Cosmetic surgery patient checklist – a good start but it doesn’t go far enough

Posted by Ruth Powell on
Cosmetic fillers

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Lip fillers, breast implants, eyebrow lifts, botox…. the UK cosmetic surgery industry is booming with more patients than ever opting to go under the knife.

The latest figures estimate the value of the industry at a staggering £3.6bn, a figure which many feel is fuelled by increasing pressure, particularly on women, to enhance their appearance.

Social media, magazines and reality TV all frequently accused of projecting an unrealistic idea of the “perfect” face or body – one which is often unachievable without surgical intervention.

With so much pressure and so much money on offer, it’s no surprise that alongside the respected, responsible, well-qualified surgeons there has sprung up a worrying number of unscrupulous, poorly-trained  and often dangerous practitioners.

It’s perhaps not well-known that dermal fillers are completely unregulated – meaning that practically anybody can set up as a specialist and inject substances into consenting patients.

As a result, these kinds of procedures are available at hair salons, nail bars and back rooms without any means of quality control or regulation.

There have been several attempts to tackle this problem. Following the much-publicised PIP silicone breast implant scandal, Professor Sir Bruce Keogh carried out a review of the Regulation of Cosmetic Interventions which included several recommendations put forward by the British Association of Aesthetic Plastic Surgeons (BAAPS).

That report came out in 2013, but so far precious little has happened to introduce any kind of formal regulation – either voluntary or government enforced.

As a result, we see time and time again the results of botched filler procedures. In one case, I saw a patient who had filler injected into her face, only for it to move underneath the skin to put pressure on her optic nerve. I have also heard horror stories of substances such as bathroom sealant being used as a cosmetic filler.

To put this in context, let’s compare the UK to the USA, where cosmetic procedures are regulated by the FDA. In the UK, it is estimated that around 150 different kinds of fillers are in use. In the USA, just 15 are approved.

When things do go wrong, all too often we find that patients have limited redress because the practitioner involved did not have valid insurance.

An announcement today by the Royal College of Surgeons takes a huge first step to addressing some of these concerns. The organisation has now put on its website a “checklist” that patients can use to help them decide if a practitioner is properly qualified and adequately covered. It also offers useful advice, such as waiting two weeks before deciding whether or not a procedure is really necessary – allowing a “cooling off period” for people who may feel under pressure.

These developments are very welcome but in my view simply do not go far enough. I would like to see the industry properly regulated, with severe penalties for surgeons who operate without a licence. Anything less exposes potentially vulnerable patients to a level of risk that is unacceptable.

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About the Author

Photograph of Ruth Powell

Ruth is a Senior Associate and leader of our London Clinical Negligence team. She has over 20 years experience of clinical negligence litigation and is a member of the AvMA specialist clinical negligence panel.

Ruth Powell
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0207 814 5421

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