The dangers of not researching your cosmetic surgeon and what questions you should be asking before surgery

Posted on the 04 March 2015 at 11:53

Let’s be honest, how many stories have you seen in the paper and on TV about botched up plastic surgery? Whether you’ve flicked through the channels on the TV, or picked up a newspaper recently, you’re likely to have seen at least a few headlines “My Botched Boob Job” or “My plastic surgery hell”, and if you’ve watched a programme called “Botched up bodies” currently screening on Channel 5, then you’ll be forgiven for thinking cosmetic surgery is an extremely high risk activity. However, as is often the case with the latest media sensations and hot topic buzz words, which are designed for viewer impact and attention, this concept is not factual. Sadly the minority group of rogue operators; the ones who are performing botched cosmetic surgery and often subscribing to dangerous practices are tarnishing the integrity and expertise of the real professionals. The media is painting the entire cosmetic surgery industry with the same brush.

Despite the scrutiny of the industry as a whole since the PIP breast implants scandal, and the recent media headline, call-to-clean up bid from the Royal College of Surgeons suggesting mandatory surgical specialization regulations, there do exist de facto; expert cosmetic surgeons and clinics that are regulated who are performing by most professional of standards. However, the problem remains that patients are not reviewing their options carefully enough and many opt for cheaper practices, which can end in disappointing and sometimes dangerous results. It’s true that patients should not be taken in by glitz and glossiness of the clinic’s presentation! It’s no secret that the most effective form of cosmetic clinic marketing features super beautiful looking, often digitally enhanced people, which offer false hope and unrealistic expectations. What’s more is the rogue operator is unlikely to give the patient an accurate and truthful diagnostic, rather than turn away unfavorable candidates for surgery they will push for the sale. What you need to look for is substance and a proven track record, a clinic with surgeons who are regulated, accredited and safe. Patients must be educated on how to find the best cosmetic surgeon to carry out their procedure, thankfully the problem of rogue operators can be easily avoided by arming yourself with a few simply, yet important questions, so that whether or not legislation is put forward for specialist surgeon qualifications, the power is put back in the hands of the patient.


Is your surgeon qualified and experienced enough?

Far from referring to these “plastic surgery abroad” cases, these problems lie close to home at time, and according to reports, some GP’s with just 4 years experience are turning to setting up their own clinics, offering treatments such as liposuction without the knowledge or training in this very specialized of fields. Similarly, there are also instances where non-surgical dentists have administered neurotoxin during treatments, when they don’t have the specialised training required and therefore lack the skills and experience required to cope on the occasion of a routine procedure goes wrong. The call from the Royal College of Surgeons for a specialist register category for cosmetic or aesthetic surgeons is one that myself and my colleagues at our clinic, Cosmetic Surgery Partners feel needs support, as we work to ensure every patient has the best cosmetic surgery available to them, with the best chance of getting the results they want and furthermore all of our surgeons are UK trained, qualified and regulated with a proven long standing track record in a number of specialist cosmetic surgery procedures. 


How to choose your cosmetic surgeon and avoid the risks of inexperience

Naturally patients may assume that behind the marketing material, before and after pictures and video testimonials, there must lie a skilled and experienced specialist surgeon, this is sometimes not the case which is why regulations must be put in place to rid the industry of those untrained in these specialties, and give the public what they require. Skilled specialist cosmetic surgeons who are trained and experienced in providing the services required with a proven track record.

For the most part the only way a patient can tell whether their surgeon is the right one for their given procedure is to see beyond the marketing material and ask the questions that really count. With that in mind, we offer a short guide on what patients should be asking about their surgery before going ahead and booking with a surgeon or clinic.


Is my surgeon registered with the GMC?

The GMC (General Medical Council) is a body that regulates the medical industry in the UK, and works to protect the public and maintain the health and safety of those taking medical treatment or advice. They operate a well maintained register that every qualified doctor must register with, and they have a number of standards by which those registered must comply. The register is split into specialties, and you should check whether your surgeon is registered for the plastic and reconstructive surgery specialism, and also that they have undertaken a cosmetic surgery fellowship, as these are not part of standard NHS training. It should go without saying that an Oncologist, for example, is far from the best choice for performing a decent breast augmentation.


Is my surgeon registered and accredited by UK professional bodies?

Although optional, professional bodies such as the British Association of Aesthetic Plastic Surgeons (BAAPS), the Royal College of Surgeons (RCS), the British Association of Plastic Reconstructive and Aesthetics Surgeons (BAPRAS) and the UK Association of Aesthetic Plastic Surgeons (UKAAPS) can be joined by surgeons specializing in the field of Cosmetic Surgery. Professional and experienced surgeons generally belong to one or all of the above, and this gives some clue as to how qualified and experienced they are. It is worth noting that as with the GMC specialist register the membership application process for these organisations is stringent and belonging is in itself a seal of approval & testament to quality.

It is also worth noting that we can only promote and suggest UK qualified surgeons. The qualifications of cosmetic surgeons in other countries may not be as thorough or difficult to obtain as the UK counterparts.


Is the cosmetic surgeon experienced in MY surgery procedure?

Knowing how many operations your surgeon has successfully completed is one thing, but finding out how many successfully completed operations similar to yours is the key to getting an idea of how well your surgeon will perform. Remember that often when clinics advertise they will show fantastic results, those results may not be of the hands of the surgeon who you have come to consult with at the clinic!


Can I see examples of my surgeons work?

