Profiling UK injectable aesthetic practitioners: A national cohort analysis

Ethics in aesthetic practice: results from a survey of medical doctors attending aesthetic medicine programs in Italy

BACKGROUND

Within a rapidly evolving digital age in which social media plays a key role, the number of aesthetic medicine procedures performed globally is increasing.

METHODS

Physicians who participated in training courses in aesthetic medicine in Italy run by two different medical societies SIME (International School of Aesthetic Medicine Carlo Alberto Bartoletti Foundation) and Agorà (Post-Graduate School of Aesthetic Medicine Agorà), completed a survey (November 2023 - January 2024) to assess their viewpoints on ethics in aesthetic medicine and findings combined.

RESULTS

Of 452 physicians, 72.6% - 88.2% strongly agreed about the importance of maintaining up-to-date aesthetic medicine knowledge, protecting patient confidentiality, appropriate patient communication, prioritizing patient care and safety, respecting patient dignity and privacy, and obtaining informed consent. Around half of the respondents strongly agreed with correlations between social media (including the use of filters, idealized photos, and the constant sharing of content for personalized feedback) and psychological dysfunctions/body dissatisfaction, and that physicians should examine patients with highly filtered photographs for warning signs and unrealistic expectations. Approximately 15.4% - 55.0% strongly agreed with the importance of focusing on the patient's best interest, not performing procedures on those with unrealistic expectations, letting patients decide who to involve in consultations, education in key ethical principles in aesthetic medicine (including patient autonomy and self-determination), submitting experimental aesthetic procedures to a territorial ethics committee, and obtaining informed consent from adolescents for their procedures (as well as their parents/caregivers). 43.0% - 52.0% strongly disagreed that it was unnecessary to communicate all treatment information to patients, hear and respect patient opinions, or involve patients in decisions. One-third of respondents reported previously encountering ethical issues for treatment.

CONCLUSION

In a survey of physicians focused on ethics in aesthetic medicine, most strongly agreed with key ethical principles in aesthetic medicine; however, more formal education/training was required to highlight the importance of patient autonomy and self-determination principles, involving patients in decisions, focusing on the patient's best interest, hearing/respecting patient opinion, avoiding procedures on those with unrealistic expectations, communicating all treatment aspects to patients, letting patients decide who to involve in consultations, and understanding the negative impact of social media on patients.

Cosmetic gatekeepers: Negotiations of beauty and (re)shaping bodies by medical aesthetic practitioners

Aesthetic practitioners who administer (non-)surgical medical cosmetic procedures play a central, and growing, role in the (re)shaping of predominantly women's bodies. This article focuses on how these practitioners negotiate their role as cosmetic gatekeepers - those with the medical and sociocultural skills, knowledge and tools - in (re)shaping the bodies of their client-patients. Adopting a reflexive thematic analysis of interviews conducted with aesthetic practitioners in the UK and the Netherlands, we identify three main themes. The first theme, conceptualizing beauty, describes the different ways in which aesthetic practitioners describe and negotiate the concept of 'beauty', including discussions of beauty as both subjective and objective. The second theme, shaping bodies, explores how practitioners consider why and how they (do not) suggest aesthetic procedures and how they (do not) see themselves as significant shapers of bodies and beauty. Finally, the theme of cosmetic gatekeepers examines the ways in which aesthetic practitioners provide boundaries in terms of how, when, why and on whom they (do not) perform procedures. Inherent to these discussions are constructions of the (non-)surgical 'other' and tensions between commercialism and 'medico-cosmetic' considerations that must be navigated by aesthetic practitioners. This article furthers explorations of how certain aesthetic appearances are (re)produced as desirable in increasingly expansive, diversified and normalized (non-)surgical cosmetic servicescapes.

The Primacy of Ethics in Aesthetic Medicine: A Review

Background

The landscape of modern aesthetic medicine has witnessed a paradigm shift from traditional doctor-led care to a consumer-driven model, presenting a plethora of ethical challenges. This review discusses the ethical dimensions of medical aesthetics, exploring the implications of consumer demand, societal influences, and technological advancements on patient care and well-being.

Methods

Drawing upon a comprehensive analysis of existing literature, this review synthesizes evidence regarding the rise of aesthetic medicine, ethical challenges encountered in practice, and the implications of social media and marketing in shaping patient perceptions and decision-making.

Results

Aesthetic medicine confronts unique ethical challenges stemming from its elective nature and the pervasive influence of societal beauty standards. Concerns include the commodification of beauty, conflicts of interest, limited evidence-base of treatments, and the rise of nonphysician providers. Moreover, the evolving role of social media influencers and medical marketing raises ethical dilemmas regarding transparency, patient autonomy, and professional integrity.

Conclusions

The ethical landscape of aesthetic medicine necessitates a proactive approach to address emerging challenges and safeguard patient well-being. Guided by principles of autonomy, beneficence, nonmaleficence, and justice, recommendations are proposed to enhance informed consent practices, mitigate appearance anxiety, facilitate shared decision-making, and promote responsible use of social media. Professional societies are urged to establish clear ethical guidelines and standards to uphold professionalism and patient trust in the field of aesthetic medicine.