Standards › ASF Health Standards v10 › Standard 32
Standard 32
Aesthetic and Cosmetic Procedures (non-surgical only)
Aesthetic and cosmetic procedures (non-surgical): qualification, realistic consent, pre-procedure assessment, sedation safety, advertising and follow-up..
Each criterion is shown in three settings: Humanitarian settings, Transition and fragile, and Standard. In standard settings, every criterion is Must.
Training colours: red means essential, green recommended, yellow optional. Each course shows its level for each setting: humanitarian, transition and fragile, and standard.
32.1Practitioners Are Qualified for Each Procedure They PerformHumanitarian settings: MinimumTransition and fragile: MustStandard: Must
Each practitioner holds the qualification and training for each specific procedure they perform, verified with the issuing body. A general medical licence is not sufficient on its own.
Why it matters. Each practitioner must hold the qualification and training for the specific procedure they perform, not only a general licence. This is what keeps each procedure in the right hands.
How the surveyor verifies this criterion
Sample. Review the qualification and competence records for all practitioners who performed procedures in the last 12 months.
1. Procedures outside a practitioner’s scope are not performed.
Method. Check each procedure against the scope recorded for the practitioner.
Evidence to show. Scope of practice and competence (AES-POL-001).
Pass when. No procedure falls outside the recorded scope.
Immediate fail (any one means the criterion is not met). A practitioner injecting dermal fillers with no training in the technique.
Staff responsible
| Role | Responsibility | Level |
|---|---|---|
| Manager (ISCO 1342) | Maintains the Scope of practice and competence | Must |
| Manager (ISCO 1342) | Checks the criterion at each review | Must |
Documents: who does each step
| Document | Writes | Approves | Fills in | Checks and signs | Files and uploads |
|---|---|---|---|---|---|
| AES-POL-001 · Scope of practice and competence | Chief executive (ISCO 1120) | Governing body members | N/A | Chief executive (ISCO 1120) | Secretary (ISCO 3344) |
E-learning: who must take each course
| Course | Who must take it |
|---|---|
| Credentialing, Competence and the Training Matrix (T-14) | Manager; Nurse |
References
In process of development. Will be available soon.
32.2Consent Reflects Realistic Outcomes and Allows Time to ReconsiderHumanitarian settings: MinimumTransition and fragile: MustStandard: Must
For elective procedures, the patient receives realistic information about expected results, risks, complications and alternatives, and has a defined period to reconsider before the procedure.
Why it matters. For elective procedures there is time to decide. The patient should receive realistic information about the outcome, and time to reconsider before committing.
How the surveyor verifies this criterion
Sample. Review 20 consent records for aesthetic procedures in the last 3 months, with the reconsideration periods recorded.
1. The consent states realistic outcomes, including that results vary and may not be permanent.
Method. Check each consent for the outcome statement.
Evidence to show. Aesthetic procedure consent and reconsideration record (AES-FRM-001).
Pass when. Every consent states realistic outcomes.
2. The patient is given time to reconsider before the procedure.
Method. Check the period between consent and procedure for each sampled case.
Evidence to show. Consent, realistic outcomes and reconsideration (AES-SOP-001).
Pass when. Every sampled case has the reconsideration period recorded and kept before treatment.
Immediate fail (any one means the criterion is not met). A patient consented in the chair and treated the same day after one conversation.
Staff responsible
| Role | Responsibility | Level |
|---|---|---|
| Nurse (ISCO 2221) | Completes the Aesthetic procedure consent and reconsideration record | Must |
| Manager (ISCO 1342) | Maintains the Consent and realistic outcomes | Must |
Documents: who does each step
| Document | Writes | Approves | Fills in | Checks and signs | Files and uploads |
|---|---|---|---|---|---|
| AES-SOP-001 · Consent, realistic outcomes and reconsideration | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Secretary (ISCO 3344) |
| AES-FRM-001 · Aesthetic procedure consent and reconsideration record | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Secretary (ISCO 3344) | Manager (ISCO 1342) | Secretary (ISCO 3344) |
E-learning: who must take each course
| Course | Who must take it |
|---|---|
| Patient Rights and Responsibilities (A-01) | Manager; Nurse |
References
In process of development. Will be available soon.
32.3Pre-Procedure Assessment Identifies ContraindicationsHumanitarian settings: MinimumTransition and fragile: MediumStandard: Must
Each patient is assessed before the procedure for medical history, current medicines (including anticoagulants and supplements), pregnancy, allergies and conditions that make the procedure unsafe.
