As cosmetic procedures surge in popularity, experts warn that “Instagram beauty” is driving a rise in botched results and serious complications across South Africa.
From injectable fillers to surgical enhancements, the demand for aesthetic procedures continues to grow, but so too are reports of things going wrong, often linked to unqualified practitioners and unrealistic expectations shaped by social media.
According to Dr Nombulelo Metuse, a Plastic and Reconstructive Surgeon at Mediclinic Muelmed, the core problem is not cosmetic medicine itself, but rather who is performing it and how informed patients are when making decisions.
“One of the single biggest risks right now is the use of unqualified practitioners,” she said.
“In South Africa, anyone can market themselves as a ‘cosmetic doctor’, but we’re seeing how a lack of anatomical knowledge and poor sterile techniques can result in serious complications requiring complex revision.”
Metuse says social media has amplified the pressure on appearance, while also distorting what is realistically achievable.
“Patients today are more aware and often more critical of their appearance because of selfies, video calls and filters,” she explained.
“Surgery, however, cannot replicate FaceApp or Instagram filters. Yet we continue to see influencers promoting clinics and practitioners without verifying credentials, often using edited ‘before and after’ images.”
She adds that confusion around professional titles is worsening the problem, leaving patients unsure of who is actually qualified to perform procedures.
“There is a lack of understanding around who is actually qualified to perform different cosmetic procedures,” said Metuse.
For non-surgical treatments such as Botox and fillers, she advises patients to seek properly trained medical professionals. “A GP may be acceptable if they have properly accredited aesthetic training, but be cautious of practitioners trained through short or ‘weekend’ courses.”
“Only a specialist plastic and reconstructive surgeon registered with both the Health Professions Council of South Africa (HPCSA) and the Association of Plastic, Reconstructive & Aesthetic Surgeons of Southern Africa (APRASSA) can perform these surgical procedures. This is non-negotiable.”
Metuse also warns that complications from poorly performed procedures are not uncommon, and in some cases, irreversible.
“These are not rare scenarios,” she said.
“They are complications we see regularly in clinical practice, often linked to poor practitioner selection, inappropriate treatment choices, or excessive intervention.”
She lists distorted facial proportions from overfilling, asymmetry from poorly performed liposuction or Brazilian Butt Lifts, and implant complications in breast surgery among the most common issues. In severe cases, she says, patients have suffered fat embolism or permanent disfigurement.
Another growing concern is the use of unregulated or counterfeit products.
“Counterfeit Botox and fillers pose significant risks. In some cases, complications have included tissue necrosis, long-term granulomas and permanent disfigurement,” she warned.
“If a product is not approved by the South African Health Products Regulatory Authority (SAHPRA), it should not be used.”
Metuse is urging patients to take greater responsibility before undergoing any cosmetic procedure, starting with verifying credentials.
“Patients should check registration with the HPCSA and membership with APRASSA, and ask about training and experience,” she said.
“And finally, insist on a proper consultation that includes a full medical history and risk discussion.”
She also flagged pricing and rushed consultations as major warning signs.
“If a practitioner does a same-day consultation with a procedure push, that’s a red flag. And if prices seem too good to be true, they probably are. If your provider disappears after the procedure, that’s a serious warning sign.”
While cosmetic treatments can deliver positive results when done correctly, Metuse says the risks are often underestimated.
“Cosmetic procedures, even ‘lunchtime treatments’ are still medical procedures and carry risks. When done correctly, cosmetic work can be safe and rewarding. But if done poorly, it can have serious consequences.”
Saturday Star