Beyond the Licence: Exemplary Damages for Aesthetic Work Outside a Doctor’s LCP

On 15 November 2024 the High Court in Kuala Lumpur ordered a general practitioner in aesthetic practice to pay exemplary damages, after finding that the doctor had performed nose-implant procedures outside the scope of the doctor’s aesthetic credentialing. The decision, Adam bin Hamil v Dr Chiam Tee Kiang [2024] MLJU 3311; [2025] 2 MLRH 1 (Roz Mawar Rozain J), carries a plain message for aesthetic practice: a patient’s wishes do not widen what a practitioner is permitted to do.

How aesthetic practice is credentialed

Registered medical practitioners who offer aesthetic procedures work under the Ministry of Health’s Guidelines on Aesthetic Medical Practice for Registered Medical Practitioners. The Guidelines have three chapters: Chapter 1 for general practitioners, Chapter 2 for medical specialists and Chapter 3 for surgical specialists. A practitioner who is credentialed receives a Letter of Credentialing and Privileging (LCP) from the Ministry’s Medical Practice Division and is entered in a national registry of practitioners in aesthetic medical practice.

One point of precision matters. On the sources reviewed, the LCP comes from the Ministry’s Guidelines, an administrative credentialing scheme, and not from the Private Healthcare Facilities and Services Act 1998 itself. That Act deals with a different matter: the registration and licensing of the premises where care is given.

A nose implant, two procedures and corrective surgery

The plaintiff went to an aesthetic clinic about an existing nose implant. The defendant, a general practitioner holding a Chapter 1 LCP, recommended removing the implant because of the risk of extrusion and infection. The plaintiff declined and wanted the implant kept. In May 2021 the defendant instead trimmed the implant and grafted cartilage taken from the ear. When swelling and infection persisted, a second trimming procedure followed in July 2021. The plaintiff then went elsewhere and had corrective surgery in December 2021, followed by reconstructive and laser treatment.

Qualification, breach and causation

The court had to decide whether the defendant was qualified under Chapter 1 of the Guidelines to perform these procedures, whether there was a breach of duty, and whether the procedures caused the harm.

The ruling: consent cannot enlarge a doctor’s permitted scope

The claim was allowed in part. The court held that a Chapter 1 LCP permits only basic aesthetic procedures, and that implant trimming with ear-cartilage grafting was outside it.

Three points stand out. First, a doctor who holds out as qualified to carry out nose-implant procedures is judged by the standard of a cosmetic surgical specialist, and performing procedures beyond one’s qualification was treated as a fundamental breach. Second, the defendant did not tell the patient about the limits of the credentialing held, which undermined the patient’s informed choice; the court applied Foo Fio Na v Dr Soo Fook Mun & Anor [2007] 1 MLJ 593 and Rogers v Whitaker (1992) 175 CLR 479 on the duty to disclose. Third, a patient’s consent, and even a patient’s insistence, cannot authorise a doctor to act beyond the licensed scope. The procedures were found to have aggravated the plaintiff’s condition, so causation was established.

To mark its disapproval the court awarded RM100,000 in exemplary damages, which punish and deter instead of compensating. General damages were RM150,000. With special damages and future medical costs, the award was reported as about RM340,000; published summaries differ on the overall figure, apparently depending on whether costs are included. The sources reviewed do not record any appeal outcome as at 19 September 2026.

Analysis: the deterrent message grows louder

On 30 July 2025 Malay Mail reported a Sessions Court decision in Kuala Lumpur, with the parties not named, arising from breast-filler injections given in 2020 at an unlicensed centre in Petaling Jaya by a doctor who had no LCP. The filler had been represented as pure hyaluronic acid but was laboratory-tested as mainly silicone, and the patient needed three later operations. The court was reported to have awarded RM800,000 in exemplary damages and RM85,000 in general damages, plus special damages and costs. According to the report, the judge considered that the RM100,000 awarded by the High Court in November 2024 had not been enough of a deterrent, held that consent obtained without disclosing a lack of qualification is invalid, and found the centre’s owner and company liable together with the doctor. Whether that decision has been appealed is not known.

Nor is the duty of care confined to doctors. Commentary by Kevin Wu & Associates (Mondaq, 13 March 2023) discusses Teng Ngit Yoong v Liew Nyok Fen, a 2020 decision in which a beautician who performed a chemical peel was held to owe the customer a duty of care.

Reported incidents form part of the backdrop. In October 2020 The Star reported the death of a 23-year-old woman during a liposuction procedure at a beauty salon in Cheras that reportedly had no licence for medical procedures; the owners were detained and later released on police bail. The sources reviewed record no charge, conviction or civil judgment arising from that incident. On 9 August 2023 CodeBlue reported the Malaysian Medical Association’s call for tighter enforcement in the beauty and aesthetics industry.

Practical takeaways for patients, practitioners and clinic owners

• Patients: before any aesthetic procedure, check the national registry and ask which chapter the practitioner’s LCP falls under. A general practitioner with an LCP is not a plastic surgeon, and a beauty salon is no place for medical procedures.

• Aesthetic practitioners: know the limits of your chapter and decline or refer work that falls outside it. A patient’s insistence is no defence.

• Doctors generally: tell patients what your credentialing does and does not cover. Non-disclosure can invalidate consent.

• Indemnity: cover may not respond to work outside scope or to exemplary damages. Check the policy wording.

• Clinic owners and hospitals: verify each practitioner’s LCP against the procedures offered, and keep the premises properly registered or licensed. In the 2025 case the owner and company were reportedly held liable with the doctor.

Authorities and sources

• Adam bin Hamil v Dr Chiam Tee Kiang [2024] MLJU 3311; [2025] 2 MLRH 1 (High Court, Kuala Lumpur, 15 November 2024)

• Foo Fio Na v Dr Soo Fook Mun & Anor [2007] 1 MLJ 593 (FC); Rogers v Whitaker (1992) 175 CLR 479

• Teng Ngit Yoong v Liew Nyok Fen (2020), as discussed by Kevin Wu & Associates, Mondaq, 13 March 2023

• Ministry of Health, Guidelines on Aesthetic Medical Practice for Registered Medical Practitioners; Private Healthcare Facilities and Services Act 1998

• Malay Mail, 30 July 2025; The Star, 19 and 22 October 2020; CodeBlue, 9 August 2023

• eLaw headnote; published law-firm commentary by Mah Weng Kwai and RDS

This article is general legal information only and is current as at 19 September 2026. It is not legal advice and does not create a solicitor-client relationship. Court decisions may be appealed and the law may change; please seek advice on your own circumstances. — Chris & Partners, Advocates & Solicitors