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khaledian Z, tajvar M. The necessity of policy making for cosmetic surgery in the Iran's health system. jha 2025; 27 (1) :1-4
URL: http://jha.iums.ac.ir/article-1-4426-en.html
URL: http://jha.iums.ac.ir/article-1-4426-en.html
1- Department of Health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran
2- Department of Health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran ,mtajvar@sina.tums.ac.ir
2- Department of Health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran ,
Abstract: (18 Views)
Dear Editor,
In today's societies, influenced by sociocultural developments such as advertisements, social media, competitive culture, and consumerism, people pay more attention to their bodies and adopt various behaviors to manage them, including cosmetic surgery [1]. Cosmetic surgeries are voluntary interventions performed in the absence of congenital abnormalities or specific diseases, aimed at changing physical appearance and enhancing beauty and elegance [2]. More than 14.9 million cosmetic surgeries were performed worldwide in 2022. Over the past three years, this rate has increased by 25% for procedures related to the body (such as liposuction, abdominoplasty, and arm and lower body lifts), by 18% and 15% for breast and facial surgeries, respectively [3]. This trend has risen in Iran over the last decade, positioning the country among the highest-ranking nations for cosmetic surgery, and second in the Middle East. For example, the demands for the most common cosmetic surgery, rhinoplasty, in Iran is seven times higher than that in the United States [2]. Several factors contribute to the increasing demand for cosmetic surgery. Dissatisfaction with body image, low self-confidence, the need for social approval, visibility, and more favorable social relations serve as individual causes, while external factors such as media influence, celebrities, families, and friends also contribute. Some structural and social factors, such as transition from traditionalism to modernity, the growth of cosmetic surgery centers, the acceptability of social networks, a booming economic market, extensive advertising, the medicalization of beauty, and the policy of abandoning the medical community by the Ministry of Health, are leading causes. Women's desire for beauty interventions is greater than men, which is somehow related to social pressures to achieve physical ideals and sexual attractiveness [1, 4]. Cosmetic surgery can improve mental health; however, it can also have unpleasant consequences for clients’ health and impose financial burden on health system. Cosmetic procedures are often expensive and typically not covered by insurance, leading to financial burdens, inequalities in access, and even catastrophic costs [1, 3]. These surgeries induce an additional burden on the health system due to the increasing demand for resources, such as staff and equipment [5]. Cosmetic surgery is not officially recognized as part of the Iranian public health system. Consequently, in some hospitals, financial considerations resulted in the use of alternative surgical codes. Unfortunately, this practice results in longer wait times for essential services, pushes applicants toward private centers, and exposes patients to substandard care from uncertified specialists. Ultimately, this situation increases the risk of errors, complications, and the need for subsequent hospitalizations and reconstructive procedures [4, 5]. The management of cosmetic surgeries take into consideration globally due to high revenue generation, its association with the fashion and advertising industries, induced demand, and the social and health consequences associated with these procedures. However, there is currently no documented policy or legislation in this field in Iran, making it necessary to establish an agenda. For effective management of cosmetic surgeries within the health system, it is essential to emphasize proper governance, collect and integrate relevant information into the health information systems, conduct necessary research projects, develop strategies to improve realistic beauty standards, ensure access to surgery and reduce the pressure on healthcare resources through the participation of all stakeholders.
The following evidence-based strategies are recommended to minimize complications, improve patient outcomes, and maintain safety standards in the field of cosmetic surgery. These strategies include:
Ethical considerations: None
Funding: None
Conflicts of interests: The authors declare that there is no conflict of interest.
