Cosmetic surgery should be regulated

A special edition of the UK journal, Clinical Risk published by the Royal Society of Medicine, looks at how the combination of an under-regulated market, 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 are at more risk than ever before.

A special edition of the UK journal, Clinical Risk published by the Royal Society of Medicine, looks at how the combination of an under-regulated market, 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 are at more risk than ever before.

Dr Harvey Marcovitch, who commissioned leading experts in the field to write for this special issue says, “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 ‘Clinical Risk in Aesthetic Surgery’, Nigel Mercer of the British Association of Aesthetic Plastic Surgeons (BAAPS) calls for tighter regulation in the UK, “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? If we have to sell anything, we should sell our advice, not procedures. If we cannot self-regulate then regulation will eventually be imposed. All cosmetic treatments are medical interventions, and every medical intervention has a complication and failure rate.” .He also suggests that there should be a Europe-wide ban on advertising all cosmetic surgical procedures, including on internet search engines.

In ‘France Sets Standards for Practice of Aesthetic Surgery’: French 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; neither possession of a general medical degree nor that the practitioner is experienced are sufficient qualifications; a ban on all forms and methods of publicity and advertising, direct or indirect, in whatever form, including the Internet”

In ‘Minimizing Risk in Aesthetic Surgery’ Foad Nahai of the International Society of Aesthetic Plastic Surgeons (ISAPS) says, ” Regulations governing the training of all cosmetic surgeons are sorely needed. Governments are reluctant to become involved, as they see this issue as a dispute between various physician groups and not a public safety or patient safety issue. Since by law any physician is allowed to practice cosmetic surgery, attempts by individual physicians or plastic surgery organisations to restrict those who are not qualified is viewed as a restraint of trade.”

In ‘Improving the Safety of Aesthetic Surgery’ Rajiv Grover recommends 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.

In the UK, although there are measures and standards to help regulate the industry, some cosmetic surgeons operate outside these regulations. Some treatments and procedures are unlicensed for cosmetic use, but can be given at the discretion of doctors, or by some clinics. Invasive cosmetic surgery and laser treatments are regulated.
Some cosmetic surgical procedures are not covered by current regulations, such as botox injections and injections of aesthetic fillers.

Surveys by the International Society of Aesthetic Plastic Surgery show that England has one of the poorest controls of cosmetic surgery in the world, says Dai Davies from Plastic Surgery Partners. He believes that the UK is one of the worst regulated countries in the world and says, “practically anyone can perform risky treatments (such as injectables) that should only be performed by qualified doctors. The industry is out of control.”