The Government has recently announced its reforms for the cosmetic surgery industry to enhance patient safety. Whilst some of the proposed measures are welcome and overdue, there have been criticisms that the changes do not go far enough. The fact is that the new landscape will not clean-up the vagaries of the industry overnight.
Cosmetic surgery in the UK is now big business with an estimated 700,000 surgical and non-surgical procedures performed each year by an industry worth approximately £2.3bn. There has been a recent dramatic rise in the number of young people opting to have cosmetic procedures which may in part be explained by the ever watchful eye of social media and a perceived need to ‘look good’ online. Horror stories such as Leslie Ash’s botched lip surgery, the tragic case of Claudia Aderotim who died in the US after an injection of an unapproved substance into her buttocks and of course the PIP breast implant scandal are timely reminders that procedures are not without risk. Yet despite these the popularity of breast enhancements, botox and tummy tucks is ever increasing.
So what should someone contemplating cosmetic surgery look out for when considering a clinic and a procedure?
- Ensure any clinic you are considering for treatment is licensed with the Care Quality Commission (CQC). If the procedure involves surgery, check the treatment provider is registered with the General Medical Council (GMC) and a member of BAAPS (British Association of Aesthetic Plastic Surgeons). Only 43,000 of the 700,000 annual cosmetic procedures performed in the UK last year were done by BAAPS approved registered clinicians. BAAPS has thorough training and accreditation standards and so membership can reasonably be seen as a hallmark of quality.
- Check how experienced your treatment provider is, both generally, and with respect to the proposed procedure. Can they tell you their success record? Beware ‘have a go’ inexperienced clinicians who are trying to move into a more lucrative field of cosmetic surgery without the requisite skills, training or experience.
- Have you been told of (and shown photographs of) possible complications that may result from the treatment you are considering? Typically these include infection, bleeding, wound breakdown, delayed healing, thrombosis, unfavourable scarring, asymmetry, and in extreme cases even nipple necrosis and gangrene. Most competent surgeons will overstate the complications, rather than the reverse.
- Who is being tasked with obtaining your consent – the clinician performing the procedure or just a nurse or salesperson? You should insist on the former as you need to be properly informed of the risks as well as the benefits of the procedure in order to be able to give proper informed consent to proceed.
- Although there is currently no legal requirement for the cosmetic treatment provider to make a handwritten consultation note, operation note or to provide a patient with any written information about the treatment, you should insist on this beforehand.
- Make sure that it is contractually clear, prior to treatment, who is responsible for monitoring your condition after surgery and dealing with a poor surgical outcome and who will be financially liable for the correction of any complications. This is important because there is currently no legal requirement placing a duty on clinics or surgeons to provide aftercare where a patient is harmed as result of a cosmetic procedure. There is talk of the government creating a system of redress if things go wrong. However, at the moment, the patient usually ends up going for help to the NHS, often through a local Accident & Emergency department.
- Are you aware of the long-term financial implications as well as the immediate costs of the procedure? For example, in the case of breast implants, there may be the need for future investigations, such as scans to check implant integrity, so details of additional costs should be known in advance.
- Try to avoid clinics offering sales gimmicks such as “time limited deals” and “two for one offers”. A good clinician will give you time to think about procedures very carefully and will let you change your mind if needs be before you proceed.
- Avoid cosmetic surgery ‘holidays’ abroad – it is harder to research a foreign clinician’s record, liability insurance and facilities. Also cheaper may be riskier. A survey by BAAPS taken in 2009 found that a quarter of plastic surgeons asked saw an increase in the number of patients who had experienced complications stemming from procedures performed abroad. Aftercare can also be harder because complications can take weeks or even months to develop and, by then, the patient will have already returned home.
- Be extra careful if you are contemplating having dermal fillers or Botox injections which are available to members of the public without prescription and are currently no better regulated than ballpoint pens or toothbrushes! Government ministers have very recently announced that they may make it illegal to offer such procedures without training, nothing has yet been sent in stone.
Although the Government talks of toughening up regulation of cosmetic surgery in the UK following last year’s report by the medical director of the NHS in England, Sir Bruce Keogh, there is a still a relatively ‘light-touch’ approach to what is and is not permissible in comparison with orthodox surgery. This makes it more difficult for the lawyers when things go wrong. It can be hard to prove that practitioners in the field have adopted an approach that breaks the rules or cannot be endorsed by the majority of the profession. Legal redress to obtain compensation is possible and we have been involved in several successful such cases. However until the law is in a stronger position to protect you and to avoid having to resort to legal action at all, it is wise to take all steps that you can to protect yourself.