According to Time Asia in an article published several years ago but still widely cited, Indonesia then had only 43 licensed plastic surgeons for a population of well over two hundred million people.

An estimated 400 illicit procedures were performed each week in Jakarta alone.

Most licensed plastic surgeons work hard and devote much of their time to reconstructive surgery rather than to cosmetic enhancement. Though very skilled, they are in short supply.

In other words, most cosmetic surgery in Indonesia is performed by unlicensed practitioners who are unregulated with respect to education, specialty training, certification, or facility used, which is sometimes the back room of a beauty parlor or worse.

While updated statistics are not available, the shortage of qualified providers is so extreme and the black market so ingrained that it seems unlikely it could be very much improved, especially considering the negative impact of the global economic downturn.

While more effective governmental regulation and legal action might offer a start, there are serious systemic obstacles that are not easy to overcome.

One prominent Asian plastic surgeon noted that it is the "bargain hunting instinct" of many local patients that encourages their own abuse and has turned illicit cosmetic activity into such a profitable activity for the perpetrators.