The title of “cosmetic surgeons” or “cosmetic specialists” does not exist under the Health Professions Council of South Africa (HPCSA). However, many South Africans, interested in cosmetic surgery, are being targeted by these so-called professionals on Instagram or TikTok. Reality TV star Nozipho Ntshangase, who is undergoing “a mommy makeover”, says that you must separate marketing from medicine.
Professor Chrysis Sofianos. Image supplied.
Plastic surgeon Professor Chrysis Sofianos agrees and warns that this confusion, combined with cut-price offers, is driving a wave of life-altering, botched surgeries and costly legal battles.
The real risks
Sofianos notes that filtered photos and persuasive marketing tactics conceal the very real risks associated with procedures performed by non-specialists.
“Only specialists in plastic and reconstructive surgery are trained and recognised to perform complex operations safely.
“Anything else puts patients at risk of life-long complications,” he states.
International data points to the danger.
A 2024 study in the Aesthetic Surgery Journal found that cosmetic surgeries performed by residents had a revision rate of 22.2%, meaning that more than one in five patients needed additional corrective surgery.
This is compared to surgeries performed by experienced attending surgeons, which had a revision rate of just 3.6%.
The lesson is clear: there is no substitute for years of surgical training and experience.
The HPCSA logged 2,041 complaints in 2023/24, up from 1,458 in 2020/21 – a dramatic 40% rise in just three years.
Negligence, incompetence, and insufficient care topped the list, with 1,820 cases formally registered for further action.
The regulator does not break down how many of those cases involved cosmetic procedures.
Insta baddie to botched BBL
However, the Association of Plastic, Reconstructive and Aesthetic Surgeons of Southern Africa (APRASSA) has raised concerns that unqualified practitioners are offering complex operations such as liposuction, breast reductions, and Brazilian butt lifts (BBLs).
Poorly executed, these procedures can leave patients scarred, disfigured, or in need of corrective surgery costing hundreds of thousands of rand.
APRASSA has noted that the problem lies not only in poor outcomes but in the confusion created by titles.
“Cosmetic surgeon” and “aesthetic surgeon” are not recognised specialities in South Africa.
Only plastic and reconstructive surgeons, who undergo upwards of seven years of additional surgical training and board examinations, are licensed to perform these operations.
But on social media, even a doctor with a few days of training can pose as an expert, blurring the line between influencer and surgeon.
Cut-throat discounts and appealing social media feeds don’t only empower unqualified GPs – they can also help negligent surgeons mask their poor results behind filters and promotions, until the damage is already done.
But corrective procedures can cost as much as five times more than the original surgery, with patients carrying both the financial burden and years of physical pain and emotional trauma.
The risks are all too real.
South Africa has already seen several high-profile cases where patients’ lives and health have been permanently impacted:
- Benoni surgeon banned: In 2020, a surgeon was struck from the register after multiple patients lodged complaints of failed procedures that left them scarred for life. One patient lost a leg and his career, others were left disfigured, and many endured years of pain before justice was served.
- Pretoria malpractice claim: In 2018, a mother of three sued for over R1.8m after a GP misrepresented his qualifications and left her disfigured following breast reduction surgeries. The case highlighted how easily patients can be misled by non-specialist healthcare providers.
- BBL controversy: More recently, APRASSA has raised alarms about GPs marketing BBLs. Although regarded globally as one of the riskiest cosmetic operations with one of the highest mortality rates among cosmetic surgeries, some practitioners openly advertise the procedure on social media.
“These are not isolated events,” Sofianos warns.
“They reflect a dangerous pattern of unqualified individuals performing invasive surgeries without the training or facilities to do so safely.”
Reality TV star Nozipho Ntshangase, who recently underwent “a mommy makeover”, says that you must separate marketing from medicine. Image supplied.
Seperating marketing from medicine
Ntshangase, a star on The Mommy Club, has found that separating marketing from medicine has been critical.
“I know how tempting those Instagram results look, but you often don’t know who’s really behind the scalpel,” she says.
She recently underwent a "mommy makeover" and says choosing the right surgeon gave her peace of mind.
“I wanted a surgeon who was properly qualified, who operates in a proper hospital, and who was upfront about the risks.
“The investment is not just for the results, but for my safety and future.”
She offers the following tips for navigating social media safely:
- Look beyond the likes: “A popular page doesn’t mean a safe surgeon. Always cross-check their HPCSA registration.”
- Ask for proof: “Don’t accept before-and-after pictures at face value. Make sure they’re real patients, not stock images.”
- Trust your instincts: “If someone is pushing discounts on WhatsApp or promising scar-free results or no downtime, that’s a red flag.”
Sofianos adds that patients considering cosmetic surgery should check their doctor’s credentials on the HPCSA iRegister portal, and can also check their membership with APRASSA.
“South Africa has world-class specialists. But patients must do their homework.
“Don’t trust titles, don’t trust filtered photos, and don’t trust bargain prices.
“Only trust proper credentials – your life and your safety may depend on it,” he concludes.
