What is the Sara Law?

 

Last Saturday, September 18, the so-called “Sara Law” was published in the Official State Gazette. Sara Law, a significant change in the field of cosmetic surgery. This law was enacted in the wake of the tragic death of Sara, a patient who died after undergoing liposuction performed by a cardiovascular surgeon, which prompted her family to push for this legislative initiative.

 

The Sara Act amends Annex II of Royal Decree 1277/2003, which establishes the general framework for the authorization of healthcare centers, services, and facilities. This decree regulates, among other aspects, the classification and definition of healthcare units

 

“…the specialty of Plastic, Reconstructive and Aesthetic Surgery becomes a guarantee of safety for the patient…”

 

medical procedures, including cosmetic surgery. The reform addresses the growing demand for cosmetic surgery procedures and the proliferation of new centers offering these services, which has created a need to establish greater regulatory oversight and ensure that only qualified professionals perform these procedures.

 

Context and Objective of the Law

 

The Royal Decree 1277/2003 It establishes a framework for regulating the authorization and operation of healthcare facilities and services in Spain. In its annexes, it classifies medical units and defines the specialties that must be staffed by accredited professionals. In light of the increase in cosmetic procedures, the need to update these regulations was identified in order to prevent unlicensed practice and ensure that physicians are adequately qualified.

 

“…Clinics, hospitals and anesthesia services have from now on legal responsibility over who performs the intervention…”

 

In 2022, Congress passed a nonbinding resolution calling for stricter controls on cosmetic surgery, requiring that procedures be performed only by properly trained and certified specialists. The Sara Act updates the regulations to more clearly define who is authorized to perform these procedures.

 

Legislative Changes: New Definition of Cosmetic Surgery

 

The amendment introduced by the Sara Act to Annex II of Royal Decree 1277/2003 directly affects the definition of a cosmetic surgery unit. The key change is that it now specifies that cosmetic surgical procedures may only be performed by physicians specializing in Plastic, Aesthetic, and Reconstructive Surgery or other medical-surgical specialties that include in their training program the necessary skills.

 

Previous text:

 

“U.47 Cosmetic Surgery: a healthcare unit in which a physician specializing in plastic, cosmetic, and reconstructive surgery, or another surgical specialist within their respective field, is responsible for performing surgical procedures aimed at improving the appearance of the body, face, or hair.”

 

Text amended by Law Sara:

 

“U.47 Cosmetic Surgery: a healthcare unit in which a physician specializing in Plastic, Aesthetic, and Reconstructive Surgery—or another surgical or medical-surgical specialty within the scope and competencies specified in the official curriculum for that specialty—is responsible for performing surgical procedures aimed at improving the appearance of the body, face, or hair.”

 

Practical Implications

 

With this change, the training program for each medical specialty defines the competencies of the professionals who are qualified to perform cosmetic surgery procedures. However, from the patient’s perspective, it remains difficult to determine whether the doctor

 

“…It is practically impossible for the patient to know the detailed content of the training programs of each specialty…”

 

who is attending you is qualified to perform a specific procedure, unless he/she is a specialist in Plastic, Reconstructive and Aesthetic Surgery, which guarantees this training.

 

It is virtually impossible for patients to know the detailed content of the training programs for each specialty, which makes it difficult for them to make informed decisions about a physician’s suitability. In this context, the specialty of Plastic, Reconstructive, and Aesthetic Surgery becomes a guarantee of safety for patients.

 

“…inspections by the health services of the autonomous communities of the centers that offer cosmetic surgery should be implemented…”

 

Control Mechanisms

 

The new regulations also establish the need for additional oversight mechanisms for physicians in other specialties who perform cosmetic surgery procedures. These oversight mechanisms can come from two main sources:

 

1. Clinics and hospitals: The facilities where these procedures are performed now have a legal responsibility to ensure that the physicians performing them are properly trained in accordance with their training programs. In addition, anesthesia departments are also required to verify the qualifications of these professionals.

 

2. External entities: In cases where clinics or anesthesiologists are not required to perform the procedures, it is recommended that the health authorities of the autonomous communities conduct regular inspections of facilities that offer cosmetic surgery. These regulatory bodies must ensure that the quality and safety standards established by the Sara Law are met.

 

The Sara Law represents an advance in the regulation of cosmetic surgery in Spain, increasing the guarantees for patients and demanding that only professionals with the appropriate training can carry out these procedures, strengthening supervision and control in this sector.

 

The collaboration of clinics, hospitals, anesthesia services and health services of the different autonomous communities is essential for the implementation of the Sara law.