Monday, October 21, 2013

Victims of Unlicensed Aesthetic Procedures in Malaysia. A Facebook Exchange.

Recently, I posted a thought on my facebook and had the following exchanges:

I: "Saw a patient for revision of her double eyelids, she had had the operations done three times by a male "doctor" from China said to be trained in Korea. The operation was a disaster with asymmetrical and very high double eyelids. The operation was done in a hotel and the bed in the hotel room was used as the operating table. It is amazing how naïve some people are. I asked her how she got to know the "doctor", she said she was edged on by other friends who said the "doctor" was good. A group of four of them went for the knife but the results were disappointing. The doctors revise their double eyelids a few times then disappeared off the thin air. I asked if she knew the name and address of the doctor, she said he had no name card or any address. "
Not the actual patient but with similar looks
skin creases too high with too much fat taken out.
Doctor A: "This is just the tip of the iceberg. Some have it done at residential areas other than hotel and saloon. Just 2 day ago got patient have her breast implant done in saloon, she come to me coz incision site got infected with pus discharge, ask her to admit refuse then discharge with antibiotic. She is rich but not very smart."
I: "The patient is lucky earlier this year my surgical colleague performed mastectomy on a woman who had silicone injected and the breast went gangrenous not to mention a guy who had penis injection to enlarge his manhood which also went septic and had the thingy amputated."
Doctor A: "That breast implant cost her 20,000 ringgits and the man who performed the surgery could not stop shaking hands during the procedure as if it his first case. Having silicone injected into the breast is just crazy."
I : "It costs a few hundred for a big bucket of silicone and they charge thousands for each injection. The side effect takes a few month or even years to develop by then it's not their problems.  Nobody is going to touch the lesion as it is integrated into the skin muscle and nerve. Removing these things can cause uneven scars and worse still causes loop sided face if the facial nerves were accidentally cut."
A patient had persistent red and swollen forehead after injection of some
unknown agent 3 years ago; most likely to be silicone.

This woman had some filler injected in a hotel and for the
past 2 years had a swollen and hard mass over the left cheek.
Again likely to be silicone.

Persistent upper lid swelling for four years after
silicone injection in a beauty saloon.

Red and swollen cheek with tight skin after silicone injection.
The nose also appear rigid and tight.
Doctor A: "It is very difficult for the Ministry of Health to control because more than 70%  of cosmetic procedure are done by non-registered and unlicensed practitioner. As long as things go smoothly everyone keep quiet. Silicone is a lot cheaper compare with biodegradable filler."
I: "Even if things go bad, these patients have no way to complain because there are no consent forms and the personnel are not covered by medicolegal insurance because they are phony doctors. Some beauty centres get round the problems of being prosecuted by employing outsiders to do the jobs and then deny responsibility saying the place was only rented to these people. Another ploy is for these beauty centres to take patients to hotels for the procedure which exonerate the centres from allowing unlicensed personnel performing illegal procedures in their premises."
I: "Another toxic substance that is often used is hydrophilic polyacrylamide gel."
Doctor B: "Amazing! All this while I thought this only happens in Indonesia, because Indons are more stupid. It turns out that Malaysians are as stupid as well! China docs operating from hotel rooms, saloons, houses of rich tai tais, as well as local doctors' clinics who take commissions for "collecting" patients and allowing their clinics to be used, is very common here in Indonesia. Usually weeks before their arrivals, words will spread around, and all the tai tais will register with either a local doc, saloon owner, or in the event the surgeries are done in a residential house, the owner of the house who is usually a rich tai tai who lives in a good class bungalow. For some reasons, China docs are perceived as very experienced and talented here. I don't know why. They usually will fly in and stay for just 2-3 days, performed at least 1-2 dozens surgeries per day, then disappeared back to their countries. The most popular surgeries are upper and lower blepharoplasty."
I: "Did one revision lower blepharoplasty yesterday on a patient from Pontianak who had had surgery done in a saloon by a China doctor. Apart from the scar in the lower lids none of the fat or skin was removed and the doctor never visited again."
Doctor B: "Siliconomas are very common here. And what surprises me is the high incidence in rich tai tais. I always be rich, you need to be smart and educated. But, it's not very educated and smart to have liquid silicone injected into one's face or breasts. These rich tai tais can afford to see qualified doctors and surgeons who practice in proper established clinics, but I wonder why they choose to have surgeries done in hotel rooms or saloons by some "flying" doctors whom they will never see again after their procedures."
I: "Sorry to offend the ladies, but most women will have anything done to their bodies if you say you got something to make them beautiful. The other day an Indonesian agent bought a woman from Pontianak for treatment. I treated her frown lines, crow feet and forehead, she took out a bunch of ringgits and after paying the fee she says "I got another thousand ringgits here, is there anything you can inject for my face?" I told her there is nothing else she needed then the agent found an excuse to speak to me privately and said "she is very rich just give her anything she will pay without questions" That's how crazy some patients are and she was in her late 50s."
Doctor B: "Even Pontianak patients are like that? I thought only those from Jakarta. I know they always carry around SGD 1000 bank notes, heaps of them, in their wallets or purses, when they go to see doctors or shopping in Singapore."
I: "Now with the high exchange rate, a lot are carrying ringgits.

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