I was invited onto BBC News 24 last night to discuss the Keogh report - a long overdue review of the UK's £2.3billion cosmetic surgery industry. Keogh's proposals are all very sensible and long overdue. I hope the government implements his recommendations in full.
This area of medicine is, at present, terribly under regulated. The industry had been drinking in the last chance saloon for a long time. The PIP scandal and the subsequent Harley Medical Group (HMG) voluntary administration was the final straw. Any chance of continued self regulation was lost when HMG turned its back on its injured patients in November 2012 leaving them high and dry.
Cosmetic surgery negligence
One of the points I made was about the lack of a single quality mark in the industry - there are 4 or 5 groups claiming that their quality mark can be trusted. The consumer is confused. The industry needs to agree on a single quality mark and then publicise it heavily - this will help reduce the chances of a patient seeing a back street cowboy or an uninsured 'fly in fly out' surgeon.
Surgeons training needs to be soundly checked and continuing professional development needs to be rigorously enforced. I have pursued a lot of cases against surgeons whose expertise is breast augmentation who have dabbled in rhinoplasties. The results can be catastrophic and permanent. There is insufficient auditing of results and insufficient checks on training.
Cosmetic surgery marketing
This can be misleading - just because a doctor advertises with his breast augmented Page 3 girl clients on his website does not mean he can do a good blepharoplasty or rhinoplasty. The high pressure tactics of “this deal is only available today” also have to stop. No one should be pressurised into a cosmetic operation.
Dermal filler negligence
Other problems identified by Keogh relate to dermal fillers (‘injectables’ as the industry calls them). I have seen a number of cases in this area - mostly related to a excessive amounts being used combined with a lack of consent by the patient. The errors are usually due to failure by practitioners to explain the difference between permanent and semi-permanent fillers. Some of the fillers themselves can be hazardous – the fillers can break down and form very unpleasant nodules under the skin. When is the risk of this ever explained? - never in my experience.
The indications are the Keogh’s report will be implemented in full – this is good news for patients and competent doctors. The only concern I still have is who will enforce the new rules and will they have enough money to do so? If not then an annual levy needs to be raised from all responsible cosmetic surgery providers in order to stamp out the back street cowboys and incompetent surgeons.
By Clinical Negligence Solicitor James Bell.
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