Laws & Looks

MS Bharath and Reshma Rajagopal emphasise the need for ethical considerations and legal regulations in the aesthetic medicine industry, and the importance of thorough research, proper training, and adherence to safety standards when choosing an aesthetic medicine practitioner.

Sushruta, the ancient Indian physician is widely regarded as the father of plastic surgery in India. In his book ‘Sushruta Samhita’, which was the ground norm in India for surgeons several years thereafter, Sushruta describes the process of rhinoplasty (reshaping of the nose). So, the practice and procedure surrounding aesthetic medicine cannot be something that is perceived to be a recent advancement.

Perhaps the recent surge in the aesthetic medicine industry can be attributed to the social media influencers and platforms that have been a driving factor in instilling their perception of beauty in society. The rapid growth in aesthetic and plastic surgeries over the last decade has posed a plethora of questions on the ethical concerns and legalities involved.

STATISTICS

As per the International Society of Aesthetic Plastic Surgery (ISAPS), India ranks at the top of most lists of countries opting for aesthetic procedures. From an ethical perspective, one could argue that the increase in such a percentage would promote an unrealistic standard of self-beauty and appreciation. The fact, however, remains that there is a drastic surge in the number of people opting for such procedures in India.

While the proportion of people signing up for the procedures is relatively high, it would be an ideal time to consider the adequacy of the laws and regulations surrounding aesthetic and cosmetic surgery.

The legal mechanisms for aesthetic practice and procedures are regulated by the National Medical Council (NMC), the Indian

Association of Aesthetic Plastic Surgeons (IAAPS), and the Indian Association of Dermatologists, Venereologists and Leprologists (IADVL). These organisations set guidelines and regulations to ensure that plastic surgery procedures are performed safely and ethically.

NATIONAL MEDICAL COUNCIL

The NMC is responsible for establishing guidelines for medical education and practice in India. In September 2022, the NMC issued the much-needed advisory and guidelines on aesthetic surgery and hair transplant procedures.

1. Aesthetic procedures including hair transplants should be carried out only by properly trained and licensed registered medical practitioners.

2. It is unethical for a medical practitioner to train an individual, who is not an accredited professional, to perform or assist in surgery.

3. As aesthetic procedures are not emergency surgeries, there is no reason to allow any untrained person to perform these under the pretext of ‘exceptional circumstances’.

4. Persons should have adequate infrastructure and manpower to carry out such procedures.

5. Assistants or technicians should be from a medical background, such as nurses.

In the same advisory, the NMC also notified the guidelines for a competency-based postgraduate training programme for M.Ch in plastic and reconstructive surgery to offer a structured programme for comprehensive training.

INDIAN ASSOCIATION OF AESTHETIC PLASTIC SURGEONS

The IAAPS is a self-regulating professional association for plastic surgeons in India. It sets ethical standards for the practice of plastic surgery and promotes professional development among its members. The organisation also maintains a code of conduct for its members and investigates any complaints of malpractice or unethical behaviour.

INDIAN ASSOCIATION OF DERMATOLOGISTS, VENEREOLOGISTS AND LEPROLOGISTS

The IADVL was established in its present form on January 28, 1973. The organisation hosts several conferences, seminars, and workshops throughout the year to provide continuing medical education to its members.

In addition to the regulatory bodies, the Indian government has also implemented laws to regulate the practice of plastic surgery. The Clinical Establishments (Registration and Regulation) Act, 2010, requires all medical establishments, including plastic surgery clinics and hospitals, to register with the government and adhere to certain safety and quality standards. The government also requires all medical establishments to maintain records of all procedures and treatments performed on patients.

LEGAL ISSUES

Despite these regulations, there have been certain cases of malpractice and unethical behaviour in the aesthetic medicine industry. For instance, recent years have recorded several highprofile cases of aesthetic surgery gone wrong. If a surgeon fails to meet the standard of care in performing an aesthetic procedure and the patient suffers harm as a result, the surgeon may be held liable for medical malpractice.

The Consumer Protection Act of 1986 and the Indian Penal Code provide legal remedies for patients who have suffered harm because of medical negligence or malpractice. After the decision of the Supreme Court in 1995 in Indian Medical Association vs. VP Shantha, the medical profession has been brought under the purview of Consumer Protection Act, 1986 vide Section 2(1)(o), 1986. The patients can also file a complaint before the medical council on the alleged malpractices.

While there are provisions and procedures to address malpractice and to seek remedies after such incidents, it is time to consider if appropriate and specialised licenses and regulations have to be brought in, considering the nature and seriousness of the procedures.

As such, it is important for patients to thoroughly research their dermatologist and/or plastic surgeon and ensure that they are properly trained, licensed, and experienced before undergoing non-invasive or invasive procedures. Patients should also ensure that the facility where the procedure is being performed is properly registered and adheres to safety and quality standards.

It is imperative that there is a complete disclosure of the process, procedure, side effects, and risks associated with the procedure to the patient and that there is written informed consent from the patients. Such practices would not only encourage and ensure a safe procedure but failure to do so may result in unwarranted legal action against the doctor.

Overall, it is important for patients to carefully research their options and choose a qualified and experienced aesthetic medicine practitioner who practices ethical and safe procedures. Patients should also be aware of their legal rights and options in case of medical malpractice or other legal issues.

About the author:

MS Bharath founded KRIA Law in March 2021 after 20 years of practice and 12 years of leading a regional office as a senior partner of a large Indian IP firm. In 2020, the Indian National Bar Association (INBA) nominated him as the IPR Lawyer of the Year. He currently serves as an officer on several international IP organisations such as member of India Global Advisory Council of International Trademarks Association (INTA) since 2015, Councillor of Asian Patent Attorneys Association (APAA), and Current President of IP Association of South India.

About the author:

Reshma Rajagopal has rich experience in IP prosecution and litigation. She has been managing portfolios of clients with several hundreds of proceedings before various courts, tribunals, and forums including the Madras High Court; city civil courts in Chennai; DRT, Chennai; consumer forums Chennai; Trademark Office, Chennai, and the erstwhile IPAB, Chennai. She commenced her practice in a national IP firm prior to joining KRIA Law ,and currently is a member of International Trademark Association’s (INTA’s) Indigenous Rights Committee.