Mirroring an increasing demand for a better quality of life, the medical aesthetics industry has become a new growth driver in the consumer market. However, the rapid development of the industry has led to a rise in consumer disputes, raising the question of how court rulings can protect consumers¡¯ legitimate rights and interests, and how judicial work can further contribute to the high-quality development of the medical aesthetics industry.

On March 13, the Shanghai Changning District People¡¯s Court (hereinafter referred to as ¡°Changning Court¡±) held a press conference to release the White Paper on Adjudication of Cases Involving Medical Aesthetics Disputes (2020-2025) (the ¡°White Paper¡±). The White Paper systematically reviews data on such cases concluded over the past six years, provides an in-depth analysis of industry malpractices, and summarizes key points of adjudicative rules. It serves both as judicial guidance for the high-quality development of the medical aesthetics industry and as a warning to consumers against irrational choices.

At the press conference, Wang Fei, Vice President of the Changning Court, released the White Paper, and Chen Yuqi, Chief Judge of the Changning Court Civil Division, presented five typical cases. The press conference was hosted by Ruan Weihan, Deputy Director of the Office and Spokesperson of the Changning Court. Attendees included representatives from the Changning District Committee of Political and Legal Affairs, the Changning District Consumer Rights Protection Committee, the Changning District Medical Mediation Committee, as well as some deputies to the Changning District People¡¯s Congress, members of the Changning District Committee of the Chinese People¡¯s Political Consultative Conference (CPPCC), and media reporters.

 Five core characteristics of medical aesthetics disputes

Based on a comprehensive analysis of 215 cases of medical aesthetics disputes over the past six years, the White Paper outlines the following characteristics of such disputes, which reflect a deeper link between industry development and consumer demand.

First, there is a high concentration of involved entities, with private institutions as the focal point of risks. The medical aesthetics institutions involved are primarily private providers. Among them, the top five institutions account for nearly 35% of the total number of cases, indicating that leading institutions, due to their large business scale and high service frequency, have more concentrated risk exposure. Some institutions have notable shortcomings in medical quality control and internal management.

Second, the consumer base is diversifying, with significant gender and age stratification. Women remain the core group of medical aesthetics consumers, accounting for 93.49% of the total; whereas male consumer demand is steadily rising, up 3.17% compared to the previous statistical period, indicating continued growth potential in the male medical aesthetics segment. In terms of age distribution, the primary group aged 20¨C40 accounts for over half of the total, while consumers aged 50 and above account for 22.79%, forming a diversified consumption pattern where the younger seek beauty enhancement, the middle-aged seek anti-aging treatments, and the elderly seek restorative procedures.

Third, treatments show a complex nature, with a surge in disputes over light medical aesthetics. As light medical aesthetics grows more popular, minimally invasive procedures such as injections and Thermage have become mainstream. Over 20% of cases involve two or more combined procedures. Since 2023, disputes over light medical aesthetics have become a high-incidence area of disputes, increasing by 42% year-on-year.

Fourth, consumers often pursue unreasonable claims, leading to a significant gap between claimed and awarded compensation. Across the 215 cases, the total amount claimed by plaintiffs was 37.44 million yuan, while the amount ultimately awarded by the court was 8.99 million yuan, accounting for less than 25%. Many consumers do not know enough about the legal provisions governing compensation for medical aesthetics damages, hence a noticeable gap between their expectations and judicial standards. Among the 67 cases in which consumers sought punitive damages and claimed ¡°a refund plus treble compensation,¡± only three received such awards.

Fifth, consumers tend to pursue contractual remedies, with contract disputes being the most prominent type. Contract disputes account for more than 60% of the cases, with core disputes focusing on issues such as false advertising, failure to meet service standards, and prepaid card refunds. This highlights the prominent problems of non-compliant contracts and unfulfilled promises in the medical aesthetics industry.

Eight pain points underlying medical aesthetics disputes

Drawing on judicial practice, the White Paper accurately identifies eight pain points that make medical aesthetics disputes prone to occur, pointing directly to the ¡°hidden risks¡± in industry development.

- Unregulated marketing and promotion: Some institutions create appearance anxiety through tactics such as ¡°low-price baiting and upselling upon arrival,¡± exaggerate treatment outcomes, downplay risks, and induce consumers to overspend or spend blindly.

