Resumen

Objectives: To evaluate ethical knowledge, informed consent practices, and procedural training among licensed non-surgical aesthetic providers in the United States and United Kingdom/Europe, and to identify gaps impacting patient safety and ethical decision-making. Introduction: Ethical practice is a cornerstone of patient safety in aesthetic medicine, yet formal ethics training and standardized informed consent protocols remain inconsistent. As non-surgical procedures such as fillers, neuromodulators, and energy-based treatments expand in popularity, variability in ethical literacy, risk disclosure, and procedural competency raises concerns regarding patient protection and professional standards. Materials / method: Medscape hosted and distributed a cross-sectional, multi-regional survey on ethics in aesthetic medicine to inform future content development. We analysed data from 317 respondents (U.S.: 165; UK/EU: 152) who were licensed non-surgical aesthetic providers routinely using non-surgical treatments. We assessed ethics education, knowledge of the four core principles, informed consent practices, duration of filler/device training and barriers to declining patient-requested procedures. Descriptive statistics and chi-square tests were used to summarize and compare responses by region. Results: 58% of respondents had attended ≥1 ethics training, but <50% correctly identified all four core principles of ethics. Written informed consent was consistently obtained by 72% of providers, but disclosure of rare, severe filler risks was inconsistent. Nearly 20% reported performing filler injections or energy-based procedures without formal training; only 1/3 received >1 month of preparation. Barriers to declining inappropriate procedures included fear of reputational harm (59%), patient harassment (50%), and financial loss (46%), reflecting the market-driven pressures of aesthetic medicine. Conclusion: This multi-regional survey highlights critical gaps in ethics education, risk communication, and procedural training among non-surgical aesthetic providers. Most clinicians obtained written consent and communicated expected outcomes to patients, but rare but severe complications were under disclosed. Ethical decision-making was influenced by patient and commercial pressures. To enhance patient safety and professional credibility, we recommend standardized ethics curricula, competency-based procedural training, and comprehensive consent protocols that address both common and catastrophic risks.