SINGAPORE: A beautician was sentenced to three weeks’ jail on Thursday (Jan 2) for carrying out a double eyelid procedure on a patient even though she was not a licensed medical practitioner.
The patient had a drooping left eyelid and the botched aesthetic procedure ended up worsening her condition.
Liu Chengjun, 56, pleaded guilty to one charge under the Medical Registration Act, with another similar charge considered in sentencing.
She was also ordered to pay compensation of S$126.95 (US$93), or serve one more day in prison.
Investigations found that she had been providing beauty procedures like facials and eyebrow services at her home. The address is redacted in court documents.
The patient, a 25-year-old woman, wanted to make her existing double eyelids more defined. She heard about Liu’s services from a friend.
In September 2021, the patient’s mother enquired with Liu about a double eyelid procedure for her daughter.
Over WeChat, Liu said that she could insert a thread into the patient’s eyelids to achieve the desired effect.
The mother asked if Liu had photos of the results of the procedure on other patients, and Liu sent her nine sets of “before and after” photos.
When asked if she had performed the procedure on these patients, Liu claimed that this was the case.
The patient and her mother visited Liu’s home on Jul 10, 2022 to find out more about the procedure.
Liu told them it involved injecting anaesthetic into the eyelids, then using a needle to insert a thread into each eyelid to make the double eyelids more obvious.
She also told them she was experienced at performing the procedure, and that it was “harmless”. She added that her daughter, whom the patient and her mother also met, had the procedure done previously.
They arranged to carry out the procedure on Jul 19, 2022. The patient and her mother arrived at Liu’s house at about 3pm that day.
The patient lay down on a bed with her eyes closed. Liu drew a line on each eyelid and disinfected the eyelids with ethanol.
She injected a solution containing lidocaine and epinephrine into both eyelids to numb them, then used a needle with thread to sew along the lines she had drawn earlier.
The entire procedure took about half an hour, after which the patient paid Liu S$800.
The patient’s eyelids were swollen after the procedure. They remained swollen for some time after and she was unable to open her eyes fully.
Liu gave the patient a cream for haemorrhoids that she had bought on Taobao, and advised her to apply it. But the swelling continued for about a week and the shape of the eyelids became uneven.
The patient was dissatisfied with the results and asked Liu to remove the threads. Liu agreed, but asked the patient to let the swelling subside first.
On Aug 17, 2022, the patient went to Liu’s home to remove the threads. Liu again injected lidocaine and epinephrine into both eyelids to numb them.
She then inserted a needle to pierce the patient’s skin and create an opening, before using a tweezer to remove the thread at each eyelid.
Liu also refunded S$800 to the patient.
But the patient’s eyelids remained swollen and about two weeks after the removal of the threads, her eyelids were still uneven.
She consulted doctors, including a family physician and two plastic surgeons. One surgeon, Dr Leo Kah Woon, advised her that her drooping eyelid would cost S$4,000 to S$5,000 to repair.
According to Dr Leo, the patient’s left eyebrow had become significantly higher than her right eyebrow, and this was likely caused by the two procedures Liu performed.
It was very unlikely for the patient’s condition to worsen so drastically in just a few months if it had been left on its own, the doctor said in a memorandum.
Plastic surgeon Dr Woffles Wu also provided his expert opinion that the procedure Liu performed should only be done by a registered medical practitioner with the requisite specialist training.
Risks from the procedure, which may include infection, drooping of the eyelid and trauma to the eyeball, could be severe and require surgical correction, Dr Wu’s report stated.
The Ministry of Health (MOH) received information on Oct 29, 2022 about the procedure that Liu had performed on the patient.
Officers inspected Liu’s house on Nov 16, 2022 and found syringes, needles and bottles of Botulinum toxin – or Botox – as well as a bottle of the lidocaine and epinephrine solution.
MOH prosecutor Jason Nim informed the court that Liu was previously fined in 2012 for running a massage business without a licence.
He sought four to six weeks’ imprisonment for Liu, arguing that the patient’s facial appearance was altered by the procedure and this had affected her emotionally.
Mr Nim also highlighted the steps that Liu took to promote her services to the patient and her mother over WeChat and when they visited her place.
Defence counsel Ashvin Hariharan of Ashvin Law Corporation asked for not more than two weeks’ jail.
He acknowledged that the procedures worsened the patient’s drooping eyelid, but argued that this was less harmful than if Liu had brought about a condition that the patient did not already have.
He said that this was a “purely cosmetic issue” as there was no evidence of any obstruction of the patient’s visual field. The patient did not follow through with an eye and visual field exam.
Mr Hariharan also said that Liu did not know the procedures she was performing required a medical licence and that she did not represent herself as a medical professional.
The punishment for acting as a medical practitioner without being registered and without a valid practising certificate is up to a year in jail, a fine of up to S$100,000, or both.
The maximum penalty is doubled for repeat offenders.
