Harmonized ethical and empowered empathy for aesthetic literacy (HEEAL): a systematic review towards a patient-centered practice paradigm in aesthetic medicine and plastic surgery

Contemporary society is witnessing a surge in non-surgical aesthetics and plastic surgery, reflecting a growing interest in physical enhancement and rejuvenation. However, despite this burgeoning trend, there remains a gap in the literature concerning the ethical considerations, patient empowerment strategies, and empathetic engagement within these fields.

This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, systematically searching relevant literature from January 2010 to January 2024 across multiple databases. The search aimed to identify studies focusing on ethics, empowerment, and empathy within aesthetics and plastic surgery. Thematic analysis was utilised to synthesise the findings from the selected studies.

The systematic literature search yielded 344 articles, from which 16 met the inclusion criteria. Thematic analysis of these studies revealed key themes revolving around ethical considerations, patient empowerment, empathetic engagement, and the concept of empowered empathy. Additionally, the review proposed the Harmonised Ethical and Empowered Empathy for Aesthetic Literacy (HEEAL) paradigm as a guiding framework for personalised practice in these fields.

Empathy, while acknowledged as essential for patient care, presents challenges such as empathy contagion and fatigue. The proposed HEEAL paradigm provides a comprehensive framework for delivering personalised patient-centred care in non-surgical aesthetics and plastic surgery. The review highlights the critical role of empowered empathy in navigating the complexities of patient care, ensuring both patient satisfaction and practitioner resilience in the face of emotional demands.

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