The IAGS model assigns each step a task, a responsible role and a verifiable record. The basis of a decision and any interests involved should be clear.
The process pathway
Wishes and starting point
Record goals, expectations, previous treatments and limitations without implying an instruction to treat.
Check independence
Before engagement, check the adviser’s experience, professional suitability and potential conflicts of interest.
Provide independent advice
Discuss options, no treatment, deferral, risks and open questions. Identify missing information explicitly.
Prepare the decision
Give the patient time for questions and an autonomous decision. Treatment is not a required outcome.
Choose a treating physicianOptional
Use understandable requirements for selection. Selection support must not conceal a referral arrangement.
The treating physician decides independently
The treating physician examines the patient and takes responsibility for medical decisions and informed consent. They may decline treatment.
Treat and provide aftercare
Treatment, aftercare and necessary management of complications remain part of medical care.
Review the outcome independently
Another qualified physician assesses the outcome at a justified time against documented goals.
Clarify next steps
Consider observation, further investigation or possible revision without the reviewer offering treatment.
Disclose interests. Document the basis. Assign responsibilities. Enable scrutiny.
Separate roles remain separate
Roles A, B and C are held by different individuals. An outcome reviewer should not review their own earlier advice or recommendation.
External advice does not replace the treating physician’s medical responsibility. They examine, inform and decide independently and may decline treatment. The IAGS website does not determine individual indications.
| Role | Task | Not permitted within the IAGS model |
|---|---|---|
| Independent adviser A | Assess wishes, alternatives, benefits, risks, limitations and open questions | Subsequently provide elective aesthetic treatment to this patient or profit from their treatment |
| Treating physician B | Take responsibility for examination, medical decision-making, informed consent, treatment and aftercare | Present one’s own follow-up as an independent external outcome review |
| Independent outcome reviewer C | Assess the course and outcome against understandable criteria | Also be the original adviser or treating physician; offer aesthetic follow-up or revision treatment |
Treatment restriction and necessary care
Anyone providing independent advice or outcome assessment under the IAGS model must not subsequently provide elective aesthetic treatment to that patient. This includes other aesthetic procedures and revisions. Financial participation through affiliated providers is also excluded.
The rule is not limited to the procedure originally discussed. It must not be circumvented by changing the intervention, company or billing provider.
The rule does not prohibit necessary medical care. Emergency care must not be prevented or delayed. Exceptions are documented and, where necessary, another person is appointed for the subsequent independent review.
Describe individual modules accurately
Independent advice or outcome review can be provided separately. A single module is not described as a fully implemented IAGS process pathway.
A review conducted only after treatment cannot retrospectively replace independent advice that was not obtained beforehand.
Your choice remains yours
Independent advice should make a decision understandable without prescribing it. No treatment, deferral and further clarification remain options in their own right. The treating physician independently retains responsibility for their medical decision.