Impact of Unlawful Aesthetic Practices in Brazil: A Multicenter Survey on Complications and the Need for Regulatory Reform.

[BACKGROUND] The illegal practice of medicine in aesthetic procedures poses significant public health risks because of complications from unqualified individuals. Invasive treatments such as botulinum toxin and fillers are frequently performed by nonmedical professionals without proper medical training, resulting in infections, necrosis, and lasting sequelae.

[OBJECTIVE] This study aimed to analyze the complications from nonphysicians encountered by Brazilian specialists (dermatologists, plastic surgeons, and other specialists) in their clinical practice.

[MATERIALS AND METHODS] A multicenter survey involving 1,058 physicians (primarily dermatologists and plastic surgeons) across Brazil assessed complications from aesthetic procedures performed by nonmedical individuals. Descriptive statistics categorized complications by type and severity, identified responsible practitioners, and estimated the health care and economic burdens.

[RESULTS] Over half of the respondents treat more than 100 patients monthly, and 12.69% of patients had undergone procedures by nonmedical professionals. On average, five complications were treated monthly per physician; 17% led to permanent sequelae. Common issues included scarring (78.68%), inflammation (72.15%), and infection (65.43%). Most cases required up to 3 specialists and 7 to 8 consultations per year, often involving multiple surgeries.

[CONCLUSION] These findings underscore the urgent need for regulatory enforcement, public education, and legal protection. Brazil's experience may inform other countries confronting similar issues related to the unauthorized practice of aesthetic medicine.