Why it matters. Before a procedure, the centre must check the patient’s history, medicines and conditions that would make the procedure unsafe. Identifying them in advance prevents harm that is otherwise discovered on the table.
How the surveyor verifies this criterion
Sample. Review 20 pre-procedure assessment records and the contraindication checks recorded in them.
1. A documented assessment is completed before each procedure.
Method. Check each record for an assessment dated before the procedure.
Evidence to show. Pre-procedure assessment and contraindications (AES-SOP-002).
Pass when. Every sampled procedure has an assessment before it starts.
2. Contraindications are checked and recorded, including pregnancy, medicines and allergies.
Method. Check each assessment for each listed contraindication.
Evidence to show. Pre-procedure assessment record (AES-FRM-002).
Pass when. Every assessment checks each contraindication.
3. A contraindication found is resolved, or the procedure is not done.
Method. Check each recorded contraindication for resolution or for the procedure not being done.
Evidence to show. Pre-procedure assessment record (AES-FRM-002).
Pass when. No procedure goes ahead with an unresolved contraindication.
Immediate fail (any one means the criterion is not met). A procedure performed on a pregnant patient whose pregnancy was not recorded.
Staff responsible
| Role | Responsibility | Level |
|---|---|---|
| Manager (ISCO 1342) | Maintains the Pre-procedure assessment and contraindications | Medium |
| Nurse (ISCO 2221) | Completes the Pre-procedure assessment record | Medium |
Documents: who does each step
| Document | Writes | Approves | Fills in | Checks and signs | Files and uploads |
|---|---|---|---|---|---|
| AES-SOP-002 · Pre-procedure assessment and contraindications | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Secretary (ISCO 3344) |
| AES-FRM-002 · Pre-procedure assessment record | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Secretary (ISCO 3344) | Manager (ISCO 1342) | Secretary (ISCO 3344) |
E-learning: who must take each course
| Course | Who must take it |
|---|---|
| Care & Treatment: Twelve Clinical Criteria for Safe Ambulatory Practice (AMB-04) | Manager; Nurse |
References
- World Health Organization (2021). Global Patient Safety Action Plan 2021–2030: Towards Eliminating Avoidable Harm in Health Care. Geneva: WHO. https://www.who.int/publications-detail-redirect/9789240032705 Used for: https://news.gmj.ge/guideline/global-patient-safety-action-plan-2021-2030-towards-eliminating-avoidable-harm-in-health-care/
32.4Sedation and Anaesthesia Are SafeHumanitarian settings: MinimumTransition and fragile: MustStandard: Must
Any sedation or anaesthesia is given by staff trained and credentialed for it, with monitoring and emergency equipment, and with a written agreement for transfer to a hospital if a complication occurs.
Why it matters. Sedation and anaesthesia in an aesthetic clinic can cause serious harm if the person giving it is not trained, or if the patient is not monitored. Credentialed staff and monitoring keep it safe.
How the surveyor verifies this criterion
Sample. Review the sedation and anaesthesia records for 10 procedures, with their monitoring and equipment checks.
1. Sedation and anaesthesia are given only by competent clinicians in an equipped setting.
Method. Check each record for the clinician’s competence and the equipment check.
Evidence to show. Sedation and anaesthesia safety (AES-SOP-003).
Pass when. Every sampled case has a competent clinician and checked equipment.
2. Monitoring is continuous and recorded through recovery.
Method. Check each record for continuous monitoring entries to discharge.
Evidence to show. Sedation and anaesthesia monitoring record (AES-FRM-003).
Pass when. Every record is continuous to discharge.
Immediate fail (any one means the criterion is not met). A sedated patient discharged with no monitoring and no means to resuscitate.
Staff responsible
| Role | Responsibility | Level |
|---|---|---|
| Manager (ISCO 1342) | Maintains the Sedation and anaesthesia safety | Must |
| Nurse (ISCO 2221) | Completes the Sedation and anaesthesia monitoring record | Must |
Documents: who does each step
| Document | Writes | Approves | Fills in | Checks and signs | Files and uploads |
|---|---|---|---|---|---|
| AES-SOP-003 · Sedation and anaesthesia safety | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Secretary (ISCO 3344) |
| AES-FRM-003 · Sedation and anaesthesia monitoring record | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Secretary (ISCO 3344) | Manager (ISCO 1342) | Secretary (ISCO 3344) |
E-learning: who must take each course
| Course | Who must take it |
|---|---|
| Aesthetic & Injectable Medicine Accreditation (AMB-09) | Manager; Nurse |
References
- WHO (2019). Anaesthesia at the district hospital. Used for: General anaesthesia and sedation safety at district level. Not aesthetic-specific. https://news.gmj.ge/guideline/anaesthesia-at-the-district-hospital/
32.5Advertising and Claims Are AccurateHumanitarian settings: MinimumTransition and fragile: MediumStandard: Must
Advertised results, prices and credentials are accurate. Before-and-after images are used only with written consent and without altering the result.
