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Cosmetic surgery: a perfect storm

Clinical Risk Publishes Special Edition on Cosmetic Surgery with Articles by Top Names

<p><strong>London &ndash; 16 November 2009&nbsp;</strong>&ndash;&nbsp;Prestigious journal from the Royal Society of Medicine &lsquo;Clinical Risk&rsquo; today publishes a special edition entirely dedicated to the current and most relevant issues in cosmetic surgery today. With articles written by some of the top names in the industry including aesthetic plastic surgeons and spokespeople for the British Association of Aesthetic Plastic Surgeons (BAAPS) Nigel Mercer, Chris Khoo and Rajiv Grover, as well as psychologist Eileen Bradbury and former President of the American Society of Aesthetic Plastic Surgeons (ASAPS) Foad Nahai, the issues raised offer clarification and could raise fresh alarm about this dangerously under-regulated market, its overwhelming media hype and unique brand of professional greed in a theme best defined by BAAPS President Nigel Mercer as &lsquo;a perfect storm&rsquo;.</p> <p>The articles, which despite appearing in a medical journal are written in layman terms, cover a wide variety of themes ranging from the current regulatory framework in the UK and the US (comparing it with France, where aesthetic plastic surgery cannot be advertised or promoted to the public), a 14-year analysis of lawsuits pertaining to cosmetic surgery cases, the risks to surgeons&rsquo; reputations through media exposure and recommendations for minimizing risks for patient and practitioner alike.</p> <p>According to Nigel Mercer, consultant plastic surgeon and President of the BAAPS (;</p> <p>&ldquo;We have reached a stage where public expectation, driven by media hype and, dare one say, professional greed, has brought us to a &lsquo;perfect storm&rsquo; in the cosmetic surgical market. It is against this backdrop that these articles should be read.&rdquo;</p> <p>According to Dr Harvey Markovitch, Editor of &lsquo;Clinical Risk&rsquo; (;</p> <p>&ldquo;Patient safety is this journal&rsquo;s main aim and there can be no area of medicine where patients in the UK are more in need of protection. We need tight control of advertising of cosmetic surgery &ndash; including internet advertising. We need proper regulation of the industry and we need both surgeons and GPs to manage patient expectation.&rdquo;</p> <p>Highlights:</p> <p>Clinical Risk in Aesthetic Surgery, by Nigel Mercer: This article discusses the role of the media and calls for tighter regulations in the UK, comparing with the Food and Drug Administration&rsquo;s role in the US. Key quotes:</p> <p>If we have to sell anything, we should sell our advice, not procedures. If we cannot self-regulate, then, like the financial institutions, regulation will eventually be imposed.</p> <p>Perhaps, like tobacco, there should be a Europe-wide ban on advertising all cosmetic &lsquo;surgical&rsquo; procedures, including on search engines.</p> <p>All cosmetic treatments are medical interventions, and every medical intervention has a complication and failure rate. Consequently, there are no &lsquo;consumers&rsquo; or &lsquo;clients&rsquo; but only &lsquo;patients&rsquo;</p> <p>France Sets Standards for Practice of Aesthetic Surgery, by French consultant plastic surgeon Alain Fogli, reveals strictly defined guidelines for cosmetic surgery in France which include, for example:</p> <p>Surgical procedures can only be undertaken by surgeons who are registered specialists and deemed competent. Possession of a general medical degree, and the fact that the practitioner is &lsquo;experienced&rsquo; are not sufficient qualifications</p> <p>All forms and methods of publicity and advertising, direct or indirect, in whatever form, including the Internet, are forbidden.</p> <p>Minimizing Risk in Aesthetic Surgery, by Foad Nahai, President of the International Society of Aesthetic Plastic Surgeons (ISAPS) and former President of ASAPS &ndash; this article reveals an innovative approach to minimizing risk in each facet of &lsquo;the safety diamond&rsquo;: patient, facility, procedure and surgeon. Additional points he makes:</p> <p>Regulations governing the training of all cosmetic surgeons are sorely needed. Governments are reluctant to become involved, as they see this issue as a &lsquo;turf battle&rsquo; between various physician groups and not a public safety or patient safety issue. However, there is no question that this is a patient safety issue of paramount importance and I take our governments to task for not addressing it.</p> <p>Since by law any physician is allowed to practise cosmetic surgery, attempts by individual physicians or plastic surgery organizations to restrict those who are not qualified is viewed as a restraint of trade.</p> <p>Improving the Safety of Aesthetic Surgery: Recommendations Following a 14-Year Review of Cases to the Medical Defence Union (1990-2004), by consultant plastic surgeon and BAAPS Secretary Rajiv Grover, discusses how aesthetic surgery has historically been a field with a significant rate of litigation. A 14-year audit of claims to the MDU allows a unique insight into the nature of events which lead patients to seek litigation. The article provides recommendations to avoid these situations such as careful pre-operative counselling. keeping thorough documentation and exploring with the patient what degree of correction and scarring is realistic - suggesting the use, for example, of conservative percentages.</p> <p>Another article in this special one-off issue is &lsquo;Managing Risk to Reputation&rsquo; by Magnus Boyd, Partner at Carter-Ruck Solicitors, which deals with how the press can influence the outcome of a professional investigation or the expression of anger from a disgruntled patient.</p> <p>According to Nigel Mercer;</p> <p>&ldquo;Perhaps the single most important factor in reducing clinical risk in cosmetic surgery is the motive for performing any procedure must never be financial gain, so I suggest we get our act together as an industry as we are in grave danger of biting the hand that feeds us.&rdquo;</p> <p>ENDS</p> <p>The latest issue of&nbsp;Clinical Risk&nbsp;will be available online on Monday 16 November. Please mention the journal if you cover this story.</p> <p>For further information, or to arrange to speak to either doctor, please contact</p> <p>RSM media officer, Carmel Turner, 020 7290 2904, 07949 516471</p> <p>Or</p> <p>BAAPS media officer, Tingy Simoes 020 7549 2863 or email&nbsp;</p> <p>Clinical Risk</p> <p>The journal&nbsp;Clinical Risk&nbsp;aims to give both medical and legal professionals an enhanced understanding of key medico-legal issues relating to risk management and patient safety, through authoritative articles, reviews and news on the management of clinical risk. The AvMA Medical and Legal Journal and the Healthcare &amp; Law Digest, both included within Clinical Risk, contain articles on current medico-legal issues and reports on a wide range of recently settled clinical negligence cases.</p> <p>The BAAPS (, based at the Royal College of Surgeons, is a not-for-profit organisation, established for the advancement of education and practice of Aesthetic Plastic Surgery for public benefit. Members undergo thorough background screening before they can join. Information about specific procedures and surgeons&rsquo; contact details can be found on the website, or by contacting their office at 020 7430 1840. Further materials can be posted to members of the public seeking specialised information. BAAPS is also on Twitter: &nbsp;&nbsp;and Facebook:</p> <p>For all media enquiries, please contact </p>

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