1. This document serves as guidelines on aesthetic practices for medical practitioners.

2. This document is based on:

• the Report of the Workgroup on Recommendations on the Regulation and

Training of Aesthetic Medicine in Singapore appointed by the Ministry of Health1;

• consultation and views of the two professional medical bodies - the College of

Family Physicians, Singapore and the Academy of Medicine, Singapore;

• consultation and views of the Society of Aesthetic Medicine, Singapore; and

• consultation and views of the Singapore Medical Council.

It contains aesthetic treatments and procedures that are currently regarded as having low / very low level of evidence and / or being neither well established nor acceptable. These are:

(a) Mesotherapy;

(b) Carboxytherapy;

(c) Microneedling dermaroller;

(d) Skin whitening injections;

(e) Stem cell activator protein for skin rejuvenation;

(f) Negative pressure procedures (e.g. Vacustyler); and

(g) Mechanised massage (eg. “slidestyler”, endermologie” for cellulite treatment).

16. There will be circumstances in which doctors may wish to practise such low-evidence procedures on patients. In general, these circumstances are:

(a) All other conventional and sound-evidence based treatments / procedures have

been attempted on the patient and have not been shown to produce the desired outcomes;

(b) The procedure has on the available evidence not been shown to carry any risk of significant adverse effects or harm to any patient;

(c) The patient is aware that the procedure is low-evidence in nature and only offered in view of the lack of efficacy of conventional and sound-evidence based treatments and gives specific consent to this, on a consent form.

17. Having satisfied all the above circumstances and documentations, it is still required of doctors to practise List B aesthetic procedures only under highly monitored conditions that enable the efficacy or lack thereof of such procedures to be objectively demonstrated. The

objectives, methodology, analysis and findings obtained through such treatments must be of sufficient scientific validity to establish efficacy or otherwise. In addition, patient response should be documented and retained, alongside all case records of such treatments.

18. In the event that the procedure yields adverse or neutral outcomes, the practice of the procedure(s) must be terminated.

19. The patients must not be charged highly profitable fees for such procedures of lowevidence, but a fair fee representing the cost of the procedures plus the cost of providing and administering them. Financial documents relating to these procedures must also be

retained for the purpose of audit when required.

20. It is important for a doctor to understand that the provisions of the SINGAPORE MEDICAL COUNCIL’s Ethical Code and Ethical Guidelines apply to all doctors who wish to practise List B aesthetic procedures. A doctor must continue to ensure that he / she practises in the best interests of

his / her patients and that any procedure is clinically justifiable if challenged.

21. No doctor shall advertise that he or she is performing aesthetic procedures in List 

22. Doctors who wish to perform List B aesthetic procedures should list themselves with the SINGAPORE MEDICAL COUNCIL’s AESTHETIC PRACTICE OVERSIGHT COMMITTEE using the prescribed List B and Other Aesthetic Procedures notification form (available on SINGAPORE MEDICAL COUNCIL’s website) before carrying out any List B aesthetic procedure. 

Doctors who perform List B aesthetic procedures will be subject to audit by the MOH. Proper documentation of the indications and outcomes of the treatments and procedures are therefore of utmost importance.

23. Doctors who are currently performing aesthetic procedures should note the respective classification of their procedures and must comply with the recommendations made on the minimum standards of training, qualification and practice laid out in this document, as well as any requirements set by the MOH.

24. Doctors who wish to perform procedures that fall within the definition of Aesthetic Practice in paragraph 3 of these guidelines but are not listed in List A or List B should list themselves with the SINGAPORE MEDICAL COUNCIL’s AESTHETIC PRACTICE OVERSIGHT COMMITTEE using the same prescribed List B and Other Aesthetic Procedures notification form. SINGAPORE MEDICAL COUNCIL’s AESTHETIC PRACTICE OVERSIGHT COMMITTEE may then decide on the classification of the procedure and / or further dictate how the doctor should proceed. Doctors are advised not to perform any such procedures until the procedures have been classified.