Singapore
Cheaper prices, peer influence fuel demand for illegal home-based aesthetic services; Singaporean experts warn of botched procedures
They were lured by the cheap prices advertised by home-based ‘aestheticians’, but ended up paying more when the procedures go wrong. — TODAY pic

SINGAPORE, June 19 — They were lured by the cheap prices advertised by home-based "aestheticians”, but ended up paying more when the procedures go wrong.

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They would then turn to qualified practitioners, who told TODAY that they have seen a consistently rising number of people seeking to correct botched procedures done by these unlicensed operators.

A recent court case of a woman sentenced to one week’s jail for performing unlicensed home-based lip reduction surgery has cast the spotlight on a small industry of unauthorised operators offering aesthetic services.

While the patient in the court case suffered no ill-effects from the procedure, some have not been so lucky and have had to pay the price.

"Usually rectification surgery costs more than the primary surgery itself because reconstructive surgery is a lot more complex,” said Dr Leo Kah Woon, a plastic surgeon at Dr Leo Aesthetic Plastic and Reconstructive Surgery.

"The whole cost of treatment for them ends up being more than if they come to a licensed practitioner like us to begin with.”

Dr Woffles Wu, a plastic surgeon at Woffles Wu Aesthetic Surgery & Laser Centre, said: "Some of them come in quite desperate, they realised... (it was) a silly thing to do and instead of saving the cost, they end up having to spend more to correct it.”

Singapore Medical Council guidelines on aesthetic practices for doctors state that aesthetic procedures, whether they are invasive or not, should be performed only by a licensed doctor at a registered clinic or operating theatre.

The practice is also outlawed by the Private Hospitals and Medical Clinic Act, which states that any premises to be used for healthcare purposes must be licensed.

No such licence is available for home-based businesses to carry out these procedures.

Illegal aestheticians advertise on Carousell, other platforms

TODAY could easily find seven home-based "aestheticians” offering invasive and injectable procedures out of their homes on online platforms such as Carousell.

This reporter approached three home-based businesses that advertised services such as Botox and lip fillers.

All three of them claimed to have licensed practices and certifications, but when asked to show documentation or photos of them, they all declined.

These operators then reassured this reporter that invasive procedures are safe by producing "evidence” such as Facebook posts of their "awards”, claiming they had years of experience in the medical field.

They also claimed to have a private limited company registration, and that their products are softer on the skin than those available off-the-shelf and would not cause infections.

They quoted this reporter prices ranging from S$138 (RM476) to S$238 for Botox and lip filler procedures.

Dr Adrian Ooi, consultant plastic surgeon and medical director at Polaris Plastic and Reconstructive Surgery, said that the same procedures could cost between S$200 and S$2,000, depending on the amount injected.

Professional aestheticians condemn illegal practices

Dr Leo said that home-based operators misrepresent the products they are promoting by claiming, for example, that they have natural ingredients.

He said this gives patients "a false sense of security”, even though in reality there is a high risk of infection by using these products administered by an unlicensed operator.

Dr Leo cited a particular case involving a patient who underwent botched procedures after finding the service on Chinese social media and e-commerce platform Xiaohongshu.

Dr Leo said there is also peer influence, when patients see that their friends did not experience adverse results.

However, all three plastic surgeons interviewed cautioned that it is not worth patients risking infection by going ahead with these procedures, with some extreme cases even resulting in death.

Dr Wu said it is difficult to clamp down on such practices as government agencies do not have the resources to monitor the illegal operators, and so they rely on complaints.

In most cases, "people are just too ashamed to talk about it”, he added.

Lawyers warn of legal implications, health risks

TODAY approached three lawyers to find out about the regulations governing such businesses.

When asked of common cases regarding unlicensed home-based operators offering medical aesthetic services, Jacqueline Chua, a lawyer with Jacque Law LCC, said that "they typically involve non-medically trained persons (mostly foreigners) providing beauty services”.

"Such procedures include Botox, fillers, tattoo removal, performing laser procedures, procedures on lips, injections for the removal of fat and so forth,” she added.

Kelvin Ong, a lawyer with Contigo Law LLC, said that "medical services which require a doctor’s medical licence should not be done at home”.

Jessica Cheung, a senior associate with Edmond Pereira Law Corporation, agreed that the procedures must be done by registered healthcare professionals at licensed healthcare premises.

"In Singapore, healthcare premises (such as hospitals, medical and dental clinics) are licensed by the Ministry of Health,” she said.

People should steer clear of such unauthorised businesses as they "may find themselves implicated in the commission of a potential offence, but, more importantly, for their own personal health and safety”, Chua said.

She warned that the illegal operators may not be able to give proper treatment if an injury occurs. They may also try to avoid paying financial compensation and, if they are foreigners, they can leave Singapore easily.

TODAY reporter goes undercover

This TODAY reporter arranged a consultation as a customer with a home-based business which advertises Botox and dermal filler services on Carousell.

I did not initially identify myself as a reporter and attended the consultation at the house, which is located in Singapore’s east, posing as a potential customer.

The "aesthetician”, who wore purple scrubs with her brand name stitched on top, had turned a regular bedroom into a makeshift clinic.

She had placed a dentist’s chair in the middle and a patient bed, similar to those in general practitioners’ clinics, against the wall.

In a cabinet, she stored imported products such Botox-related products and lip fillers, and in one corner was a sterilisation machine for cleaning her medical tools.

On the wall, the woman displayed eight or so framed "certifications”.

When I asked for specifics of the Botox and lip filler procedures, she mentioned that treatment would be carried out after applying a strong numbing cream for 15 to 20 minutes.

She would then inject toxins into my skin according to how she would decide to "design” the shape of my lips. This reshaping should last up to one to two years, depending on my alcohol intake, she added.

The woman described administering so-called "platelet-rich plasma” procedures that involved withdrawing plasma from the bloodstream and injecting it into the face for three sessions monthly.

She reassured me that this procedure rejuvenates the skin’s collagen, and is an "exclusive” service not usually available in Singapore.

The woman also talked about administering Profhilo, a product broadly similar to Botox, which involves injections.

She added that it was a well-known treatment used to hydrate the skin.

The woman said that she does not run a company in Singapore, which means she can keep her prices affordable. She promised me that the quality of her service is either equivalent or better than any doctor in Singapore.

The prices she charged for these services ranged from S$188 to S$238.

After declining to go ahead with any procedures, I identified myself to the woman as a TODAY reporter and formally interviewed her.

The woman then refused to answer questions about the legality of her practices.

Instead, she insisted on only addressing inquiries about her aesthetic services and failed to give a clear response when asked if she knew of the rules and regulations for medical practitioners in Singapore.

TODAY has chosen not to identify the woman or the specific location of her home-based business. — TODAY

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