An aesthetic doctor in Singapore administered over three times the recommended annual amount of dermal fillers to a patient in a single session, leading to prolonged complications and restrictions on his medical practice.
The patient, whose name was not disclosed, consulted Dr. Isaac Wong Kai Jie, founder and medical director of The Artisan Clinic at Paragon, on April 1, 2023. Wong recommended dermal filler injections and subsequently injected a total of 7ml in one session, exceeding the 2ml annual limit indicated on the product’s packaging. Following the procedure, the patient experienced persistent pain on the left side of her face and visible discolouration, which Wong diagnosed as vascular occlusion—a blockage in a blood vessel.
Wong attempted to manage the complication by administering multiple injections of hyaluronidase, an enzyme used to break down hyaluronic acid commonly found in many dermal fillers. Despite ongoing treatment—including hyaluronidase, growth factors, and steroids—over the course of 18 months, the patient suffered sustained facial pain, neuralgia, and neuritis. The pain reportedly persisted for at least 19 months, during which she experienced significant weight loss of approximately 20 kilograms, high blood pressure, and a decline in mental well-being that ultimately led to job loss.
The patient sought additional evaluations outside Wong’s care, consulting with specialists including an ear, nose, and throat surgeon, an anaesthesiologist, and a general practitioner. She underwent nerve surgery in August 2024 to alleviate her symptoms.
Following the complications, the patient filed a complaint with the Singapore Medical Council (SMC) in November 2024. An independent complaints committee reviewed the case and referred it to the council’s interim orders committee (IOC), which imposed restrictions on Wong’s practice on August 26, 2026. These measures include a prohibition on offering or administering dermal fillers. The IOC’s decision, chaired by psychiatrist Lee Cheng of the Institute of Mental Health, cited the need to protect public safety and uphold the public interest. Wong has appealed the IOC’s decision, with a hearing scheduled for October 28.
In his defense, Wong contested the assertion that the annual dosage limit was 2ml, noting that the manufacturer had updated the recommended maximum single-session dose to 12ml in November 2025 after new toxicological assessments. He argued that no harm would occur if allowed to continue practicing, emphasizing his extensive experience with over 19,600 filler injections since 2018 and a low incidence rate of vascular occlusion (0.005%). Wong also highlighted a signed consent form indicating the patient was informed of the risks and benefits prior to treatment.
The SMC countered that the relabelling occurred after the incident and expressed concern that Wong knowingly exceeded the regulatory dosage limits at the time of treatment. The council also questioned his continued use of hyaluronidase injections despite the specific brand of fillers reportedly lacking hyaluronic acid, and criticized the lack of prompt referral to specialists. Wong maintained that hyaluronidase was administered to treat the vascular occlusion per manufacturer guidance and that he did refer the patient for hyperbaric oxygen therapy in April 2023.
Further investigations revealed that Wong faces at least five other similar complaints alleging dermal filler overdosing and adverse effects. The ongoing legal and regulatory proceedings will determine the future of his medical practice.