Counterfeit dermal fillers pose a real danger to unsuspecting Malaysians trying to enhance their looks.
A Google search indicates there are over 150 clinics in Malaysia where one can get dermal fillers - however, not every product and practitioner can be verified, and this can spell danger.
According to Malaysian Society of Aesthetic Medicine president Dr Hew Yin Keat, fake products can cause facial disfigurement and blindness.
"Filler particles have even been detected in blood vessels of the brain, which can cause a stroke," he said in an interview.
Dermal fillers, which are made from hyaluronic acid, collagen or biosynthetic polymer, are used to enhance facial features, body contour deformities and replace volume loss due to ageing.
Dr Hew said that allergic reactions are common, especially if the filler isn't pure, or is contaminated with foreign substances such as peanut oil, industrial silicone or glue.
"The contents could have been adulterated with cheaper alternatives or compromised by heat during transportation. Using these products could lead to fever, pus formation and scarring," he warned.
Even more worrying is an increasing number of advertisements and testimonials for fake products on Facebook, Instagram and other social media platforms.
Health Ministry director general Datuk Dr Noor Hisham Abdullah explained that injectable facial and dermal fillers are not registered under the Drug Control Authority of Malaysia, but controlled and regulated by the Medical Device Act 2012.
Those selling unregistered products are committing an offence under the Control of Drugs and Cosmetics Regulations 1984, which provides for a fine of less than RM25,000 (S$8,956) or a jail term of up to three years or both, under Section 12 of the Sale of Drugs Act 1952, for the first offence.
He advises consumers to seek treatment only from certified aesthetic doctors, dermatologists or plastic surgeons.
"People should be well-informed about what they use. These products come in pre-packaged sterile syringes meant for single use."
In a survey with Star2.com readers, respondents claimed they were willing to fork out between RM1,800 and RM2,800 to "plump up" hollow cheeks and areas under the eyes.
Fortunately, 80% of respondents said they would seek dermal filler treatment only from qualified doctors, instead of purchasing beauty enhancement products online or from non-medical practitioners.
Marketing executive Sharmini Xavier, 33, would not risk purchasing these items online. "The public should be aware products sold online may not be sterile. It could be a toxic blend that may lead to long-term illness, scarring and disfigurement."
However, peer pressure and increasing marketing strategies for people to look good, may force people into sampling new products.
Student Azlan Harun, 21, feels that the Internet age emphasises a person's appearance more than their ability. "My seniors tell me it's easier to get a job if you are good-looking. As a student, I'm forced to look for the best bargains online."