I write this article as a doctor – not to extinguish the dream of beauty, but to protect the survival of those dreams.
As a doctor specializing in Plastic Surgery – Aesthetics, I understand that the desire to become more confident, more perfect in the eyes of others – and yourself – is completely legitimate. However, what makes me increasingly worried is the rapid increase in the demand for cosmetic surgery in Malaysia as well as many countries in the region, while knowledge about medical safety, the distinction between licensed doctors and unlicensed cosmetic services is extremely limited.
The rapid but uncontrolled increase
According to the statistics of the Malaysian Society of Aesthetic Plastic Surgeons (MSAPS) in 2023:
Malaysia recorded more than 320,000 non-surgical cosmetic procedures (filler injections, botox, peels, facelifts, etc.)
Nearly 47,000 cosmetic surgeries were performed in the year - an increase of 18% compared to the previous year.
Notably, more than 60% of non-surgical cosmetic services were performed at facilities without a doctor's supervision.
I have personally treated severe complications due to home filler injections, nose augmentation with floating liquid silicone, and even patients who suffered from sepsis after liposuction at an unlicensed "underground" spa. Some people lost their eyesight, some almost lost their lives.
Some unfortunate situations I have encountered
Case 1:
A young girl had lip filler injections from an unlicensed "beauty specialist". Immediately afterwards, her lips turned purple and were in severe pain. When I got to the hospital, I discovered that the blood vessels in her lips were blocked and the tissue had begun to die. Despite intervention, the damage was permanent – both cosmetically and psychologically.
Case 2:
A woman in her 40s had liposuction at a facility that called itself a “high-end cosmetic center” on the outskirts of Kuala Lumpur. The equipment was not sterile, there was no anesthesiologist, and there was no post-operative resuscitation. She was hospitalized two days later in severe septic shock and almost died.
Why does this still happen?
Lack of awareness of medical risks: Many people think that cosmetic surgery is “beauty”, not medicine. They do not know that an injection can cause embolism, stroke, and death if placed in the wrong place or if sterilization is poor.
Believing in cheap prices and excessive advertising: Beauty services are rampant on social networks with super cheap prices, no verification, and no guarantee of safety. Users are easily convinced by eye-catching before-after images, without checking the qualifications of the person performing the procedure.
The law is not yet strict in managing the non-invasive beauty industry.
Aesthetics is medicine, not a game
What I always emphasize: Any cosmetic intervention, whether filler injection or liposuction, is a medical procedure. And it should only be performed by a doctor with a professional certificate, in a place with adequate equipment, sterilization, and emergency support.
When beauty affects the cardiovascular system - A forgotten risk
Did you know? Injecting botox/filler in the wrong place can cause cerebral embolism, stroke, myocardial infarction.
Some cosmetic patients do not have a general examination before surgery, while having underlying cardiovascular diseases such as:
Hypertension
Arrhythmia
Valveolar stenosis or a history of myocardial ischemia
They are at risk of cardiac arrest during anesthesia or during post-operative resuscitation, if there is no anesthesiologist - resuscitator monitoring. That is why a thorough pre-operative screening and cardiovascular testing are mandatory for me in all cases.
What do you need for safe cosmetic surgery?
Choose a doctor who is certified in Plastic Surgery - Cosmetic Surgery
Check that the place has a medical license (LCP - Letter of Credentialing & Privileging)
Get a full health check before performing any procedure, even simple injections
Don't chase cheap prices - chase safety
Beauty is not wrong - but it must be done correctly
Beauty is a right, a personal choice - but no one should pay with blood and health for appearance. As a doctor, I do not deny the cosmetic industry, on the contrary, I love this profession because it can bring confidence and happiness. But only when aesthetics go hand in hand with medical ethics and standards, can we truly call it the art of healing.
"You deserve to be more beautiful - but you deserve more to be safe."
