Cosmetic surgery industry "clean-up" plans

11 September 2012

By Plastic Surgeon Dr Dirk Kremer

Big Ben and the Houses of Parliament Government plans to review the plastic surgery industry hit headlines recently. While I welcome the desire to protect patients and promote best practice, changes to the industry, especially new regulation, will have to be very carefully considered.

We need to make sure changes will have the right effect for patients, and won’t unnecessarily burden the many qualified, reputable plastic surgeons that already adhere to codes of best practice.

Sir Bruce Keogh, the medical director of the NHS conducting the review, told The Times that he is wants to introduce tighter rules in several key areas:

  • Making it routine practice for surgeons to register all devices — from breast implants to hip replacements — on a detailed register that can be used to detect trends and trace individual patients.
  • Requiring clinics to join a scheme, similar to that run by the travel industry, that will offer patients protection if a company goes bust.
  • Tightening the rules on anti-ageing dermal fillers, which require only basic safety checks and can legally be injected by anyone.
  • Introducing minimum training requirements for surgeons carrying out cosmetic procedures.
  • Carrying out psychological screening to ensure that people are not seeking to solve mental health problems with surgery.

Some of these proposals make good sense, such as restricting injecting dermal fillers to qualified plastic surgeons. Others present more complex issues.

Take the issue of prosthetic registration. This would be great in an ideal world, but I think it is a rather naïve suggestion. It would be a massive undertaking to record all types of implants nationwide. It would have to involve NHS patients as well as private. The costs and amount of work involved would be horrendous - will the cash strapped NHS bear the cost or would the Government put their hands in their pockets?

In fact, an UK breast implant register has been tried before, running from 1993-2003 - and failed for a variety of reasons.

Psychological screenings sound noble and great on paper but qualified cosmetic surgeons already look for signs of body dysmorphia during consultation. The more conscientious will refer for psychological assessment.

In terms of training, this is presumably in reference to general surgeons, GPs, dentists et al carrying out plastic surgery procedures. Cosmetic surgery procedures should be carried out by qualified plastic surgeons. If one of the above wish to perform cosmetic surgery of any kind, they should undergo the necessary academic training first.

It will be interesting to watch this process unfold and see what final suggestions are made. In the meantime avoid any added risk to yourselves by checking the qualifications of every cosmetic surgery practitioner you approach.

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