Regulating Cosmetic Procedures and Operations in the Public and Private Sectors
Health Minister Dr. Ahmed Al-Awadi issued Ministerial Decision No. (232) of 2026 regarding the amendment of the requirements and conditions to be met for cosmetic procedures in the public and private sectors. The decision establishes a comprehensive regulatory framework that defines the medical specialties authorized to perform cosmetic interventions and surgeries, the levels of physicians permitted to practice them, as well as the controls governing liposuction, laser use, patient psychological evaluation, and the mechanism for handling complications arising from cosmetic procedures.
The decision, published by Al-Anbaa, defines cosmetic interventions and procedures as surgeries and interventions aimed at improving the human body’s shape or form based on the individual’s desire and request, in accordance with established medical principles, their latest developments, and professional ethics and conduct.
The decision approved lists of cosmetic procedures for specialties including plastic surgery, dermatology, ophthalmology, otolaryngology (ENT), general surgery, obstetrics and gynecology, oral and maxillofacial surgery, vascular surgery, and gynecology. These procedures are to be performed in both the public and private sectors in accordance with specified requirements and controls.
The decision restricted the performance of cosmetic interventions and procedures to physicians at the level of specialist, senior specialist, or consultant, who hold a Board certification or its equivalent, or who are under their supervision.
Furthermore, the decision authorized plastic surgery specialists to perform various cosmetic procedures, including neurotoxin injections, filler injections, thread lifts, and simple superficial female cosmetic procedures such as exfoliation, whitening, microdermabrasion, chemical peels, intense pulsed light (IPL) therapy, laser treatments, hair transplantation, removal of skin lesions, and all types of platelet-rich plasma (PRP) therapy.
Permitted procedures also included all types of abdominoplasty, liposuction, breast augmentation or reduction, free fat injection, facial implants, rhinoplasty, vaginoplasty, labiaplasty, vulvectomy, minor labia plasty (nymphoplasty), facelift, blepharoplasty (including double eyelid surgery), and surgical brow lift.
Dermatology
The decision authorized dermatologists to administer subcutaneous neurotoxin injections to treat palmar, plantar, and axillary hyperhidrosis, as well as neurotoxin injections for cosmetic purposes. They are also permitted to perform dermal filler injections, biostimulatory agents, mesotherapy injections, skin boosters, PRP therapy, and laser and other energy-based devices for the skin. Procedures also include dermasanding, chemical peels, laser skin resurfacing, and Subcision/Skin Punch procedures for scar revision.
Ophthalmology
The decision authorized ophthalmologists to perform simple eyelid surgeries and correct eyelid disorders such as ptosis, congenital deformities, entropion, ectropion, eyelid retraction, and lagophthalmos. They are also permitted to administer neurotoxin injections in the periorbital area, dermal filler injections around the eyes, periorbital ablative laser treatments, non-surgical thread brow lifts, and direct brow lifts.
Otolaryngology
The decision specified that the cosmetic procedures permitted for otolaryngologists are restricted to the head and neck regions only. These include neurotoxin injections, filler injections with a maximum volume of 50 cubic centimeters, thread lifts, intense pulsed light (IPL) therapy, and laser treatments.
The decision allowed general surgeons to perform mastectomies without liposuction or breast lifts, minor abdominoplasty without liposuction, and repair or plication of rectus diastasis.
It also permitted obstetrician-gynecologists to use laser or radiofrequency for vaginal tightening, and ablative laser for vulvar lesions.
**Facial, Oral, and Maxillofacial Surgery**
The decision also allowed facial, oral, and maxillofacial surgeons to administer neurotoxin injections exclusively to the face, inject facial fillers up to a maximum volume of 50 cubic centimeters, perform submentoplasty, manage soft tissues of the nose during orthognathic surgery without osteotomy, and place facial implants.
**A Second Category Requiring Additional Training and Expertise**
The decision defined another category of cosmetic interventions and procedures, restricting them to physicians in specific specialties at the level of specialist, senior specialist, or consultant holding a Board certification or its equivalent. These physicians must have completed an accredited fellowship training of no less than 12 months of in-person attendance, according to the specialty approved by the department councils of each hospital.
The decision also authorized these procedures for Board-certified physicians with at least five years of experience in performing cosmetic surgeries according to their specialty, subject to approval by the relevant department council.
**Advanced Procedures for Dermatologists**
These include dermabrasion, hair transplantation, rhinophyma reconstruction, non-surgical eyelid surgery, cryotherapy for skin, surgical and non-surgical treatment of hypopigmentation disorders, scar treatment including excision and revision surgery, thread facelifts and neck lifts, repair or reconstruction of earlobe perforations, keloid excision with repair using flaps or grafts, and submental liposuction up to a maximum volume of 50 cubic centimeters.
**Advanced Procedures for Otolaryngologists**
These include surgical rhinoplasty, otoplasty/pinnaplasty, facial reconstruction, facial flaps and grafts, facial and neck skin flaps and grafts, revision and treatment of facial and neck scars, facelifts, facial implants, and submental liposuction up to a maximum volume of 50 cubic centimeters.
**Advanced Procedures for Ophthalmologists**
These include all types of eyelid surgeries and canthopexy, all types of flaps and grafts around the eye and face, various augmentation, rejuvenation, and eyelid and eyebrow reconstruction procedures, mid-face lifting, and injections including neurotoxins, dermal fillers, fat injections, fat transfer, and fat injection in the orbital area.
