I. Overview

High-Intensity Focused Ultrasound (HIFU) has become a popular non-surgical cosmetic treatment in the Philippines for skin tightening, lifting, and contouring. It’s marketed as “non-invasive,” “no downtime,” and “safe,” but in practice it can cause serious injuries when improperly performed—such as:

Burns and blistering
Scarring and hyperpigmentation
Nerve damage (facial weakness, numbness, asymmetry)
Fat atrophy or contour deformities
Eye or vision-related complications (if done too close to the orbit)

When this happens, patients often ask: “May habol ba ako?” The short answer is: yes, Philippine law provides civil, criminal, administrative, and consumer remedies. But the exact remedy depends on the facts and the evidence you can present.

This article walks through, in Philippine context:

The legal framework governing cosmetic clinics and HIFU treatments
Types of liability (civil, criminal, administrative, consumer)
Key legal concepts: negligence, standard of care, informed consent, waivers
Evidence you need to build a case
Step-by-step options if you suffered HIFU injury

This is general information, not a substitute for consultation with a Philippine lawyer.

II. Legal Framework Applicable to HIFU and Cosmetic Clinics

Several laws and regulations overlap when dealing with cosmetic clinic negligence and HIFU injuries:

Civil Code of the Philippines
- Obligations arising from contracts (clinic–patient relationship)
- Quasi-delicts (torts) or “culpa aquiliana”
- Damages for physical injuries, moral and exemplary damages
Revised Penal Code (RPC)
- Criminal negligence (reckless imprudence resulting in physical injuries)
- Estafa or fraud (if there was deception, misrepresentation, or intent to defraud)
Medical Act of 1959 (RA 2382)
- Regulates the practice of medicine
- Only duly licensed physicians may practice medicine; issues arise when non-doctors perform or “supervise” HIFU in a way that crosses into medical practice
Professional Regulation Commission (PRC) laws and rules
- Discipline for doctors, nurses, and other licensed professionals
Food and Drug Administration (FDA) Act (RA 9711)
- Regulates medical devices, including many HIFU machines
- Issues of registration, device safety, and compliance
DOH licensing regulations for health facilities
- Clinics performing certain procedures may need DOH licenses/permits
- DOH can investigate and sanction facilities for violations
Consumer Act of the Philippines (RA 7394)
- False, deceptive, or misleading advertising
- Product and service defects
- Liability of service providers for unsafe services
Local ordinances / business permits
- LGU can sanction or close clinics for operating without the proper permits

III. Nature of the Legal Relationship: Contract + Quasi-Delict

When you go to a cosmetic clinic for HIFU, two main legal relations arise:

Contractual relationship
- You pay for a service; they promise to perform it with due care and skill.
- Failure to do so = breach of contract.
- Grounded on Civil Code provisions on obligations and contracts (e.g. liability for negligence in performance of obligations).
Quasi-delict (tort) relationship
- Independent of the contract, anyone who, by fault or negligence, causes damage to another is liable to pay damages.
- This is crucial if:
  - You didn’t sign any clear contract, or
  - You want to sue both individual staff and the clinic/corporation.

You can often base your case on both breach of contract and quasi-delict, depending on strategy.

IV. What Counts as “Negligence” in HIFU Treatments?

In Philippine jurisprudence, medical negligence exists when:

A health professional fails to exercise the level of care, skill, and diligence that a reasonably competent professional in the same field would exercise under similar circumstances, resulting in injury.

For HIFU and cosmetic clinics, negligence might look like:

A. Pre-treatment Negligence

No proper medical evaluation of the patient’s skin condition and medical history
Failure to identify contraindications (recent fillers, certain skin diseases, use of certain drugs, autoimmune conditions, pregnancy, etc.)
Failure to check whether the patient is an appropriate candidate (e.g., unrealistic expectations, certain facial structures, extremely thin fat layer)
No patch test when such would reasonably be expected

B. Treatment Negligence

Wrong settings (energy level, depth, duration, number of passes) for the patient’s skin type and anatomy
Using the device on contraindicated areas (e.g. too close to the eyes, thyroid area, or over metal implants if contraindicated)
Inadequate supervision of staff; technicians left unsupervised
Poor hygiene or infection control leading to secondary infection
Use of unapproved, counterfeit, or unregistered HIFU machine
Performing the procedure by unqualified personnel (e.g. non-physician performing medical-level judgment and interventions without adequate supervision)

C. Post-treatment Negligence

Failure to provide proper post-procedure instructions
Failure or delay in addressing complications (no follow-up, no referral to specialist)
Downplaying serious symptoms and failing to act when a reasonable practitioner would

The key is whether their actions fall below the accepted standard of care for such procedures in the local profession.

