Facts about medical aesthetic practice — Ungku Mohd Shahrin

OCTOBER 23 — Regarding the unfortunate incident of the aesthetic procedure (liposuction) performed in a beauty centre that has been widely discussed amongst public and aesthetic practitioners alike, I would like to share some information concerning medical aesthetic practice in Malaysia.

Definition

The definition of aesthetic medicine is relatively new. In 2013, the Malaysia Ministry of Health (MOH) defined aesthetic medicine as “An area of medical practice which embraces multidisciplinary modalities dedicated to creating a harmonious physical and psychological balance through non-invasive, minimally invasive and invasive treatment modalities which are evidence-based.

“These modalities focus on the anatomy, physiology of the skin and its underlying structures, to modify the otherwise 'normal' (non- pathological) appearance in order to satisfy the goals of the patient and are carried out by Registered Medical Practitioners.”

Classification

There are many ways to classify Aesthetic medicine procedures. It depends on the applicability of the aesthetic medicine procedure to the patient. Aesthetic Medical Practice (AMP) committee, Ministry of Health Malaysia, classified aesthetic procedures into three categories.

The first one is non-invasive. “This is defined as external applications or treatment procedures that are carried out without creating a break in the skin or penetration of the integument. They target the epidermis only.”

Second is minimally invasive procedures. “This is defined as treatment procedures that induce minimal damage to the tissues at the point of entry of instruments.

These procedures involve penetration or transgression of the integument but are limited to the sub-dermis and subcutaneous fat, not extending beyond the superficial musculoaponeurotic layer of the face and neck, or beyond the superficial fascial layer of the torso and limbs”.

Lastly, invasive procedures. “This is defined as treatment procedures that penetrate or break the skin through either perforation, incision or transgression of integument, subcutaneous and/or deeper tissues, often with extensive tissue involvement in both vertical and horizontal planes by various means, such as the use of knife, diathermy, ablative lasers, radiofrequency, ultrasound, cannula, and needles.”

In other words, the non-invasive procedure only targets outer layers of the skin, such as superficial chemical peel, intense pulsed light, and microdermabrasion.

Minimal invasive procedures only target deeper skin layers and muscles such as Botulinum toxin or dermal fillers, and invasive procedures are all the surgical procedures that need cutting and perforating the inner layer of the human body specializsd expertise such as nasoplasty or liposuction.

Who can perform the medical aesthetic procedure?

According to the Malaysia Ministry of Health Act, 586 (Private Healthcare facilities and Services Act 1998), and Aesthetic Medical Practice Guidelines 2013, aesthetic medicine procedures can only be performed by registered medical practitioners (doctors) with Letter of Credentialing and Privileging (LCP) in licensed premises.

The regulation stipulated that all medical professionals need to follow very stringent rules before performing the procedure to safeguard public health. The service provider (doctor/clinic/medical center/Hospital) obligation is to display all the certificates or documentation correctly for the patient to see.

In summary, before you agree to do aesthetic medicine procedures, please verify:

1. Premise licence (clinic license given by MOH — i.e., Form B or Form F) 

2. Doctor Full Medical Registration by Malaysia Medical Council (MMC) and valid Annual Practice Certificate (APC) provided by Malaysia Medical Council 

3. Letter of Credentialing and Privileging (LCP) licence that stated the type of procedure they can perform given by Aesthetic Medical Practice Division, MOH

If the service provider cannot produce all three documents, you can be sure that it is done illegally.

Finally, as a reminder to the general public who plan to do any medical aesthetic procedure or surgery, make sure it is performed only by registered medical practitioners with a Letter of Credentialing and Privileging (LCP) from the Ministry of Health Malaysia and carried out at licensed medical facilities and not in beauty centre or aesthetic medispa.

* Dr Ungku Mohd Shahrin Mohd Zaman is president of Pertubuhan Doktor Estetik Berdaftar Malaysia (PDEBM).

** This is the personal opinion of the writer(s) or organisation(s) and does not necessarily represent the views of Malay Mail.

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