- Chaotic pricing models: Issues include mismatches between the payment recipient and the contracting party, failure to issue formal invoices after payment, and unclear fee structures, making it difficult for consumers to prove the nature of the fees and the transaction parties involved when seeking legal remedies.

- Lack of qualification compliance: Frequent violations include non-medical institutions (e.g., beauty salons) illegally offering medical aesthetics procedures, licensed institutions performing high-risk procedures beyond their authorized scope, and unqualified doctors practicing, all of which pose significant medical safety risks.

- Failure to fulfill informed consent obligations: Some institutions use standard terms in place of detailed disclosure, have consumers sign blank consent forms, fail to provide supplementary notification when treatment plans are changed during procedures, and maintain insufficient medical records, which infringe on consumers¡¯ right to be informed and to give informed consent.

- Improper use of drugs and devices: A small number of institutions use counterfeit or substandard drugs and medical devices of unknown origin, or even pass off ordinary products as high-end medical aesthetics products, directly harming consumers¡¯ right to physical health.

- Insufficient awareness of evidence preservation: Many consumers fail to retain records of institutional promises before treatment or to document diagnoses and evidence of injuries after treatment, making it difficult to prove their claims. Some institutions fail to retain patients¡¯ medical histories, particularly pre- and post-treatment photos, leading to disputes.

- Differences in evaluating treatment outcomes: Disputes over ¡°unsatisfactory results¡± not caused by medical malpractice are increasing, due to differences between consumers¡¯ subjective expectations and the objective medical standards, making dispute resolution more difficult.

- Involvement of professional bad-faith claimants: Some professional claimants exploit gray areas in the industry to file frequent claims based on grounds such as ¡°false advertising¡± or ¡°qualification deficiencies,¡± disrupting industry order and driving up the total number of medical aesthetics disputes.

Guidance for both medical aesthetics consumers and operators

From a judicial perspective, the White Paper provides clear compliance guidance for both medical aesthetics consumers and operators, aiming to foster an ecosystem characterized by ¡°judicial protection, industry self-discipline, and rational consumption.¡±

For consumers, four points should be kept in mind to avoid risks: 1) Distinguish the nature of services, verify the Medical Institution Practicing License and doctors¡¯ qualifications through official channels of the Health Commission, and stay away from medical aesthetics procedures offered by beauty salons. 2) Sign contracts properly, specifying key terms such as treatment content, price, product brands, outcome commitments, and liability for breach of contract, and retain records of the institution¡¯s promotional promises. 3) Choose treatments prudently based on individual health conditions, and be wary of ¡°low-price baiting¡± traps, carefully read the risk disclosure statement, and fully understand the risks before signing. 4) Preserve medical records properly, including pre- and post-treatment photos, medical records, payment receipts, and chat logs. In the event of adverse reactions, seek prompt treatment at a qualified medical institution and obtain and preserve diagnostic documentation.

For operators, strict compliance with laws and regulations is required, along with adherence to four bottom-line requirements: 1) Regulate marketing practices, eliminate false advertising and inducement of consumption, strengthen professional and legal training for staff, and implement a system for documenting consultation records. 2) Fully fulfill informed consent obligations by providing comprehensive disclosure of treatment risks, indications, and contraindications in both written and oral forms. When treatment plans are changed during procedures, provide supplementary notification and complete the necessary formalities promptly. 3) Ensure the compliance and completeness of medical records, manage pharmaceuticals and medical devices in accordance with regulations, create and maintain records in line with medical standards, retain consumers¡¯ pre- and post-treatment photos, and safeguard consumers¡¯ right to access their medical records. 4) Resolve disputes through good-faith negotiation, using platforms such as the medical mediation committee for amicable discussions, and, after reaching an agreement, apply for judicial confirmation to render it enforceable, thus achieving finality through mediation.

