Are NFTs the Answer to Cowboy Cosmetics?

Non-fungible tokens (NFTs) are unique digital assets created and traded on the internet. Over the past year, they have gained significant traction and investment, being heralded as a revolution in authentication and ownership. Employing blockchain technology, an immutable ledger of transactions is held, maintained across thousands of computers around the world.

The application of NFTs has seen digital art gain early traction, although the “use-cases” are still being established in this nascent technology.¹ Within the health care sphere, some have suggested the role of NFTs in supply-chain tracking of medications.² An extension of the technology has been proposed to validate credentials and degree certificates, leveraging a key strength of the blockchain technology: transparency.

Responding to the 2013 Keogh review into the regulation of cosmetic interventions, the Royal College of Surgeons in the United Kingdom has created the Cosmetic Surgery Certification Scheme.³ This recently re-launched scheme runs in parallel to a multitude of independent societies, including the British Association of Aesthetic Plastic Surgeons, the British Association of Plastic and Reconstructive and Aesthetic Surgeons, the British Association of Oral and Maxillofacial Surgeons, the UK Association of Aesthetic Plastic Surgeons, the British Society of Facial Plastic Surgeons, the British Oculoplastic Surgical Society, the Association of Surgeons of Great Britain and Ireland, the British College of Aesthetic Medicine, the Joint Council for Cosmetic Practitioners, and the General Medical Council specialist register. Furthermore, licensing organizations such as licensing boards or the General Medical Council do not provide a centralized credential for aesthetic practice.

In the United States, a few of the organizations available include (without limitation) the American Academy of Aesthetic Medicine, American Academy of Anti-Aging Medicine, American Academy of Cosmetic Surgery, American Academy of Dermatology, American Academy of Facial Plastic and Reconstructive Surgery, The Aesthetic Society, American Society of Plastic Surgeons, Foundation for Facial Aesthetic Surgery, National Coalition of Estheticians, National Aesthetic Spa Network, Professional Beauty Association, Society for Clinical and Medical Hair Removal, Society of Dermatology SkinCare Specialists, Society of Permanent Cosmetic Professionals, Society of Plastic Surgical Skin Care Specialists, The Spa Association, and Vegas Cosmetic Surgery and Aesthetic Dermatology. This trend is observed around the world, with a multitude of organizations offering professional support, information, guidance, and oversight within a single country.

The proliferation of associations above reporting to regulate and oversee their members could potentially dilute the value of membership. It also presents a challenging landscape for patients looking to verify the credentials of their practitioner. Although there are many benefits to joining professional societies beyond authentication, NFTs could prove valuable in helping prospective patients safely and quickly identify whether their practitioner is qualified to provide their care.

Furthermore, beyond their role in identification and authentication of credentials, holding an NFT would enable formation of communities to share information and resources, building a collaborative hub that could potentially enhance training and development opportunities. It is important to note, however, that the technology is in its infancy, and further developments and refinements are inevitable.

The described application of NFTs would, however, require a centralized body to ensure appropriate award and oversight of these tokens and would not solve the problem of multiple professional bodies, should each look to provide their own NFT. This suggests that rather than further creation of professional bodies, a consensus should be achieved for a singular body to govern the safe practice of cosmetic interventions. NFTs may therefore find a role in the future landscape of cosmetic practice as part of a greater overarching strategy. A transparent and open form of communication enabled by NFTs may hold the key for future optimism in improving patient safety.

Disclosures

The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article. Dr Mosahebi is a Research section co-editor for Aesthetic Surgery Journal.

Funding

The authors received no financial support for the research, authorship, and publication of this article.

Author notes

Dr A. Zargaran is a plastic surgery core surgical trainee, Chelsea & Westminster Hospital, London, UK