Authors’ contributions: M.T: Conceptualization, Study design, Writing– review & editing, final approval. Z.K: data collection, Writing– original draft, Writing– review & editing
Consent for publication: None
Data availability: None
AI deceleration: None
Acknowledgements: None
In today's societies, influenced by sociocultural developments such as advertisements, social media, competitive culture, and consumerism, people pay more attention to their bodies and adopt various behaviors to manage them, including cosmetic surgery [1]. Cosmetic surgeries are voluntary interventions performed in the absence of congenital abnormalities or specific diseases, aimed at changing physical appearance and enhancing beauty and elegance [2]. More than 14.9 million cosmetic surgeries were performed worldwide in 2022. Over the past three years, this rate has increased by 25% for procedures related to the body (such as liposuction, abdominoplasty, and arm and lower body lifts), by 18% and 15% for breast and facial surgeries, respectively [3]. This trend has risen in Iran over the last decade, positioning the country among the highest-ranking nations for cosmetic surgery, and second in the Middle East. For example, the demands for the most common cosmetic surgery, rhinoplasty, in Iran is seven times higher than that in the United States [2]. Several factors contribute to the increasing demand for cosmetic surgery. Dissatisfaction with body image, low self-confidence, the need for social approval, visibility, and more favorable social relations serve as individual causes, while external factors such as media influence, celebrities, families, and friends also contribute. Some structural and social factors, such as transition from traditionalism to modernity, the growth of cosmetic surgery centers, the acceptability of social networks, a booming economic market, extensive advertising, the medicalization of beauty, and the policy of abandoning the medical community by the Ministry of Health, are leading causes. Women's desire for beauty interventions is greater than men, which is somehow related to social pressures to achieve physical ideals and sexual attractiveness [1, 4]. Cosmetic surgery can improve mental health; however, it can also have unpleasant consequences for clients’ health and impose financial burden on health system. Cosmetic procedures are often expensive and typically not covered by insurance, leading to financial burdens, inequalities in access, and even catastrophic costs [1, 3]. These surgeries induce an additional burden on the health system due to the increasing demand for resources, such as staff and equipment [5]. Cosmetic surgery is not officially recognized as part of the Iranian public health system. Consequently, in some hospitals, financial considerations resulted in the use of alternative surgical codes. Unfortunately, this practice results in longer wait times for essential services, pushes applicants toward private centers, and exposes patients to substandard care from uncertified specialists. Ultimately, this situation increases the risk of errors, complications, and the need for subsequent hospitalizations and reconstructive procedures [4, 5]. The management of cosmetic surgeries take into consideration globally due to high revenue generation, its association with the fashion and advertising industries, induced demand, and the social and health consequences associated with these procedures. However, there is currently no documented policy or legislation in this field in Iran, making it necessary to establish an agenda. For effective management of cosmetic surgeries within the health system, it is essential to emphasize proper governance, collect and integrate relevant information into the health information systems, conduct necessary research projects, develop strategies to improve realistic beauty standards, ensure access to surgery and reduce the pressure on healthcare resources through the participation of all stakeholders.
The following evidence-based strategies are recommended to minimize complications, improve patient outcomes, and maintain safety standards in the field of cosmetic surgery. These strategies include:
- Demand management: Improving community health literacy to inform potential patients about risks, benefits, and alternatives as well as providing psychological counseling for applicants to manage expectations and address underlying motivations.
- Access improvement: Designing financial assistance opportunities to ensure access to safe surgery for eligible individuals and providing insurance coverage options for cosmetic procedures.
- Human resources and training: Providing in-service training for healthcare professionals in new, low-complication techniques, and issuing professional qualification certificates for surgical operators.
- Resource optimization: Optimizing the allocation of health resources to reduce pressure, and applying clinical guidelines to standardize care.
- Safety measures: Ensuring patient safety through organized regulatory rules and processes, establishing reporting mechanisms for side effects, developing accreditation programs for surgical facilities based on quality management requirements, and preparing an optimal supply of equipment.
Ethical considerations: None
Funding: None
Conflicts of interests: The authors declare that there is no conflict of interest.
Authors’ contributions: M.T: Conceptualization, Study design, Writing– review & editing, final approval. Z.K: data collection, Writing– original draft, Writing– review & editing
Consent for publication: None
Data availability: None
AI deceleration: None
Acknowledgements: None
Type of Study: Letter to Editor |
Subject:
Health Services Management
Received: 2023/03/31 | Accepted: 2024/06/19 | Published: 2024/12/18
Received: 2023/03/31 | Accepted: 2024/06/19 | Published: 2024/12/18
References
1. bbasi Asfajir AA, Ghasemi M. A study on the socio-cultural factors affecting women's cosmetic surgery (A case study of women in Noor city). Sociological Studies of Youth.2017; 7(25): 9-26. [In Persian] Available from: http://sanad.iau.ir/fa/Journal/ssyj/Article/977093
2. Ghorbani A, Piroozi B, Safari H, Shokri A, Aqaei A, Yousefi F, et al. Prevalence of elective cosmetic surgery and its relationship with socioeconomic and mental health: A cross-sectional study in west of Iran. Health Science Reports .2022; 5(6):e872. doi: 10.1002/hsr2.872 [DOI:10.1002/hsr2.872]
3. Procedural Statistics Release [Internet]. The American Society of Plastic Surgeons; 2022. [Cited 2023 Sep 26]. Available from: https://www.plasticsurgery.org/news/plastic-surgery-statistics.
4. Tajvar M, Pourfarokh P, Bahmanziari N, Jaafaripooyan E, Nazari M, Sajadi H S. Management of cosmetic surgery in Iran: challenges and solutions. Tehran University Medical Journal. 2023; 81 (1):38-48. [ In Persian] Available from: http://tumj.tums.ac.ir/article-1-12330-fa.html
5. Khunger N. Complications in Cosmetic Surgery: A Time to reflect and review and not Sweep them under the Carpet. J Cutan Aesthet Surg. 2015; 8(4):189-90. doi:10.4103/0974-2077.172188 [DOI:10.4103/0974-2077.172188]
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