The British Association of Aesthetic Plastic Surgeons (BAAPS) & the Royal College of Surgeons seek regulation of the sector which exists largely in private practice, not the NHS. Does that surprise you? They are the ethical voice of the cultural and commercial tussle between ethics and profit. Of course BAAPS members want to be paid for their expertise but in a manner that is consistent with their ethics and the hippocratic oath. Financial deals and discounts that act as incentives to patients to sign up for surgery should be banned, they say. Are offers such as 10% reductions to previous customers or buy one get one free a good thing? Does this drive an ‘addiction’ to cosmetic surgery? There is a perception that those seeking surgical enhancement are vulnerable and safeguards should be in place to protect them from profiteering. It is significant that you can self-refer to a cosmetic surgery provider and they can chose to operate without any reference to your previous medical records. Surely, information about background health issues should be provided before a surgeon subjects you to general anesthetic?
The Care Standards Act 2000 provides minimum standards for private hospitals e.g. provision of advice about the risks of a procedure. But we must ask what good these regulations are in practice, BAAPS’s & the Royal College of Surgeons clearly feel they don’t go far enough.
Injectables such as dermal fillers and Botox are excluded from the statutory definition of cosmetic surgery and not regulated. They are commonly perceived to be low risk and are widely available at low cost. But 25% of BAAPS members have surgically corrected defects from permanent filler complications. On the one hand we all want value for money but what price do you put on your health and appearance? Is lastminute.com really the place to shop for cosmetic injectibles badged ‘wrinkle relaxing injections’? The Royal College of Surgeons state those who inject Botox or fillers should be properly qualified doctors, dentists or nurses. Do you agree? What do they mean by ‘properly qualified’?
There is no General Medical Council (GMC) specialist register for cosmetic surgery (which is different to plastic surgery) which seems to suggest that this huge area of work doesn’t get proper attention from the regulatory body. Why is this? Perhaps because little is done in the state owned NHS. It’s worth about £2.5bn a year in the UK compared to $10bn in the US. Over the last 15 years cosmetic surgery increased by 197% in USA. . It is no longer a female dominated trend as male surgery is increasingly popular with an annual increase of around 7%.
The most popular female procedure was breast augmentation; its popularity apparently unaffected by the high profile issues with implants such as PIP, thought to affect 7000 women in the UK, 95% of which were inserted privately. In 2012 for the first time the boob job was overtaken by the eyebrow lift as the most popular treatment and it is popular with both sexes. Almost 40,000 women had plastic surgery in 2012 and 4,000 men.
The PIP issues raised controversial issues about a private industry that is often accused of exploiting vulnerable people. As a result an NHS director is undertaking a review of the industry. In light of the challenges of patient service delivery in the NHS it will be interesting to see if there is a contrast of approach in relation to a review of the private sector.
If you have suffered as a result of Clinical Negligence following Cosmetic Surgery, you may be entitled to financial compensation.