V. Who Can Be Liable?

1. The Doctor

If a licensed physician is involved, they can be liable if:

They personally performed the procedure negligently
They failed to supervise staff properly
They failed to obtain proper informed consent
Their clinic protocols are grossly substandard

Doctors may be liable both personally and via professional liability in civil cases, and may also face administrative cases with PRC.

2. The Cosmetic Clinic / Corporation

Clinics and corporations can be liable:

Under vicarious liability (employers liable for employees’ negligent acts within the scope of employment)
For corporate negligence, such as:
- Failing to vet and hire qualified staff
- Allowing unlicensed practitioners to act as if they were doctors
- Using unregistered or unsafe equipment
- Having no protocol for emergencies or adverse effects

3. Individual Staff / Technicians

Non-physician staff can be personally liable if they:

Perform acts amounting to practice of medicine without proper authority
Ignore instructions, use wrong settings, or otherwise cause injury through negligence

If the staff member does something clearly outside their training and authority, their personal liability becomes stronger, but the clinic is often still liable for hiring/supervising them.

4. Importers / Manufacturers (Product Liability)

If injury is due to defective HIFU equipment (e.g., device malfunction, incorrect energy output compared to settings), there can be product liability against:

Manufacturer
Importer/distributor
Sometimes the clinic, if they knew or should have known of unregistered/unsafe devices

Under consumer and civil law principles, a defective or unsafe product that causes injury can give rise to damages.

VI. Informed Consent, Waivers, and Disclaimers

A. Informed Consent

For elective cosmetic procedures, the requirement for informed consent is particularly strict. Proper informed consent generally requires:

Explanation of the procedure – what HIFU is and what will be done
Benefits and limitations – realistic outcomes, number of sessions, variability of results
Risks and possible complications – burns, scarring, fat loss, nerve damage, asymmetry, pigment changes, etc.
Alternatives – other treatments, or the option to do nothing
Opportunity to ask questions and consider options
Consent that is voluntary, not coerced, and from a competent adult (or authorized representative)

A consent form that’s just signed but not properly explained may be attacked as invalid or defective. Courts look at substance, not just the paper.

B. Waivers and “No Refund” Policies

Clinics often use:

“No refund” policies
“At your own risk” waivers
Clauses stating that results are not guaranteed

In Philippine law:

You cannot waive liability for future acts of gross negligence or deliberate violations of law.
Any waiver contrary to law, morals, good customs, public order, or public policy may be null and void.
A waiver or consent form does not shield a provider from liability for negligence, especially gross negligence.

So even if you signed a consent form, you may still have a valid case if negligence is proven.

VII. Types of Legal Remedies

A. Civil Remedies (Damages)

You can file a civil case for damages based on:

Breach of contract – that they failed to perform the service with due care and skill
Quasi-delict – that their negligence caused your injury

You can claim:

Actual damages – medical expenses, lost income, extra corrective procedures, transportation, etc.
Moral damages – for physical suffering, mental anguish, anxiety, loss of self-esteem, humiliation, especially important for visible facial injuries
Exemplary (punitive) damages – to serve as a deterrent when there’s bad faith, gross negligence, or wanton disregard of safety
Attorney’s fees and litigation expenses

The court will require proof: receipts, medical certificates, expert testimony, etc.

B. Criminal Remedies

Under the Revised Penal Code, you may file a criminal complaint for:

Reckless imprudence resulting in physical injuries
- When the injury results from inexcusable lack of precaution.
- Penalties depend on the seriousness of the injuries (serious, less serious, slight physical injuries).
Estafa or fraud
- If the clinic misrepresented material facts (e.g. claiming a person is a “board-certified dermatologist” when they are not, or claiming DOH/FDA approval that doesn’t exist) and you were induced to pay.

