Safety of cosmetic surgery

Safety of cosmetic surgery

Minimising risk and safety of cosmetic surgery can sometimes be overlooked. Cosmetic or aesthetic surgery is often a lifestyle choice. It rarely treats injury or disease and for that reason it is important that patients never lose sight of the fact that surgery is never risk free.
Unfortunately, the increased commercialisation and ‘hard sell’ of cosmetic surgery can often lead prospective patients to think that aesthetic surgery is a commodity that can be bought without much thought for the consequences. The International Society of Aesthetic Plastic Surgery (ISAPS) has published what it describes as the ‘patient safety diamond’. This is a simple 4 step process that patients should follow before contemplating surgery.The success of a surgical procedure (outcomes, complications, patient satisfaction) depends on four factors:
1. the patient
2. the procedure
3. the surgeon
4. the surgical facilityWe will look at each of these in turn.The Patient
Patient selection is critical in aesthetic surgery. A good surgeon will not operate on patients if they feel that the patient is not suitable for the requested procedure. A full history and physical examination is essential before surgery is agreed. Your surgeon might feel that you have an unacceptably high risk of complications due to an underlying medical condition or medications that you are taking. Unrealistic expectations are a common reason why surgery may not be offered. Your surgeon also needs to be sure that you are having surgery for the right reasons.

The Procedure
Surgeons must have a frank discussion with their patients about the risks of certain procedures. Some procedures like Abdominoplasty (tummy tuck) and large volume liposuction are known to carry higher risks of complications than other procedures. Detailed information on procedures and their complications can be found on the BAAPS website by following this link.

The Surgeon
In the UK, any doctor with a license to practise can call themselves a cosmetic or aesthetic surgeon. Surgery is a long apprenticeship and there is no substitute for years of training and formal plastic surgery qualifications. Your surgeon should be on the GMC’s Specialist Register for Plastic Surgery. They will have a FRCS (Plastic Surgery) qualification and will usually be members of BAAPS (British Association of Aesthetic Plastic Surgeons) or BAPRAS (the British Association of Plastic, Reconstructive and Aesthetic Surgery). They should hold (or have held) a substantive NHS Consultant appointment.
Patients should be encouraged to ask their prospective surgeon how often they perform a certain procedure and how many of those procedures have they done.

The Surgical Facility
Surgery must take place in an accredited, fully equipped and staffed setting with access to all the backup and expertise that may be required for patient care. Hospitals such as the Spire Murrayfield in Edinburgh will only allow consultants who hold (or have held) a substantive NHS consultant post to operate on their premises. The ‘back room’ of a doctor’s office is no place for cosmetic surgery and anyone, qualified or unqualified, can operate there.