Although we mentioned before and after photos as part of the marketing spiel, your surgeon should be able to provide you with these, and talk them through with you to ensure you know how the surgery was done and how the results compared to what the patient was expecting. If you’re unsure, ask to speak to past patients to ease your mind. At our clinic we run a convenient patient referral aka ‘the buddy system’; because who better to advise you of what to expect of your potential surgeon than someone who has been operated by them before!


A summary of questions to ask your surgeon

  1. Are you registered on the GMC specialist register for plastic and reconstructive surgery specialism? and have you undertaken a UK cosmetic surgery fellowship?
  2. Do you belong to any UK Cosmetic Surgery governing bodies such as BAAPS, BAPRAS, RCS, UKAAPS? (if in doubt ask for their credentials!) 
  3. Are you experience with the procedure I am interested in having, do you have a proved successful track record.
  4. Can I see past examples of your work?
  5. Can I speak to someone who has been operated by you before?

Your surgeon should never rush or force you into surgery and should be able to fully explain any aftercare or possible risks associated with the surgery as well as the benefits, the surgeon should also be honest enough to explain limitations. It is a fact that we turn down patients who have unrealistic expectations from the results of their surgery. Knowing what to ask and how to find the right surgeon for your procedure is not easy, but having cosmetic surgery should never be a quick decision, and if more patients start to ask questions of their prospective surgeons, and the Royal College of Surgeons calls are answered, we could see “botched up bodies” finally, become a thing of the past.

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Blog Comment(s) [1]

Thank you for an interesting blog. I agree with these points -

  • Are you experienced with the procedure I am interested in having, do you have a proved successful track record.
  • Can I see past examples of your work?
  • Can I speak to someone who has been operated by you before?


I disagree with the following points for which I have supportive evidence and readers can make up their own minds about validity of arguments for and against.

It is worth noting that as with the GMC Specialist register the membership application process for these organisations is stringent and belonging is in itself a seal of approval & testament to quality.

The GMC specialist register exists for appointments to a consultant post in the NHS. There is no specialist training in cosmetic or aesthetic surgery on the NHS and there is no specialist register for cosmetic surgery and in fact there cannot be one as the NHS actively discourages cosmetic procedures. So this is no guarantee that a surgeon on the specialist register is trained in aesthetic surgery. Chairman of the UKAAPS is on the record that most newly qualified plastic surgeons [on the specialist register] are not competent to undertake independent practice in aesthetic surgery.

Do you belong to any UK Cosmetic Surgery governing bodies such as BAAPS, BAPRAS, RCS, UKAAPS? (if in doubt ask for their credentials!)

This is no guarantee of quality. The largest medical negligence claim in excess of £6 million was awarded to a patient operated upon by a surgeon belonging to this group. Surgeon members of these groups also used PIP implants. Who will protect the public from `not so good members` of these organisations?

The qualifications of cosmetic surgeons in other countries may not be as thorough or difficult to obtain as the UK counterparts.

A lot of countries are far ahead in aesthetic surgery training and standards. The dangers of cosmetic surgery abroad are grossly exaggerated. There are good and bad surgeons in all countries around the world. I enclose a link to the university of leeds study into the subject and highlight their conclusion here-


Cosmetic surgery tourism is less risky than most people think Whilst we have highlighted important notes of caution above, the circulation of horror stories about cosmetic surgery in the media gives the impression that CST is much riskier than it actually is. Home country surgeons' organisations are also keen to point out the risks of CST as they don`t want to lose patients to overseas competitors.

However, whilst our research demonstrates low risk (17% had complications but only 2% of those were serious) and largely positive experiences, it was based on hospitals, clinics and agents who openly participated in our study, potentially skewing our results towards more positive outcomes. Some clinics and surgeons we contacted refused to grant us access, possibly in some cases because of problematic practice or pending complaints.

http://www.ssss.leeds.ac.uk/files/2012/11/Sun-Sea-Final-Report.pdf

Far from referring to these `plastic surgery abroad` cases, these problems lie close to home at time, and according to reports, some GPs with just 4 years experience are turning to setting up their own clinics, offering treatments such as liposuction without the knowledge or training in this very specialized of fields.

Modern Cosmetic and Aesthetic surgery is so safe and effective because of contribution by doctors from a variety of backgrounds. Liposuction pioneers were Dr Fischer an ENT surgeon, Dr Ilouz a gynaecologist and Dr Fournier a General Surgeon. Perhaps the greatest innovation in liposuction was the invention of tumescent technique by Dr Klein, a dermatologist. The untrained and unqualified GPs you mention are performing liposuction under tumescent anaesthesia using finer canulae. This is much safer than liposuction under general anaesthesia using larger canulae.

the call from the Royal College of Surgeons for a specialist register category for cosmetic or aesthetic surgeons is one that myself and my colleagues at our clinic,Cosmetic Surgery Partners feel needs support.

Plastic and reconstructive surgeons perform amazing and complex operations such as full face transplant but average cosmetic patients want less invasive procedures with quick recovery. Most modern major contributions to aesthetic surgery have come from fields other than plastic and reconstructive surgery. [eg, Lasers and tumescent anaesthesia]

In my view such a move would be anticompetitive, restrict innovation and be bad for patients and doctors alike. It would only benefit members of the above societies. Patient safety is a responsibility of all doctors and not a select few. I look forward to the day when a doctor will be judged by his or her outcomes and results rather than his or her background and affiliations.

Anonymous