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Safety guidelines to stay Pretty

Dr Noor Hisham Abdullah
Dr Noor Hisham Abdullah , Director General of Health Malaysia & Senior Consultant Surgeon in Breast and Endocrine Surgery

 

Dr. Noor Hisham Abdullah : Aesthetic  medical  practice  is  not  risk-free  as  many  may  perceive.

 

Aesthetic medical practice is popular in the recent years with the influence, partly from the Korea. This consumer driven lucrative “business” is not a medical specialty but an area of interest in medical practice. Public needs to be alert that all aesthetic procedures are not completely safe. It may cause bleeding, infections and even death.

 

 

PUBLIC NEED TO BE PROTECTED

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Illegal practices are common in unregistered premises. The Ministry of Health Malaysia together with the relevant professional bodies has released the “Guidelines on Aesthetic Medical Practice for Registered Medical Practitioners” in year 2013. However, many may not aware the importance of these guidelines in protecting the public, at the same time, regulating the aesthetic medical practice in Malaysia.  With the enforcement of these guidelines, the medical practitioners are subject to the Code of Professional Conduct and other related laws governing medical practice.

“Registered medical practitioner” is defined as a medical practitioner who is registered and holds a valid practising certificate under the Medical Act 1971 [Act 50]

Public should also aware that through these guidelines, medical practitioners are regulated with the scope of practice allowed.  They are required to meet the minimum level of competency and are required  to  register  under  the  National  Registry  of Registered Medical Practitioners Practising Aesthetic Medical Practice.

According to the guidelines, aesthetic medical practice is defined as:

An  area  of  medical  practice  which  embraces  multidisciplinary  modalities dedicated to create 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 OF AESTHETIC MEDICAL PROCEDURES

Aesthetic medical procedures should  be  supported  by  scientific  evidence and/or have local medical expert consensus that the procedures are well- established and acceptable.

These procedures can be classified into non-invasive, minimally invasive and invasive as follows.

1.Non-invasive procedures : 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. Example:

  • Superficial chemical peels,
  • Microdermabrasion,
  • Intense pulsed light

2.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 integument but are limited to the sub-dermis and  subcutaneous  fat;  not    extending  beyond  the  superficial  musculo- aponeurotic layer of the face and neck, or beyond the superficial fascial layer of the torso and limbs.  Example:

  • Chemical peel (Medium depth),
  • Botulinum toxin injection,
  • Filler injection – excluding silicone and fat,
  • Skin tightening  procedures-up  to  upper  dermis  (radiofrequency,  infrared,ultrasound and other devices)
  • Superficial sclerotherapy,
  • Lasers for treating skin pigmentation, Lasers for treating benign skin lesions, Lasers for skin rejuvenation (including non ablative),
  • Lasers for hair removal

3. 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, cannulae and needles.

The medical practitioner must communicate to the potential patient the risks involved, the possible outcome, obtain valid consent for the aesthetic medical procedure planned, and generally observe all aspects of the Code of Professional Conduct of the Malaysian Medical Council.

Importantly, public must aware that the medical practitioner should provide aesthetic medical services in a healthcare facility licensed or registered under the Private  Healthcare  Facilities  and  Services  Act  1998  and  Private  Healthcare Facilities and Services (Private Hospitals and Other Private Healthcare Facilities, Private Medical Clinics or Private Dental Clinics) Regulations 2006.
In addition, medical practitioner is required to have a Letter of Credentialing and Privileging (LCP) for the aesthetic procedure(s) which he/she intends to perform. The LCP shall be issued  by  the  Medical  Practice  Division,  Ministry  of  Health  Malaysia  upon recommendation by the Main Credentialing and Privileging Committee of Aesthetic Medical Practice.

 

COMPLAINTS

Members of the public may lodge complaints on aesthetic medical procedures carried out by a registered medical practitioner.

Malaysian Medical Council or other relevant units in the Ministry of Health Malaysia(MOH) may conduct an inquiry. The Council or MOH after due inquiry, may  recommend  to  the  Main  Credentialing  and  Privileging  Committee  of Aesthetic  Medical  Practice  for  review  of  the  Letter  of  Credentialing  and Privileging, and possible removal from the National Registry of Registered Medical Practitioners Practising Aesthetic Medical Practice.

 

Source: Guidelines on Aesthetic Medical Practice for Registered Medical Practitioners, Ministry of Health Malaysia

 

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