Complications stemming from aesthetic procedures conducted by non-medical practitioners are on the rise, posing significant concerns regarding patient safety. This paper presents a case series documenting four instances of complications following plasma jet treatment administered by non-medical professionals in Uberlandia, Brazil. The observed complications included keloids, ectropion, and persistent erythema among the patients. The primary objective of this report is to underscore the ethical and legal dimensions surrounding aesthetic medicine and the subsequent legal implications associated with managing such complications.

Introduction

The escalating incidence of complications resulting from aesthetic procedures performed by non-medical practitioners underscores the need for heightened awareness among patients regarding associated risks. This case series from Uberlandia, Brazil, aims to shed light on these occurrences and provide guidance to medical professionals regarding appropriate management strategies. Emphasizing the importance of patient education and advocating for stringent regulations to safeguard the safety and efficacy of aesthetic interventions are key objectives of this study.

Materials and Methods

Case 1: A 44-year-old female patient with Fitzpatrick skin type IV sought medical consultation nineteen days after undergoing plasma jet treatment at a non-medical facility. Dermatological examination revealed thinning of the lower eyelids, persistent erythema, bilateral eyelid retraction, hypertrophic scarring, mild cicatricial ectropion, and inferior punctate keratopathy. Subsequently, three additional cases with similar complications were reported in 2023, with one case presenting permanent ectropion.

Methods

Case 1 was managed proactively by a multidisciplinary team, comprising hyperbaric therapy, ophthalmological evaluation, and plastic surgery assessment, opting for conservative treatment modalities. Legal proceedings were initiated by the patient against the aesthetic team, and interventions such as radiofrequency therapy were employed to facilitate healing. Case 2, presenting with keloid lesions, received treatment involving radiofrequency therapy, Nd:YAG laser, and botulinum toxin injections. Cases 3 and 4, presenting with permanent deformities, only attended one initial consultation to receive a medical report.

Results

The inadequate follow-up of these patients not only compromises optimal aesthetic results but also creates significant challenges for physicians. Furthermore, legal obstacles impede physicians from performing minimally invasive procedures to address permanent deformities. Moreover, patients continue to seek swift and comprehensive resolution for errors committed by other professionals, exacerbating the complexity of the physician-patient relationship. This underscores the pressing need for enhanced collaboration between medical practitioners and regulatory authorities to ensure patient safety and ethical practice in aesthetic medicine.

Conclusion

Legal medicine assumes a critical role in addressing permanent deformities arising from aesthetic procedures, necessitating careful consideration of ethical, legal, and clinical ramifications by dermatologists. While managing complications from non-medical practitioners carries inherent legal and ethical risks, safe and conservative treatment options, including laser therapy and botulinum toxin injections administered by qualified medical professionals, remain pivotal. Prioritizing patient safety and well-being amidst these intricate scenarios is imperative.