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Cosmetic Surgery Patients At More Risk Than Ever
(press release from BAAPS)|
A special edition of the journal, Clinical Risk, published by the
Royal Society of Medicine, looks at how the combination of an under-regulated
market, "professional greed", increased marketing and overwhelming media hype
have created a "perfect storm" that threatens patients and practitioners alike.
The journal's editor argues that cosmetic surgery patients in the UK are at more
risk than ever before.
Dr Harvey Marcovitch, who commissioned leading experts in the field to write for
this special issue said, "Patient safety is this journal's main aim and there
can be no area of medicine where patients in the UK are more in need of
protection. We need tight control of advertising of cosmetic surgery - including
internet advertising. We need proper regulation of the industry and we need both
surgeons and GPs to manage patient expectation."
In one paper, entitled 'Clinical Risk in Aesthetic Surgery', Nigel Mercer,
consultant plastic surgeon and President of the British Association of Aesthetic
Plastic Surgeons (BAAPS) argues: "We have reached a stage where public
expectation, driven by media hype and, dare one say, professional greed, has
brought us to a 'perfect storm' in the cosmetic surgical market."
He adds, "There has been a massive increase in 'marketing', including discount
vouchers, 2-for-1 offers and holidays with surgery! In no other area of medicine
is there such an unregulated mess. What is worse is that national governments
would not allow it to happen in other areas of medicine. Imagine a '2-for-1'
advert for general surgery? That way lies madness!"
Clinical Risk in Aesthetic Surgery: Nigel Mercer discusses the role of the media
and advertising and calls for tighter regulations in the UK, comparing this
country's lack of regulation with the Food and Drug Administration's role in the
- "Perhaps, like tobacco, there should be a Europe-wide ban on advertising all
cosmetic 'surgical' procedures, including on search engines…".
- "If we have to sell anything, we should sell our advice, not procedures. If we
cannot self-regulate, then, like the financial institutions, regulation will
eventually be imposed…"
- "All cosmetic treatments are medical interventions, and every medical
intervention has a complication and failure rate. Consequently, there are no
'consumers' or 'clients' but only 'patients'…"
- "Perhaps the single most important factor in reducing clinical risk in
cosmetic surgery is the motive for performing any procedure must never be
financial gain, so I suggest we get our act together as an industry as we are in
grave danger of biting the hand that feeds us."
France Sets Standards for Practice of Aesthetic Surgery: French consultant
plastic surgeon, Alain Fogli describes the strictly defined guidelines for
cosmetic surgery in France which include:
- Surgical procedures can only be undertaken by surgeons who are registered
specialists and deemed competent. Possession of a general medical degree, and
the fact that the practitioner is 'experienced' are not deemed to be sufficient
- A ban on all forms and methods of publicity and advertising, direct or
indirect, in whatever form, including the Internet
Minimizing Risk in Aesthetic Surgery: Foad Nahai, President of the International
Society of Aesthetic Plastic Surgeons (ISAPS) and former president of the
American Society of Aesthetic Plastic Surgeons (ASAPS) describes how to minimise
risk in each facet of 'the safety diamond': patient, facility, procedure and
He tells readers:
"Regulations governing the training of all cosmetic surgeons are sorely needed.
Governments are reluctant to become involved, as they see this issue as a 'turf
battle' between various physician groups and not a public safety or patient
safety issue. However, there is no question that this is a patient safety issue
of paramount importance and I take our governments to task for not addressing
- Since by law any physician is allowed to practise cosmetic surgery, attempts
by individual physicians or plastic surgery organisations to restrict those who
are not qualified is viewed as a restraint of trade.
Improving the Safety of Aesthetic Surgery: Recommendations Following a 14-Year
Review of Cases to the Medical Defence Union (1990-2004): Consultant plastic
surgeon and BAAPS Secretary, Rajiv Grover, reveals a 14-year audit of claims to
the MDU which shows why patients sue. He provides recommendations to avoid these
situations such as careful pre-operative counselling, thorough documentation and
exploring with the patient what degree of correction and scarring is realistic -
and not being falsely optimistic about the likely outcome.
Managing Risk to Reputation: Magnus Boyd, Partner at leading UK solicitors,
Carter-Ruck suggests how doctors can protect their reputation and how the media
can influence the outcome of a professional investigation or the expression of
anger from a disgruntled patient.
Both Dr Harvey Marcovitch and Mr Nigel Mercer are available for comment.
The journal Clinical Risk aims to give both medical and legal professionals an
enhanced understanding of key medico-legal issues relating to risk management
and patient safety, through authoritative articles, reviews and news on the
management of clinical risk. The AvMA Medical and Legal Journal and the
Healthcare & Law Digest, both included within Clinical Risk, contain articles on
current medico-legal issues and reports on a wide range of recently settled
clinical negligence cases.
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