Knife
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Cosmetic Surgery - know the risks
Cosmetic surgery know the risks
Statistics show that there has been
a dramatic increase in the number of
cosmetic procedures within the last
decade. Between 2010 and 2011 alone
there was a 9% increase in the number
of procedures performed.
The Department of Health defines
cosmetic surgery as follows:
“Cosmetic surgery comprises operations
or the procedures that revise or change
the appearance, texture, structure or
position of bodily features to achieve
what a patient perceives to be more
desirable”
Cosmetic surgery has specific features
that set it apart from other surgical
procedures in that:
It is elective.
It is sought/performed to meet
social or psychological desires
rather than to prevent death, to
treat illness or to alleviate pain.
It can almost always be carried out
in the private sector.
It will almost always have been
paid for by the patient under
contract.
Patients will have seen advertising
material and have been influenced
by sales personnel and marketing
techniques.
The features set out above give rise
to careful consideration of the impact
of advertising or marketing on the
patient’s consent to treatment and their
expectations as to the standard of care.
Consent is often a very significant
issue in cosmetic surgery litigation
the very definition of cosmetic surgery
demonstrates that it is concerned with
meeting the perceived desires of the
patient. Thus it is important to elicit
those desires and to clarify them.
The glamorisation of cosmetic surgery
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amongst the world of celebrity can
often give the impression that surgery is
common or an everyday procedure with
little risk A well-publicised example of the
trivialisation of cosmetic surgery was a
phone-in competition in Liverpool where
the prize for the winning listener was
breast augmentation surgery.
The question of the standard of care in
relation to obtaining informed consent
in this setting will often focus on the
adequacy of the industry standard.
There is an argument that the court
should impose a higher standard on the
industry.
Regulation in the cosmetic industry
has been contentious for some time.
Cosmetic surgery providers and clinics
are regulated by the Quality Care
Commission. While there is a GMC
specialist register for plastic surgery
one does not exist for cosmetic surgery.
Therefore an ENT surgeon would not
breach the national minimum standards
if he conducted breast augmentation
surgery by reason of his not being on the
plastic surgery specialist register.
In terms of non surgical procedures
that don’t fall within the definition of
cosmetic surgery there is a lack specific
regulation. Obvious examples include
Botox injections on dermal fillers.
Procedures such as Botox and dermal
filler injections are often perceived by
the public to be minor procedures that
they can cause significant injury when
wrongly administered.
Dermal fillers in particular have been the
subject of endless debate given the lack
of regulatory framework.
In his review of the industry last year Sir
Bruce Keogh warned that fillers could
cause lasting harm and were covered
by only the same level of regulation as
ballpoint pens and toothbrushes. He said
that they were a crisis waiting to happen
and should become prescription only.
Fresh rules for the cosmetic procedures
industry announced by ministers
yesterday failed to heed Sir Bruce
Keogh’s concerns and only advised
that it will become illegal to offer
dermal fillers without training. This
has understandably caused much
concern among the British Association
of Aesthetic Plastic Surgeons (BAAPS)
who told the BBC that they were
appalled at the lack of action taken and
that legislators had appreciated the
sector’s dire warnings that dermal fillers
are a crisis waiting to happen.
The cosmetic surgery industry is a
minefield of litigation. The Mayo Wynne
Baxter clinical negligence team has
been involved in several claims relating
to the adequacy of consent and the
failure to carry out cosmetic procedures
to a reasonable standard. A common
theme emerging from the cases we have
dealt with is the fundamental importance
a patients being fully informed of the
procedure and that their expectations
are managed appropriately. Our
experience has 6