Typical cases demonstrating judicial humanity and wisdom

The five typical cases released at the press conference cover different types of disputes in the medical aesthetics field. Grounded in both the protection of consumer rights and the high-quality development of the industry, the court has fully leveraged its judicial function to safeguard the ¡°bottom line for beauty treatments.¡±

For example, in the case of Fan v. X Beauty Salon in a service contract dispute, Fan, at the recommendation of the salon¡¯s manager, underwent procedures at the salon including oxygen bubble-based facial and Radiesse injection to the nose, and was also taken to other shops for procedures such as Ultherapy and picosecond laser. Fan filed a request with the Changning Court to verify the relevant qualifications of the salon. By clarifying the nature of the procedures involved and verifying the qualifications of the salon, the Changning Court found that all procedures Fan underwent were medical aesthetics procedures, and that the salon did not possess the corresponding qualifications. Accordingly, the court granted the plaintiff¡¯s request for a refund and ordered the salon to pay punitive damages. This case has fully protected the consumer¡¯s legitimate rights and interests and has demonstrated the court¡¯s firm stance on cracking down on unlicensed medical aesthetics practices and building a strong safety defense for medical aesthetics consumption.

In the case of Zhang v. X Clinic in a medical service contract dispute, Zhang, a woman in her seventies, was repeatedly solicited by the clinic¡¯s sales staff and purchased medical aesthetics procedures such as ¡°Peach Blossom Face¡± and ¡°Peach Blossom Back.¡± She made multiple top-ups, with individual payments ranging from 50,000 to 300,000 yuan, accumulating a total of over 1.3 million yuan. However, after undergoing the procedures, she not only saw no improvement but also her appearance was worse than before. When her family learned of the situation and sought a refund, they were turned down. Through investigation and analysis of the sales process, services provided, and market prices, the Changning Court organized multiple mediation sessions between the parties, ultimately reaching a settlement under which the elderly woman received a refund of one million yuan. Due to physiological and cognitive characteristics, elderly consumers often have weaker judgment, insufficient ability to access and evaluate information, and a tendency to readily believe verbal promises. Faced with active solicitation and exaggerated claims from the sales staff, they find it difficult to rationally assess the compliance, suitability, and price reasonableness of medical aesthetics procedures, making them highly vulnerable to falling into consumption traps. This case has protected the rights and interests of elderly medical aesthetics consumers and provided clear guidance for regulating business practices targeting this demographic and promoting rational consumption among the elderly in this area.

Moving forward, the Changning Court will continue to focus on emerging issues and developments in the medical aesthetics industry, refine adjudicative rules for similar cases, strengthen diversified dispute resolution mechanisms, and enhance coordination with regulatory authorities and industry associations. At the same time, it will continue to carry out targeted legal awareness campaigns on medical aesthetics, promote the widespread adoption of compliant business practices, and work toward a new governance framework for the medical aesthetics market characterized by ¡°judicial protection, robust regulation, industry self-discipline, and reassuring consumption.¡± The goal is to make medical aesthetics a truly ¡°reassuring medical aesthetics¡± industry that meets the public¡¯s aspiration for a better life, providing solid judicial support for the high-quality development of the industry.

Comments from Deputies and Members

Tang Longying, Deputy to the Changning District People¡¯s Congress and Director of the Obstetrics Department at Changning District Maternal and Child Health Hospital

The White Paper released by the Changning Court represents a systematic review and in-depth distillation of six years¡¯ judicial practice, supported by detailed data and incisive identification of key issues. By outlining case characteristics, it accurately portrays the consumption pattern of the medical aesthetics market. By identifying the eight pain points, it directly targets the irregularities in the industry development. The White Paper serves as a reference for adjudicating similar cases and shows the direction for industry regulation. It also offers practical and instructive guidance for both consumers and operators, helping the former safeguard their rights rationally and avoid risks and encouraging the latter to return to the medical nature of their practice and operate in compliance. The White Paper injects judicial momentum into the high-quality development of the medical aesthetics industry and offers a replicable judicial model for governing the regional medical aesthetics market.

Zheng Yu, Member of the CPPCC Changning District Committee and Chairman of Shanghai Shenzhou Hospital

The White Paper provides an important judicial reference for the high-quality development of the medical aesthetics industry and also sounds a note of caution for compliant operations of medical aesthetics institutions. It presents the characteristics of the industry-related disputes through detailed data and objectively identifies shortcomings of some institutions in areas such as qualification management, risk prevention, and service fulfillment. The development of the medical aesthetics industry must be built on compliance and medical safety. We hope that medical aesthetics institutions will benchmark against the findings to identify issues in their management and operations, strengthen professional and legal training for employees, act in good faith, provide compliant services, and fulfill their responsibilities and obligations as medical institutions.