General Practitioners Cannot Make Aesthetic Procedures!

    New Disposition of the College of Physicians and Surgeons of Costa Rica (CMC)

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    Abelardo Canelo
    I am not only a fluent Spanish-English reader/speaker but also a bi-cultural person who has a broad solid background. I also have a passionate interest in different expressions of music, especially many American styles and their combinations (Folk-Country, Jazz, Pop, Rhythm and Blues, Rock, Soul, and so on), dance, stage and screen, and some other forms of artistic expression.

    On February 21st, 2019, was published in the Official Journal the Professional Profile of the Specialist in Plastic Reconstructive and Aesthetic Surgery. This new provision of the College of Physicians and Surgeons of Costa Rica (CMC) makes it impossible for general practitioners to perform invasive procedures such as aesthetics.

    Article 68:

    “Apply your knowledge and skills in the following aspects of Facial Aesthetic Surgery: facial rhytidectomy, frontal and neck lifting, secondary lifting, surgical application and injection of facial implants that are approved by the Ministry of Health for that purpose, video endoscopy facial, open and endoscopic frontoplasty, blepharoplasty, neckplasty, assessment, diagnosis, and surgical medical treatment of complications resulting from the acts described above”.

    Marking the lines where a facial aesthetic procedure is to be done

    Likewise, it defines the scope, responsibilities, and procedures that must be carried out by health professionals. For example, the specialist in Plastic, Reconstructive, and Aesthetic Surgery must be duly authorized by the CMC and demonstrate the “use of cognitive, technical, socio-affective, communicative, and leadership skills within the different sectors in which it belongs to perform health, research, education, business, and social welfare”, says the profile.

    According to Article 48, they must apply their knowledge and skills in assessment, diagnosis, Z-plasty techniques and W-plasty, tissue tearing, and shock treatment.

    According to the new profile, only plastic surgeons or specialists whose program of studies contemplates learning in these techniques are authorized for these and other plastic surgeries:

    • Mamas
    • Skin, cartilage and bone grafts
    • Burns
    • Microsurgery: reimplantation of different limbs and areas, peripheral nerve microsurgery, treatment of facial paralysis, autografts of bone and skin, hand amputations, digital reconstruction, reimplantation of fingers and hand.
    • Skull and maxillofacial: diagnosis and treatment of head and neck tumors, congenital malformations, fractures of facial bones, facial fissures and chin implant.
    • Cleft lip and palate: assessment, diagnosis and treatment; palatal closure technique, bone graft, and correction of the lip and nose.
    • Facial trauma: fractures of the jaw, maxilla, arch, and nose.
    • Trimming and profiling of ears
    • Eyelid: aesthetic correction of the upper and lower eyelid, palpebral bags, eyebrows, suspensions and laparoscopic surgery of the forehead or eyebrows.
    • Nose: rhinoplasty, partial or total reconstruction of the nose, nasal prosthesis.
    • Lips: partial or total lip reconstruction.
    • External and internal genitalia: vaginal reconstruction, male external genitalia.
    • Implantation materials: non-liquid preformed silicone or in metal pearls.
    • Facial aesthetics: front and neck lifting, secondary lifting, injection of facial implants, frontoplasty, and neckplasty.
    • Body contour: dermolipectomy, navel reconstruction, muscular wall reconstruction, liposuction, liposculpture, and fat grafting.
    • Buttocks: gluteal augmentation mediating lipoinjection and implants, and gluteal correction.
    • Hair: hair graft, reconstruction of the scalp, transplant of eyebrows and eyelashes.
    • Vaginal: rejuvenation of the vagina.

    In this sense, general practitioners cannot do these procedures or are subject to sanctions, which are established in the Code of Medical Ethics and Regulations, ranging from a suspension of the exercise of the profession up to 120 days and a financial fine of ₵ 200.

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