COSMETIC SURGERY
insistence on individual surgeon’s outcome data, both of which make choosing a surgeon a safer decision for patients to make.” BAPRAS believes that this tightening of existing regulations will help prospective patients and employing clinics recognise high quality surgical expertise, leading to improved patient safety. BAPRAS has recently published the findings of its latest research which highlights that thousands of people are at risk of physical and psychological harm from poor or inappropriate cosmetic surgery. The Association identified that two million people in the UK are considering undergoing cosmetic surgery in the next year – yet 24% of patients do not check the credentials of their surgeon. One-fifth are aware of the risks associated with the procedure and a further one-fifth are not clear on the potential outcomes of their procedure before going ahead and one-quarter are not aware if any aftercare is available in the event of something going wrong. The research also found that more than half (59%) of patients undertaking surgery less than two weeks after their first consultation are actually less confident about their appearance afterwards. Half of all cosmetic surgery patients (53%) say keeping costs down is a major consideration and the BAPRAS research found people choosing surgery in this way were much more likely to have disappointing results or feel less confident about themselves afterwards. The findings from this research
prompted BAPRAS to the launch of the ‘Think Over Before You Make Over’ campaign, to protect patients from making uninformed or unsafe choices. The campaign provides a comprehensive range of advice on what people need to know before undertaking cosmetic surgery. BAPRAS is also calling on support from cosmetic surgeons or clinics to spread the word about the campaign and helping patients to make safer choices.
Things have changed Explaining why he thinks the CSIC proposals are a necessary move, Mr Richard Matthews, a consultant cosmetic, reconstructive plastic and hand surgeon, and a member of BAAPS, said: “Things have changed since I underwent my training on the NHS in plastic, reconstructive and aesthetic surgery. Then, many cosmetic surgery procedures fell within the remit of the Health Service, but the economic strictures it now faces has resulted in fewer ‘aesthetic’ procedures being offered, meaning future plastic surgeons will not be gaining that invaluable experience during their training. “I firmly believe the onus is on the surgeon to keep abreast of the latest
28 THE CLINICAL SERVICES JOURNAL
developments in their field, but the proposal of the CSIC is to establish a certification system that demands that surgeons must undertake a minimum number of procedures; that they have the appropriate professional skills to offer a specific procedure; and that they submit to an audit of their surgical outcomes. As a member of BAAPS I already undergo an annual safety audit, so I welcome this procedure being insisted on across the industry as a whole.” Dr Tim Pearce, a skin treatments
doctor stated on his website that although the consultation document applies to the surgical end of the treatment spectrum and does not affect cosmetic treatments such as botox, fillers, dermaroller and peels, recommendations have been made for improving governance in this sector too, and that numerous discussion groups are currently underway. He said: “We in the non-surgical treatment sector watch these developments in the surgical sector with interest as it could inform the direction that we take for industry guidelines for non-invasive treatment.” Professor James Frame, president of the UK Associated Aesthetic Plastic Surgeons (UKAAPS), is more sceptical about the CSIC proposals. UKAAPS was formed some years ago as it was felt that the voice of the cosmetic surgeon was not being heard within the national groups. It also aims to offer appropriate training and education in cosmetic surgery. Prof Frame said: “None of the main
groups involved in setting up the RCS guidelines appear to involve full-time, practising, and successful senior aesthetic plastic surgeons, so I feel that any rules and regulations that they decide upon will not necessarily connect with the true needs of cosmetic surgery patients.” Plans to only allow surgeons to
undertake cosmetic surgery on the area of the body that relates to the specialty they trained in is, according to Prof Frame, also ill advised. He continued: “I do not believe that cosmetic surgery can be classed simply by anatomical region. Take, for example, the head and neck. Major skeletal deformity, constructive or reconstructive surgery, which would be undertaken on the NHS bears no comparison to a facial cosmetic procedure. We really should not be looking at areas of the body, based on NHS procedures. An NHS ENT surgeon, for example, is unlikely to have had any training in fat suction – a technique regularly used in modern cosmetic surgery – yet according to the CSIC proposals, they will be considered as being capable of undertaking this procedure. Facial cosmetic surgery requires a variety of different and specialist skills, depending on the area being worked on. For example, an eye lift requires a completely different technique to surgery around the mouth or jaw.” Prof Frame goes on to state that he believes that a better solution would be to acknowledge aesthetic surgery, including cosmetic surgery, as a specialty in its own right. He said: “Being able to transfer cosmetic surgery skills back to the NHS could greatly benefit many patients. This would, for example, allow a burns surgeon, trained in cosmetic procedures, to take this knowledge back to the NHS to improve patient wellbeing.”
Reference 1 Department of Health (2013). Review of the Regulation of Cosmetic Interventions.
https://www.gov.uk/government/uploads/ system/uploads/attachment_data/file/ 192028/Review_of_the_Regulation_of_ Cosmetic_Interventions.pdf (accessed 30/01/2015).
APRIL 2015
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