Why it matters. Aesthetic clinics often advertise results, prices and credentials that are not true. Before-and-after photos taken without the patient’s written permission are a privacy breach. Accurate claims protect the patient from being misled.
How the surveyor verifies this criterion
Sample. Review all advertising, website and social media claims for the last 6 months, and the claims review log.
1. Every claim is supported by evidence on file before publication.
Method. Check each sampled claim against the evidence file.
Evidence to show. Advertising and claims review (AES-POL-002).
Pass when. Every claim has evidence on file.
2. No before-and-after image or result is shown without consent and a typical-result statement.
Method. Check each image or result shown for consent and the typical-result statement.
Evidence to show. Advertising and claims review log (AES-REG-002).
Pass when. Every shown result has consent and a typical-result statement.
3. Prices and packages are shown accurately.
Method. Compare each published price against the current fee list.
Evidence to show. Advertising and claims review log (AES-REG-002).
Pass when. Every published price matches the fee list.
Immediate fail (any one means the criterion is not met). Advertising promising permanent results with no evidence on file.
Staff responsible
| Role | Responsibility | Level |
|---|---|---|
| Manager (ISCO 1342) | Maintains the Advertising and claims review | Medium |
| Secretary (ISCO 3344) | Keeps the Advertising and claims review log | Medium |
Documents: who does each step
| Document | Writes | Approves | Fills in | Checks and signs | Files and uploads |
|---|---|---|---|---|---|
| AES-REG-002 · Advertising and claims review log | Secretary (ISCO 3344) | Chief executive (ISCO 1120) | Secretary (ISCO 3344) | Manager (ISCO 1342) | Secretary (ISCO 3344) |
| AES-POL-002 · Advertising and claims review | Chief executive (ISCO 1120) | Governing body members | N/A | Chief executive (ISCO 1120) | Secretary (ISCO 3344) |
E-learning: who must take each course
| Course | Who must take it |
|---|---|
| Aesthetic & Injectable Medicine Accreditation (AMB-09) | Manager; Nurse |
References
- Cosmetic interventions and the CAP Code (Advertising Standards Authority and Committee of Advertising Practice, 2022)
32.6Follow-Up and Complications Are ManagedHumanitarian settings: MinimumTransition and fragile: MediumStandard: Must
Each patient has scheduled follow-up and a named contact for problems. Complications are managed through a pathway the patient was told about before the procedure.
Why it matters. Procedures can have complications days after the patient goes home. A scheduled follow-up and a named contact let the patient get help early.
How the surveyor verifies this criterion
Sample. Review follow-up and complication records for 10 procedures in the last 12 months.
1. Follow-up is arranged and attended, and missed follow-up is chased.
Method. Check each record for the follow-up date and attendance.
Evidence to show. Follow-up and complication management (AES-SOP-004).
Pass when. Every sampled procedure has follow-up arranged, and each missed one is chased.
2. Each complication is recorded, treated and reviewed.
Method. Check each complication record for treatment and review.
Evidence to show. Complication and follow-up record (AES-FRM-004).
Pass when. Every complication has treatment and review recorded.
3. Serious complications are referred and reported.
Method. Check each serious complication for referral and reporting.
Evidence to show. Follow-up and complication management (AES-SOP-004).
Pass when. Every serious complication has a referral and a report.
Immediate fail (any one means the criterion is not met). A vascular occlusion after filler not recognised or referred for hours.
