A recent report in the South China Morning Post described three ladies who developed septic shock and needed ICU admission after receiving “beauty” treatments in a local clinic. More details are available on the government website.  It is apparent that the ladies were all receiving treatments with intravenous infusions.

Intravenous infusions sound “invasive” to me, and it is of particular concern that such invasive treatments should be given in a beauty clinic.  Who was responsible?  What training had been given?  What facilities were available if something went wrong?  What protocols were in place to ensure that patient, sorry, client safety was ensured?

These are very pertinent questions when we consider the safety of cosmetic practice in Hong Kong.  I use the word “cosmetic” to indicate that these procedures do not comprise a form of therapy to treat a disease or illness.  There is obviously a perception in the client that there is room for improvement; perhaps looking younger, or fresher, less tired perhaps, or appearing more attractive.  There is absolutely nothing wrong with this but surely if clients are going to clinics to receive treatments they have an expectation that the treatments are safe; the facilities are appropriate, and staff who undertake the treatments are appropriately trained.

But how can these expectations be fulfilled if there is no control or regulation in the cosmetic industry? Two years ago, after the tragic death of a young girl in a cosmetic surgery clinic in Hong Kong, I wrote to the Secretary of Food and Health to ask about the government response to this issue.  I received a reply sometime later which said that the cosmetic industry was part of the medical profession. The medical profession is an autonomous, self-regulating professional body and the government would not interfere.

I feel that this approach is both uneducated and irresponsible.  If only all doctors were ethical and professional, but they are not.  If only the medical regulatory authorities had real powers of control, but they do not.  Governments must intervene to ensure safety in a highly lucrative industry where there is always the temptation not to put patient safety before physician profit.  In Singapore there are very clear guidelines on aesthetic practices for doctors which evolved from proactive discussion within the Medical Profession.  In the UK a government initiative has set up a review of the standards of practice in cosmetic surgery.  These are both excellent initiatives, but reflect the broad spectrum of the problem that spans from aesthetic medicine on the one hand to cosmetic surgery on the other.

Whether a patient/client is receiving treatment by a face mask on the one hand or a face lift on the other; they should have an expectation that the treatment is safe and effective, and that their money is being well spent.

That should have been the end of this blog but there is “breaking news.” In the local Chinese press and CNN there are reports that a woman has died after a beauty treatment in a beauty clinic; The therapy involved blood being removed from the woman, processed in a machine, and re-infused into the woman. We need more details but if the reports are true then this is altogether something else as this is certainly not a beauty treatment. So perhaps before we begin to consider how to regulate the “beauty” industry we need to define what it is.

Andrew Burd is professor of plastic, reconstructive, and aesthetic surgery at the Chinese University of Hong Kong. His major clinical interests involve paediatric burns care and the role of plastic surgery in the palliation of advanced malignancy. Academic interests include pragmatic ethics related to the practice of medicine including research and publication.