Concerns that vulnerable patients are seeking cosmetic surgery when mental health issues suggest they should not has led the British Association of Aesthetic Plastic Surgeons (BAAPS) to develop a new psychological screening aide for surgeons.
The aim is to help surgeons perform pre-operative psychological assessment of patients seeking cosmetic surgery, which will be used in consultations for procedures that are exclusively cosmetic (increasingly unavailable via the NHS).
New BAAPS research notes that as the popularity of cosmetic surgery grows, so does the trend for vulnerable people to attempt to solve emotional problems with a nip or tuck. BAAPS recommends that surgeons must be able to identify any ‘red flags’ or psychological disorders which could demonstrate the need for further clinical psychology evaluation or mean the patient is not a suitable candidate for treatment.
The new ‘ABCDE’ screening tool allows surgeons to more comprehensively assess key facets of patient’s behavior as well as their underlying motivations for wanting cosmetic surgery. This should help them to determine those who do not meet relevant mental health criteria and should therefore not be offered treatment.
The tool helps to steer the process to shed light on key areas – for instance patients’ external drivers for pursuing treatment; their cultural background; and level of distraction. Building on existing and well-established markers such as excessive preoccupation with a perceived defect and overall body image, the ABCDE tool encourages surgeons to maintain awareness of discrepancies between patients’ words and their actions, as well as underscoring the importance of their own intuition in recognising patients who may be psychologically vulnerable and inappropriate for treatment.
By following this mnemonic, BAAPS says that surgeons will more easily and effectively be able to screen for issues such as BDD (Body Dysmorphic Disorders).
BAAPS president Paul Harris says “Medical tourism may not be a new phenomenon, but in cosmetic surgery it is clearly increasing at a galloping pace, and botched procedures are over-burdening our NHS. Countries around the world vary in their requirements of medical professionals. Some follow a strict screening process or cooling-off period, but many don’t. Therefore many patients find themselves having to rely on NHS care back in the UK.”