We live in times where everything is personalised – from designer shoes and diet plans to sculpted facial features and body types. Social media’s before-after beauty comparisons, disposable income, celebrities endorsing surgical beauty treatments, and unabashed advertising have made these procedures seem affordable and desirable. A person’s choice to alter her features is not questionable per se – aesthetic procedures are at times even a necessity, as in acid attack or burn cases where survivors require facial remodeling. What is alarming is when aesthetic treatments where the main aim is beautifying one’s features only, are performed by untrained professionals in dangerous environments. From hair transplants having turned fatal to chemical peels burning skin to fat reduction treatments gone wrong, the list of life-threatening outcomes is long.
In this article, we analyse aesthetic procedure market in India, identifying where such procedures go wrong, the role of authorities, and the judicial attitude towards medical negligence in such scenarios.
Aesthetic Procedures – What does it mean and where do we go wrong?
Aesthetic procedures – laser and skin treatments, rhinoplasty, botox, liposuction, tummy tucks, etc., are usually voluntary in nature aiming at achieving the ideal look. Being ‘aesthetic’ and ‘voluntary’ might give the impression that they are not medical in nature. They very much are. Aesthetic procedures must be undertaken by a trained, specialised doctor in a properly registered clinical establishment.
Doctors to not switch lanes
Unregistered establishments and undertrained practitioners performing aesthetic procedures pose a growing concern. Dentists and MBBS doctors completing weekend certification courses are offering botox, laser treatments, and hair transplants beyond their scope of practice – a trend the Karnataka State Dental Council formally rebuked, citing false social media claims and unauthorised facial aesthetic and hair transplant procedures by dentists. AYUSH doctors administering unpermitted allopathic treatments, and salons offering procedures through entirely unqualified staff, compound the problem further.
Rampant advertising – Ethics for a toss
Aggressive advertising on social media, through influencer collaborations often makes unverified or exaggerated claims about outcomes, safety, and qualifications. Even when NMC’s Code of Medical Ethics prohibits doctors from advertising their services, practitioners freely advertise on social-media platforms, often without disclosing material risks and limitations. Such advertising creates a false sense of safety in the mind of the consumer, retarding informed decision-making on the part of the patient.
Only specialised doctors, Only registered Clinical Establishments
The NMC mandates that aesthetic procedures be performed only by qualified and specialised RMPs. The Tamil Nadu Medical Council similarly limits aesthetic procedures to qualified and registered RMPs, performed exclusively in licensed establishments. Clinical establishments are further required to register under the Clinical Establishments (Registration and Regulation) Act, 2010, though adoption remains uneven — 19 States/UTs have adopted it, while major urban centers like Delhi have not, leaving a significant regulatory gap. It is unethical for RMPs to train individuals to perform/assist such surgeries. Nurses, technicians, assistants should be trained by RMP and should work under her supervision.
What happens in the courtroom – Assessment of negligence
Courts apply general medical negligence standard to aesthetic procedures. Key factors include informed consent, duty of care, proper qualifications, and documentation. Negligence has been established in cases involving absent pre-procedure tests, unqualified practitioners, misrepresentation of credentials, and deviation from standard practice. In Azhar Rasheed case a patient’s death following a salon hair transplant by unqualified technicians was characterised as gross negligence. In Kailash Rajpurohit case, the doctor was held liable for failing to conduct allergy tests and lacking adequate qualifications. Courts consistently rely on documented lapses to establish negligence but tend to moderate compensation awards, reflecting a cautious approach against speculative damages. Criminal liability requires gross negligence, and a medical board opinion is a prerequisite for criminal prosecution of a doctor.
Courts have been clear that not all failed procedures indicate negligence – deterioration after surgery does not automatically imply negligence. Doctors are not assessed on a “best-care” standard, rather the standard is that of a reasonable professional.
Hospitals and clinics could be vicariously liable
Hospitals and clinics have also been held vicariously liable where unqualified staff performed procedures, misleading claims were made, or negligent practitioners were engaged. Courts have emphasised that both doctors and hospitals are obligated to ensure proactive verification of patient history and proper procedure documentation.
Conclusion
The rapid growth of aesthetic procedures has created a landscape where untrained practitioners, unregistered establishments, and misleading advertising pose serious risks to patient safety. The quick adaptation of new technology in providing such treatments adds another grey zone: when a technology is accepted in medicine but used by only a handful of practitioners in India, how does a medical board assess negligence without a substantial history of its usage?
A basic three-pronged imperative is required: stricter enforcement of who can perform aesthetic procedures and where; greater accountability in advertising and disclosure of risks; and improved patient awareness so that individuals can make genuinely informed choices before going under the knife.
References:
(1): 1736344547.pdf
(2): Other than Oral and Maxillofacial Surgeons
(3): https://www.nmc.org.in/MCIRest/open/getDocument?path=/Documents/Public/Portal/LatestNews/20220927051220.pdf
(4): TNMC/P. No: 1 / 2026; Dated:13.02.2026
(5): https://www.nmc.org.in/MCIRest/open/getDocument?path=/Documents/Public/Portal/LatestNews/20220927051220.pdf
(6): Azhar Rasheed case v. State NCT of Delhi, 2022
(7): Kailash Rajpurohit v. Enhance Aesthetic and Cosmetic Studio Pvt Ltd
(8): Sameera Khan v. Dr. D.M. Mahajan FA/652/2013 (Oct 27, 2021)