They also include energy-based devices for skin tightening and resurfacing in the periorbital area, ablative laser around the eye, and eyebrow and eyelash hair transplantation.
**Advanced Procedures for Obstetrician-Gynecologists**
The decision authorized vaginoplasty, labiaplasty, vulvectomy, and nymphoplasty.
It also permitted breast reconstruction and oncologic surgeons to perform oncoplastic breast reconstruction associated with cancer surgeries.
The permitted advanced procedures also include facelifts, submental liposuction up to a maximum volume of 50 cubic centimeters, free fat injection to the face up to a maximum volume of 50 cubic centimeters, eyebrow lifts, reconstructive eyelid surgeries, and canthopexy.
The decision also allowed vascular surgeons to use laser and sclerotherapy for the treatment of varicose veins and spider veins.
The decree sets out a detailed set of requirements for performing liposuction procedures. Foremost among these is the stipulation that the physician performing the procedure must have received adequate training and possess the necessary experience to carry out the surgery and manage its potential complications, in accordance with the conditions, controls, and standards established by the Ministry of Health.
The decree mandates that the physician fully explain the procedural steps to the patient, clarify potential complications, and obtain informed consent prior to the surgery. It also requires a prior assessment of the patient’s condition by an anesthesiologist, with the evaluation documented in the patient’s medical record.
Liposuction is permitted in same-day surgery centers, provided that the total volume of aspirated fat does not exceed five liters. Additionally, the decree requires the presence of at least one nurse to assist the physician during each liposuction procedure.
The decree specifies that the amount of fat removed should be measured based solely on the total volume of pure fat aspirated. It further stipulates that the volume of supernatant (the non-fat liquid component) must not exceed 8% of the patient’s body weight without clothing. If the aspirated volume exceeds five liters in a single procedure, regardless of the number of treated areas, the patient’s gender, or body size, the patient must be admitted to the hospital for a minimum stay of 24 hours. If the procedure is performed in a same-day surgery center and the patient requires staying at the healthcare facility for more than 23 hours, they must be transferred to a hospital.
The decree emphasizes that liposuction procedures are not considered weight-loss surgeries.
It also obligates the documentation of specific data in the patient’s medical record, including the patient’s pre-operative weight and height, Body Mass Index (BMI), the volume of extracted fluids and fat, the body area treated, the surgical or interventional technique used, the extent of intraoperative or external ultrasound use if applicable, and any complications encountered during the procedure, if any.
Furthermore, the decree requires retaining pre-operative and post-operative follow-up photographs of the patient, along with their weight and BMI.
The decree permits nursing staff to perform laser procedures under specific controls. These include the nurse obtaining a license from the Radiation Protection Administration to use the laser device, completing an accredited training course, and obtaining a training certificate. Such procedures must be conducted under the supervision of a specialist physician at the level of specialist, senior specialist, or consultant, who must also hold a license from the Radiation Protection Administration.
The decree mandates that the attending physician examine the patient before each laser session, adjust the device parameters according to the patient’s condition, and document the evaluation and informed consent in the patient’s medical record.
Psychological Assessment Prior to Cosmetic Procedures
The decree obligates physicians, before performing any cosmetic surgery on a patient with existing medical conditions or psychological disorders, to obtain an accredited psychiatric report issued by a senior registrar or higher in psychiatry. This report must confirm the patient’s psychological suitability and stability for undergoing cosmetic surgical intervention.
The decree identifies a range of psychological disorders that necessitate such an assessment, including Body Dysmorphic Disorder, Schizophrenia, Major Depression, Eating Disorders, Borderline Personality Disorder, and any other psychological condition that may impair the patient’s ability to make sound medical decisions.
The psychological report must be issued by a senior registrar in psychiatry or higher, licensed and accredited by the Ministry of Health, and must include a comprehensive evaluation of the patient’s mental state, confirming the absence of psychiatric symptoms that would contraindicate the cosmetic procedure.
The report must also demonstrate the patient’s capacity to make an informed decision, assess the feasibility of administering anesthesia and its potential impact on the patient’s condition or interactions with their psychiatric medications, and include specific precautions or requirements for follow-up care. The decision stipulates that the validity of the psychological report shall not exceed three months from the scheduled date of the procedure.
It also establishes a clear mechanism for managing complications arising from cosmetic procedures in the public sector. According to the decision, the patient’s admission to the healthcare facility is under the jurisdiction of the department or specialty that performed the procedure. The physician who performed the procedure bears professional responsibility for conducting further examinations and treating any complications.
Additionally, an interim medical report (Medical Incident Report) must be prepared for the patient and submitted, in accordance with applicable systems and regulations, to the Complications and Mortality Committee.
Mechanism for Managing Complications in the Private Sector
In the event that a patient suffers complications resulting from cosmetic procedures in the private sector, the decision stipulates that the patient be admitted to the private hospital or specialized center where the procedure was performed. The physician who performed the procedure bears professional responsibility for conducting further examinations and treating complications.
A medical report and an interim medical report (Medical Incident Report) must be prepared for the patient and submitted to the Medical Licensing Authority.
If the patient seeks treatment at a public hospital, they will be managed in accordance with prevailing systems and regulations. In such cases, treatment will be provided by physicians from the same specialty that performed the procedure in the private sector.
The final article of the decision stipulates that it shall be communicated to all relevant parties for implementation, take effect from the date of its issuance, be published in the Official Gazette, and repeal any previous decisions or provisions that conflict with its terms.