Criminal cases require proof beyond reasonable doubt, so they are more demanding than civil cases. But they can be powerful leverage for settlement.

C. Administrative Remedies

PRC complaint (against licensed professionals)
- Grounds: negligence, unprofessional or unethical conduct, gross incompetence, violation of the Code of Ethics
- Possible sanctions: reprimand, suspension, or revocation of license
DOH complaint (against clinics / health facilities)
- For unlicensed operation, violation of DOH regulations, unsafe practices
- Sanctions: suspension or revocation of facility license, fines, closure
FDA complaint (against device-related violations)
- Use of unregistered, misbranded, or substandard devices
- Possible sanctions: seizure of devices, fines, closure, administrative and criminal liability for responsible officers
DTI / Consumer Protection offices
- For deceptive advertising, misleading claims, or unfair trade practices

These administrative remedies may not give you direct compensation, but they can:

Put regulatory pressure on the clinic
Help in negotiations
Prevent similar harm to future patients

D. Consumer and Small Claims Options

If your primary concern is refunds and relatively smaller monetary amounts, you may:

File a complaint with DTI or local consumer protection offices, or
File a small claims case in court (for claims within the jurisdictional amount set by the Supreme Court’s Small Claims rules).

Small claims proceedings are designed to be faster and simpler, with no lawyers required in many cases, but they are suitable mainly for straightforward refund/compensation claims, not complex medical negligence issues requiring expert testimony.

VIII. Evidence: What You Need to Prove Your Case

In cosmetic negligence cases, evidence is everything. Helpful items include:

Medical and clinic records
- Consultation notes
- Consent forms
- Treatment records (date, settings, device used, operator’s name)
- Incident reports (if any)
Before-and-after photos and videos
- Photos taken by the clinic and by you
- Screenshots of marketing materials
- Clear photos of injuries over time
Receipts and financial records
- Proof of payment for the HIFU treatment
- Receipts for corrective treatments (dermatologists, surgeons, etc.)
- Evidence of lost income (if applicable)
Communications
- Text messages, emails, chats with the clinic or staff
- Social media messages and posts (especially those showing promises or downplaying your complications)
Expert opinion
- A doctor (e.g., dermatologist or plastic surgeon) who can:
  - Explain the nature and extent of your injuries
  - State whether the procedure seems to have been done below the standard of care
  - Estimate costs of corrective treatment
Witnesses
- Friends/family who were with you at the clinic or saw your condition before/after
- Other clients who had similar experiences (if relevant)

IX. Prescription Periods (Deadlines to File Cases)

There are time limits within which you must file your case, depending on the legal basis. Typical Philippine rules (not listing exact years since these can be affected by case specifics and later rules) generally include:

Civil actions based on quasi-delict (tort) – a limited number of years from the time you became aware of the injury and who is responsible
Civil actions based on written contract – longer prescriptive period than oral contracts
Criminal cases – prescriptive periods depend on the penalty for the offense (serious vs slight physical injuries, estafa, etc.)
Administrative complaints – may have their own time rules under PRC, DOH, or FDA guidelines

Because prescription rules can be technical and fact-dependent, you should consult a lawyer quickly after discovering the injury, especially if a significant time has already passed.

X. Practical Steps If You Suffered HIFU Injury

Here’s a practical roadmap (not mandatory, but commonly sensible):

Step 1: Seek Medical Help Immediately

Go to a qualified dermatologist or relevant specialist for proper assessment and treatment.
Explain what was done, when, on what device, and your symptoms.
Ask for a medical certificate or written report.

Step 2: Document Everything

Take clear pictures of the injuries from multiple angles over time.
Safely store all receipts, communications, and records.
Ask for a copy of your clinic records (you usually have the right to your own records, subject to reasonable procedures).

Step 3: Communicate with the Clinic (Carefully)

You may write a formal demand letter detailing:
- Facts of what happened
- Injuries sustained
- Your demands (refund, free corrective treatment with your chosen doctor, compensation, etc.)
Be polite but firm; avoid emotional or defamatory public posts at this stage, as these can complicate matters.

