usually finds in the market.

Fillers can only be administered by a medical professional and not meant to be sold directly to the consumer or even to a beautician at a salon. So any product bought off the internet is either fake or unregistered.

Some might claim the products are “parallel imports” but that means the batches are not registered and their origins and storage conditions during transportation are suspect. Their contents may have been tampered with, adulterated with cheaper alternatives or compromised by heat during its storage or transportation before it is administered to the consumer.

Another red flag is when the filler treatment is offered at a place that is not a registered medical facility (with a valid licence from the Ministry of Health of the country it is operating in) or is administered by a doctor who doesn’t have a valid licence to practice aesthetic procedures. Consumers should always know what they are being injected with as there are different types of fillers used by doctors and even within a filler type, there are differences in their properties. You should suspect the product is a fake if the person selling or administering the filler is not able to explain to you in simple terms the origins and properties of the product.

It is important to put a stop to fake products and treatments from unqualified people as serious complications could arise. Unlike counterfeit apparel, electronics and the like, the use of fake medications and medical devices can lead to serious consequences that may leave permanent and irreversible damage and even catastrophic impact on our health.

(Q) What are some of the consequence of using fake fillers? What could possibly go wrong?

(A) It is surprising to me that some would risk their health and appearance by undergoing treatments involving injections into the face or other parts of the body using products from questionable sources. Of course there are cases where consumers are truly not aware that the products are fake, but I think quite often they would rather believe that they have stumbled upon an extremely good bargain than heed the warning signs.

In the hands of an untrained person, the risks from using fake fillers are more and magnified many more times than the risks from original fillers administered by well-trained and experienced medical professionals. A well-trained filler injector would know there are risks to the procedure, as with any other medical procedure, and explain these risks to the patient prior to any procedure. In addition to taking the necessary steps to reduce the risks, the trained filler injector would also know what steps to take to help the patient should any complication arise.

The risks of using fake or unregistered fillers are as follows:

  1. Infection and all the problems associated with it such as redness, tenderness, fever, pus formation which sometimes lead to scarring
  2. Hard nodules which may appear sometimes a few years after the procedure and can only be removed by surgery
  3. Blood vessel compression which may lead to prolonged pain and swelling
  4. Injection into a vital blood vessel can lead to skin breakdown or blindness. Skin breakdown can lead to permanent scarring if not well-managed. Filler particles can travel to other parts of the body such as brain vessels which can cause an infarction or stroke
  5. Facial asymmetry or disfigurement
  6. Allergic reactions: particularly if the filler has been adulterated with, or is composed of another substance that has been treated to look similar to filler material such as peanut oil, industrial silicon or even glue!
  7. If there are any results at all, they are not lasting. Some fake fillers are absorbed by the body within days of injection.
  8. Complications when undergoing other future procedures, due to the reaction of the fake filler with other injectables or treatments with medical devices.

Click here for Part 2 of this article.