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Chinese national Jie Shao, 33, was charged on Thursday with causing reckless grievous bodily harm and using poison to endanger the life of beauty clinic owner Jean Huang who suffered a cardiac arrest during a medical procedure at the Medi Beauty Laser and Contour Clinic near Sydney's Central on Wednesday, and was formally refused bail.
Court documents allege Shao, who claims to be a graduate of a Canton Medical University and a specialist in dermatology who had practised in China and Great Britain, administered "an intoxicating substance, tramadol and lida caine (sic)," to Ms Huang, who reportedly owns the clinic.
Shao had arrived in Australia on a tourist visa, which expires in November, and was due to return to China on Thursday.
Chinese Australian Cosmetic industry professionals Y* and V* (who prefer to remain anonymous as they are concerned they might be recognised by other business owners in the industry) tell SBS Mandarin from what they know, very few Chinese practitioners are licensed.
They also comment that in this increasingly competitive industry, performing cosmetic procedures such as injections underground, "is becoming chaotic and out of control."
They also say that that flying overseas Chinese practitioners, who may not be licensed or registered in Australia, to perform certain procedures here is also a common practise by many local beauty salons.
"For procedures like liposuction, it is quite scary if you think about it," cosmetic clinic owner and manager Y told SBS Mandarin. "Those procedures have to be practised by licensed Australian medical professionals - by a proper doctor."
Y said some Chinese-owned beauty salons in Sydney would hire a local doctor to perform plastic surgery procedures for their customers, but those external doctors would cost more, "that's why some others will hire a visiting ‘doctor’ from China or wherever, claiming the 'doctor' are experts."
"Those procedures have to be practised by licensed Australian medical professionals - by a proper doctor."
"Most Australian beauty clinics don't dare to do this, but some Chinese-run clinics will risk it as they only want to make money," says Y. "It's getting worse."
"Many of those who used to practise underground in their own residence now open a proper shop and claim they are a beauty salon.
"But in fact, besides facials, they provide injections; or they fly in someone from China. I don’t think real experts would do it, as they would consider the consequences of practising this way.
"In Australia, only registered doctors are able to buy supplies from a proper source.
"Without this license, people may buy from overseas.
"As I always said to my customer, how can you know they are use good materials... It's much cheaper and easier to buy from China."
As the Sydney Morning Herald reported last year, backyard procedures are becoming increasingly common. The Australian Society of Plastic Surgeons (ASPS) has also issued a public warning and reported a rise in the number of complaints about cosmetic procedures being performed in residential properties by practitioners who are unqualified or unregistered in Australia.
Talking about the latest incident, Y says she thinks many people are risking their lives, "Many people think it only takes a few courses, then you can inject. It takes more than that."
"Also a proper doctor would know how to handle an emergency. I think many are not that responsible with their own life."
Language could be a barrier for many Chinese customers too, says Y. "That’s why they prefer Chinese-speaking practitioners, who presumably understand what they want, for procedures like double eyelid and breast surgery.”
She said, because it may take one to a few weeks to recover after certain surgical procedures, many local Chinese Australians including students prefer to have it done locally, rather than overseas, but the risk if the procedure is performed by an overseas, unlicensed/unregistered practitioner, could be there is no follow up/check up or the patient may not be insured for the procedure.
"Those doctors will fly in and leave," says Y. "They won't care anything afterward."
"They prefer Chinese-speaking practitioners, who presumably understand what they want, for procedures like double eyelid and breast surgery.”
V, a former fully trained beauty therapist told SBS Mandarin that she had left the industry after "seeing too many shocking facts."
"I've visited many local clinics, and from a professional point of view, I think most of their practitioners have not been professionally trained, not even for waxing and skin care."
She added that many are only trained briefly, which poses a higher risk for customers.
According to V, a beauty therapist requires at least 18 months to two years of study and training where "you got to know every each muscle and bone exactly."
"I bet less than one per cent of those practitioners in those so-called beauty medical clinics have those knowledge."
Discussing practitioners from China, V alleges that it’s even worse there, "you probably only need one to two weeks."
"That's why there are so many accidents these years."
She says the industry is so lucrative that her commission was once nearly 10 times that of her salary.
"I am out of this industry [now]," she tells SBS Mandarin. "I had to lie to my clients [until] I cannot take it anymore."
She adds that most of the time, what these clinics promise differs vastly from what they can actually deliver to the clients.
In the latest medical incident, the Medi Beauty Laser and Contour Clinic claims on the company website that they provide state-of-the-art beauty services based on the latest medical technologies.
"All treatment facilities, materials, resources and products meet the stringent requirements of the Therapeutic Goods Administration and Medicines Australia," it states.
"Don't judge a book by it's cover" when it comes to your healthcare
Y, who has been in the industry for years, says that it is "a severe trend at present,” that people would assume a nicely presented, sleek-looking beauty salon like Medi Beauty must be a decent and legitimate business, which, in fact they may not be.
“Some cautious customers may ask about qualifications and license," says Y. "But most of them won't, as they could be referred by their friends, seeing advertisements, or simply assuming, 'you got such a big shop - you must be proper business.'"
In the latest breast procedure case, the Chinese tourist with no Australian medical license is now facing 20 years jail, as Magistrate Sharon Freund said the prosecution case was strong and the maximum penalty for each of the offences was 10 years in custody. Now that the patient has died, it is likely that the charges will be upgraded further.
But Y refers to another cosmetic surgery case by a "fake doctor" last year, suggesting that NSW Health's regulations in regard to this industry are not stringent enough.
"NSW HCCC [Health Care Complaints Commission] can only deregister professionals," she says. "But if you are nobody [unlicensed], they are not capable to charge you."
"They can only ban you – such a ban is ridiculous when you were not supposed to practice in the first place.”
The NSW Government last year introduced a new class of cosmetic surgery under the Private Health Facilities Act, meaning that any facility that carries out surgical procedures "other than dental" that are intended to change a person's appearance and which involve general, epidural, spinal or major regional anaesthetic or unconscious sedation.
They issued a statement last year warning people about cosmetic surgical and medical procedures performed by non-registered health practitioners.
Y says she also wants tougher regulations on cosmetic surgery advertisements, particularly on Chinese language social media platform WeChat where, she says, "customers would think those big advertiser are decent businesses."
She also calls for tougher government regulation of the cosmetic surgery industry, "We think the government needs to take more care, because customers don't know how to identify. [They think] 'How can I go to a big shop but meet a fake doctor?'"
Around one in 10 Australians has had plastic surgery over the past three years or is intending to do so within the next three years. The Australian Society of Plastic Surgeons (ASPS), the peak body for Specialist Plastic Surgeons both reconstructive and cosmetic, reminds Australians who are looking for a fully trained and qualified plastic to visit their website for a credible and accurate resource
Below is a checklist published by the ASPS to help ensure you have the plastic surgeon that is right for you. More information here.