EWJ June 61 2025 web - Flipbook - Page 91
expectations, body dysmorphic disorder (BDD), or
seeking to 'fix' deeper emotional issues may not be
suitable candidates for cosmetic procedures. Thus,
Aesthetic Practitioners have a duty to identify red flags
and refer on when appropriate. Administering treatment to a psychologically vulnerable individual without assessing their suitability may amount to a breach
of duty if harm ensues.
importance of detailed consent and professional
standards.
The Role of the Expert Witness:
In aesthetic litigation, the expert witness has a crucial
role in assessing whether the standard of care met
legal and clinical expectations.
This includes:
▪ Evaluating the consent process and treatment
rationale
The Joint Council for Cosmetic Practitioners (JCCP)
and General Medical Council (GMC) both advise that
practitioners should be trained to screen for mental
health conditions and know when to decline treatment (JCCP, 2021; GMC, 2016).
▪ Reviewing treatment records, photographs, and
training evidence
▪ Offering impartial, experience-based opinion on
causation and breach
Medico-Legal Case Examples:
Case One: Lip Filler Vascular Occlusion
A 32-year-old woman attended a high-street clinic for
lip augmentation. Within hours, she developed greyish discolouration and intense pain around the injection site. She contacted the clinic but was advised to
monitor the area at home. By the time she was reviewed, necrosis had set in, requiring urgent hospital
referral.
▪ Assisting the court in understanding technical
clinical issues
Expert opinion must be independent, based on
current guidance, and within the individual's area of
expertise. For instance, an aesthetic nurse with years
of hands-on experience in administering dermal fillers
would be well-placed to assess a filler-related injury
claim.
Expert opinion concluded that the practitioner failed
to recognise a vascular occlusion and delayed appropriate treatment with hyaluronidase. The case settled
in favour of the claimant.
A Call for Reform The UK Government has
recognised the need for tighter regulation. The
Health and Care Act 2022 included provisions for a
licensing regime for aesthetic practitioners and
premises in England. Although this is a step forward,
implementation has been slow, and there is an
ongoing need for:
▪ Clear definitions of high-risk procedures
Case Two: Laser Burn and Pigmentation
A client of South Asian heritage (Fitzpatrick Skin type
IV) underwent laser hair removal at a beauty salon.
No patch test was carried out, and incorrect wavelength settings were used. The Claimant sustained superficial burns and developed post-inflammatory
hyperpigmentation. The clinic had no medical oversight, and the practitioner lacked formal training.
▪ National training and accreditation standards
▪ A public register of approved practitioners
▪ Consistent enforcement mechanisms
Until such reforms are enacted, personal injury claims
will continue to highlight the dangers of a fragmented
system. In the meantime, robust training, consent,
and documentation remain the most effective risk
mitigation tools for practitioners.
A claim for personal injury was successful on the
grounds of inadequate assessment, lack of informed
consent, and breach of duty.
Judicial Commentary and Legal Precedents:
Several landmark cases continue to inform how courts
approach personal injury in cosmetic practice:
Conclusion:
Personal injury in aesthetic medicine is a growing area
of concern, particularly within non-surgical practice.
These procedures, though widely perceived as minor,
carry real risks. Where harm results from inadequate
care, the legal consequences can be severe—for both
patient and practitioner.
In Montgomery v Lanarkshire Health Board [2015] UKSC
11, the Court held:
"The doctor is under a duty to take reasonable care to ensure that the
patient is aware of any material risks involved in any recommended
treatment."
In Bolam v Friern Hospital Management Committee [1957]
1 WLR 582, the principle was established:
"A man is not negligent, if he is acting in accordance with
such a practice, merely because there is a body of opinion who
would take a contrary view."
Practitioners must adhere to best practice standards,
respect the principles of informed consent, and exercise sound clinical judgement. For legal professionals
handling aesthetic injury claims, expert witnesses remain a vital asset in helping courts understand
whether a duty was breached, and if so, whether that
breach led to avoidable harm.
In Chester v Afshar [2004] UKHL 41, the House of
Lords stated:
"The law imposes a duty on a medical practitioner to warn a
patient of a small but well-established risk of serious injury inherent in the proposed treatment."
Only through greater professional accountability, regulatory reform, and patient-centred care can the aesthetic sector truly balance innovation with safety.
These principles provide the legal framework within
which aesthetic claims are assessed and reinforce the
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