Gravity of the non-authorized use of substances not intended for clinical use in invasive aesthetic procedures: the portuguese case

Rev Assoc Med Bras (1992). 2019 Mar;65(3):410-418. doi: 10.1590/1806-9282.65.3.410. Epub 2019 Apr 11.


Introduction: There is a worldwide increase in the number of invasive aesthetic procedures, and there is a general apprehension in medical societies towards the assurance of patient safety, that is dependent on the quality and certification of providers, of the materials and substances used, and where they take place.It is the main objective of this study to determine the perception of the gravity of non-authorized substances for clinical use in invasive aesthetic procedures among Portuguese plastic surgeons and its variation by the clinical sector of practice.

Methods: We proceeded to an inquiry by using a questionnaire, measured in a Linkert scale, and the collected data were statistically treated with a non-parametric Kruskal-Wallis test.

Results: We obtained a 41,4% answer rate and a global perception that this is a serious problem - a median of 8,00 and mean of 7,45 points on a 1 to 10 scale. 70% of the plastic surgeons that answered the questionnaire work both in the private and public sector, 19% exclusively in the public sector and 11% only in private practice. The perception of the problem was most serious among those that work exclusively in the private sector (statistically significant difference).

Conclusion: The causes of the observed difference may reside in various reasons: the higher number of patients submitted to invasive aesthetic procedures exclusively in private practice; the higher perception of regulatory deficits in the private sector; scarce specific health politics for procedures outside the traditional boundaries of medicine; the difficulty for independent regulatory agencies to adopt effective measures.

MeSH terms

  • Government Regulation
  • Humans
  • Medical Device Legislation
  • Plastic Surgery Procedures / adverse effects*
  • Plastic Surgery Procedures / instrumentation
  • Plastic Surgery Procedures / statistics & numerical data
  • Portugal
  • Practice Patterns, Physicians' / legislation & jurisprudence
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Private Sector / statistics & numerical data
  • Public Sector / statistics & numerical data
  • Statistics, Nonparametric
  • Substandard Drugs / adverse effects*
  • Surgeons / statistics & numerical data*
  • Surgery, Plastic / adverse effects
  • Surgery, Plastic / statistics & numerical data
  • Surveys and Questionnaires


  • Substandard Drugs