The First Guardian: The General Practitioner’s Pivotal Role in Navigating Aesthetic Surgery Requests in Morocco: An Ethical, Supportive, and Vigilant Framework

Abstract

In Morocco, the confluence of globalized beauty standards, social media proliferation, and a growing medical aesthetics market places the general practitioner (GP) at a critical but ill-defined crossroads. This integrative literature review synthesizes evidence from 2010–2025 to theorize the GP’s role beyond a simple gatekeeper. We propose a conceptual framework positioning the GP as the ”First Guardian”, an ethical navigator responsible for patient assessment, expectation management, and vigilant safety screening. The synthesis reveals that while the demand for aesthetic procedures is well documented, primary care lacks structured protocols for managing these requests. Key concepts include the GP’s function in medical vigilance (screening for contraindications), psychological vigilance (particularly for Body Dysmorphic Disorder (BDD)), and supportive counseling within a culturally competent, shared decision-making model. A significant gap exists in validated, GP appropriate screening tools for the Moroccan context. The review identifies three core debates: the medical necessity of elective aesthetics, the tension between patient autonomy and non-maleficence, and the challenges of navigating an under regulated market. We present an integrative framework, the Aesthetic Surgery Navigation Model (ASNM), that operationalizes the GP’s role across five phases: Elicit, Evaluate, Educate, Escort, and Endorse/Follow up. A research agenda is proposed to empirically test this framework, develop localized assessment tools, and map referral pathways, ultimately empowering Moroccan GPs to safeguard patient wellbeing in the evolving landscape of aesthetic medicine