A lawyer can help draft the letter to set up your case properly.

Step 4: Consider Negotiation and Settlement

Many cases are resolved via:

Refunds
Complimentary treatments (be cautious about returning to the same clinic if trust is broken)
Monetary compensation

If you negotiate:

Get any settlement in writing
Consider having a lawyer review it, especially if they ask you to sign waivers/quitclaims

Step 5: File Appropriate Complaints if Needed

If negotiation fails or the issue is serious:

Civil case – for damages
Criminal complaint – for reckless imprudence or fraud, if applicable
Administrative complaint – with PRC, DOH, FDA, or DTI
Small claims or consumer complaint – if the issue is mainly refund/compensation within the small claims threshold

Your lawyer can help you decide what combination of actions is realistic based on your evidence and the cost-benefit balance.

XI. Special Issues in Cosmetic and “Aesthetic” Medicine

A. “Aesthetician” vs. Doctor

In the Philippines, there is a gray area between:

Beauty services (facials, basic skin care)
Medical aesthetic procedures (e.g., injectables, laser, HIFU at certain depths)

HIFU, especially when targeting deeper layers, can cross into medical territory because it affects structures similar to those involved in surgical facelifts.

If a non-doctor is effectively making medical decisions (e.g. selecting candidates, handling complications, performing medically risky procedures without physician oversight), this may violate RA 2382 (unlawful practice of medicine), opening more liability.

B. Cheaper “Promo” Packages and Informed Choice

Aggressive marketing and promos can:

Create unrealistic expectations (“instant facelift,” “guaranteed result”)
Pressure patients into quick decisions without full understanding of risks

If the clinic’s marketing is deceptive or intentionally downplays serious risks, that can strengthen your case under both negligence and consumer protection theories.

C. Social Media and Defamation Risks

Many injured patients vent on social media. Be aware:

Truth is a defense, but you still must be careful about exaggerated or false statements.
Overly broad public accusations (“butchers,” “criminals”) without proper basis can expose you to defamation suits.

It’s safer to:

Focus on factual narratives (“I had HIFU here on [date] and experienced [injury]…”)
Avoid calling them criminals or using insulting language
Consult a lawyer before launching a public campaign

XII. Role of Experts and Litigation Challenges

Cosmetic negligence cases, especially involving HIFU, are often expert-heavy:

You usually need a medical expert to testify that:
- The standard of care for HIFU requires certain precautions
- The clinic failed to meet that standard
- The negligence caused your injuries

This can make the case more expensive and complicated than simple contract or consumer disputes. That’s why, in practice, many cases are resolved by settlement if the clinic sees clear risk.

XIII. Choosing a Legal Strategy

Your strategy depends on:

Severity of injury
Strength of evidence
Financial and emotional cost of pursuing litigation

Some typical routes:

Minor injury, good documentation but relatively low damages
- Demand letter → negotiation → small claims or consumer complaint if necessary.
Moderate injury with visible or lasting effect, clinic refuses fair settlement
- Demand letter → civil case for damages (possibly plus PRC/DOH/FDA complaint).
Severe disfigurement, serious nerve damage, or eye injuries
- Full civil case + criminal complaint + administrative complaints, depending on facts.

Always weigh the cost of litigation versus the likely outcome. A good lawyer can help you realistically assess this.

XIV. Final Thoughts

HIFU and other cosmetic procedures can significantly affect not just appearance but psychological well-being. In the Philippines, the law does not treat cosmetic injuries as trivial just because the procedure is elective. Clinics and practitioners remain bound to a high standard of care, especially when they market themselves as safe and professional.

If you’ve suffered injury:

Get medical help and document everything.
Don’t be intimidated by waivers or “no refund” policies.
Explore your options: negotiation, civil/criminal cases, and regulatory complaints.
Consult a Philippine lawyer knowledgeable in medical malpractice and consumer law to tailor a strategy suited to your specific situation.

You do have rights—and there are legal remedies to enforce them when cosmetic clinic negligence and HIFU treatment injuries occur.