Staff responsible
| Role | Responsibility | Level |
|---|---|---|
| Manager (ISCO 1342) | Maintains the Follow-up and complication management | Medium |
| Nurse (ISCO 2221) | Completes the Complication and follow-up record | Medium |
Documents: who does each step
| Document | Writes | Approves | Fills in | Checks and signs | Files and uploads |
|---|---|---|---|---|---|
| AES-SOP-004 · Follow-up and complication management | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Secretary (ISCO 3344) |
| AES-FRM-004 · Complication and follow-up record | Manager (ISCO 1342) | Chief executive (ISCO 1120) | Secretary (ISCO 3344) | Manager (ISCO 1342) | Secretary (ISCO 3344) |
E-learning: who must take each course
| Course | Who must take it |
|---|---|
| Aesthetic & Injectable Medicine Accreditation (AMB-09) | Manager; Nurse |
References
- World Health Organization (2021). Global Patient Safety Action Plan 2021–2030: Towards Eliminating Avoidable Harm in Health Care. Geneva: WHO. https://www.who.int/publications-detail-redirect/9789240032705 Used for: https://news.gmj.ge/guideline/global-patient-safety-action-plan-2021-2030-towards-eliminating-avoidable-harm-in-health-care/
Who is responsible for Standard 32
Each criterion names the positions responsible for it. Every position links to its own terms of reference.
| Criterion | Responsible | Supports |
|---|---|---|
| 32.1 Practitioners Are Qualified for Each Procedure They Perform | Aesthetic clinic medical director Aesthetic physician (injectables) |
Nurse injector |
| 32.2 Consent Reflects Realistic Outcomes and Allows Time to Reconsider | Aesthetic physician (injectables) Consent and complication follow-up nurse |
Dermatologist (aesthetic lead) |
| 32.3 Pre-Procedure Assessment Identifies Contraindications | Aesthetic physician (injectables) Dermatologist (aesthetic lead) |
Nurse injector |
| 32.4 Sedation and Anaesthesia Are Safe | Aesthetic physician (injectables) Anaesthesiologist |
Cosmetic nurse practitioner |
| 32.5 Advertising and Claims Are Accurate | Aesthetic clinic manager Aesthetic clinic medical director |
Consultation coordinator |
| 32.6 Follow-Up and Complications Are Managed | Consent and complication follow-up nurse Aesthetic physician (injectables) |
Cosmetic nurse practitioner |
Role details: reporting, supervision and training
Training shown is the general recommendation. Role-specific training is set in the next improvement round.
Questions and answers
The criterion text is the authority. These answers summarise it.
Who does Standard 27 apply to?
Clinics and practitioners who offer non-surgical aesthetic and cosmetic procedures, such as injectables and laser treatments.
What do the colours mean for this standard?
Red (Must) is required. Green (Medium) is recommended. Yellow (Minimum) is the lowest acceptable level in humanitarian settings. Standard setting is Must on every criterion.
Can a practitioner perform a procedure they are not trained for?
No. Under 32.1 each practitioner holds the qualification and training for each specific procedure they perform, verified with the issuing body.
Must a patient have time to reconsider before a procedure?
Yes. Under 32.2 consent reflects realistic outcomes and allows time to reconsider, rather than being taken in the chair on the same day.
Can a sedated patient be discharged without monitoring?
No. Under 32.4 sedation and anaesthesia are safe, and a sedated patient discharged with no monitoring is an immediate fail.
Can advertising promise permanent results?
Under 32.5 advertising and claims are accurate, and a promise of permanent results with no evidence is an immediate fail.
Do I have to use the documents on this page?
No. The policies, SOPs, forms and registers are drafts to help you. Adapt them to your clinic, write your own, or upload your own. What the assessor checks is that the criterion is met and that you can show how.
What does In process of development mean?
That part of the standard is still being prepared. It may be a document, a course, a reference or a role table. It will be added in a later version.
Guidelines for this standard
6 guideline(s) are held in the GMJ Guidelines Library and listed here. Each link opens the full guideline on news.gmj.ge. The complete library, grouped by standard, is at Guidelines.
- Cosmetic Interventions and the CAP Code (ASA / CAP)
- International Survey on Aesthetic/Cosmetic Procedures Performed in 2024 (International Society of Aesthetic Plastic Surgery)
- Guidelines for medical practitioners who perform cosmetic surgery and procedures (Medical Board of Australia)
- EN 16372:2014 Aesthetic surgery services (European Committee for Standardization)
- EN 16844:2017+A2:2019 Aesthetic medicine services — Non-surgical medical treatments (European Committee for Standardization)
- JCCP and CPSA Code of Practice: Guidance for Practitioners Who Provide Cosmetic Interventions, 2nd edition (Joint Council for Cosmetic Practitioners / Cosmetic Practice Standards Authority (UK))
Also relevant to this standard:
- Guidelines for registered medical practitioners who advertise cosmetic surgery (Medical Board of Australia)
- Anaesthesia at the district hospital (World Health Organization)
- ASPS Statement on Cosmetic Tourism (Australian Society of Plastic Surgeons)