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K E Y P O I N T S

According to the Medical Defence Union £7 million has been paid out for claims over poor cosmetic surgery in the past 13 years. Breast and facial surgery accounted for the most claims.

To help prevent substandard cosmetic surgery new regulations have been introduced by the National Care Standards Commission.

Experts stress that it's crucial to find a properly qualified consultant and to fully understand the procedure and its consequences before committing to cosmetic surgery.

Experts recommend that you ensure that you're given full details of the treatment you're going to receive and take some time to think about it before undergoing the actual operation.

Cosmetic surgery - who can you trust?

Bupa investigative news - 13 February 2003
written by Rachel Newcombe, Bupa health news reporter

The desire to change one's appearance by using cosmetic surgery is growing in the UK, with statistics indicating that up to 75,000 operations per year are performed. But, while most operations are performed to high standards by fully qualified consultants, there are a number that are carried out by underqualified or ill-prepared practitioners, sometimes with unwanted consequences. In the past 13 years more than £7 million in compensation have been paid out for cosmetic surgery mistakes.

What were the headlines?

News about various aspects of cosmetic surgery has been hitting the headlines. A study carried out by the Medical Defence Union (MDU), published in Hospital Doctor magazine, highlighted that more than £7 million has been paid out due to dissatisfaction with plastic and reconstructive surgery over the past 13 years. This story was picked up by numerous newspapers who ran headlines such as, "The cost of imperfection", "Cosmetic surgery claims costing millions" and "£7m cost of botched cosmetic surgery".

"People who are considering cosmetic surgery should check out the credentials of the clinic and the consultant who will treat them. At Bupa we ensure that all our clinics comply with nationally agreed standards and all our specialists are, or have been, consultants in the NHS. The best way to make sure that your clinic meets these standards is to check with the National Care Standards Commission (NCSC). And you can check your consultant's qualifications on the General Medical Council (GMC) register of specialists which will confirm that they are fully trained in their specialty."

Dr Andrew Vallance-Owen,
medical director
Bupa Group

What is the bigger picture?

Research carried out by the Medical Defence Union (MDU) analysed private claims made as a result of poor plastic and reconstructive surgery. The study looked at data from 264 settled claims over a 13-year period, which totalled just over £7 million.

The researchers discovered that the largest number of claims, accounting for three-quarters of all cases, were related to breast and facial surgery, with 39 per cent for rhinoplasty (nose re-shaping) and face lifts. Most of the claims about thigh and abdominal procedures were to do with liposuction.

Dr Karen Dalby, clinical risk manager at the MDU, said, "The most common reason for bringing a claim was that patients were dissatisfied with the aesthetic result of the procedure. They had thought the surgery would enhance their looks but were disappointed with the results. There were also a small number of claims arising from poor surgical technique or inadequate counselling before the operation."

What does this mean?

The 264 settled claims over a 13-year period is a cause for concern and suggests that problems may exist with some clinics. The good news, however, is that the issue is being addressed.

In April 2002, the National Care Standards Commission (NCSC) launched new Minimum National Standards. As part of the scheme, they regulate and inspect clinics and practitioners in England to ensure high levels of care are met before, during and after surgery. A spokesperson for the NCSC said the aim is to help guard the "safety and wellbeing of individuals having treatment".

But not everyone is convinced they're fully working yet. The British Association of Aesthetic Plastic Surgeons (BAAPS) said they welcomed the introduction by the NCSC, as they'd been "campaigning for stricter regulation of surgeons who carry out aesthetic surgical procedures" for a long time. But the association is concerned that the full effects have yet to be implemented.

In October 2002 an investigation by the Consumers' Association's Health Which? magazine also revealed problems in some cosmetic surgery clinics, with surgeons agreeing to unsuitable surgery and failing to provide proper information about the potential risks involved.

Sue Freeman, managing editor of Health Which? described cosmetic surgery as being "a bit of a lottery". She said it's vital that, "Patients should be fully informed of the qualifications of those carrying out operations, and the possible risks."

More recently problems with high street laser eye corrective surgery have been highlighted, suggesting that problems with underqualified individuals performing surgery may not be confined to the cosmetic field.

A C T I O N P O I N T S

Choose a consultant carefully. Ensure they're listed on the General Medical Council (GMC) specialist register - all Bupa consultants are, as well as meeting other very stringent criteria.

Ensure you're given full details of the treatment you're going to receive and take some time to think about it - we suggest a break of up to two weeks before the actual operation.

Be prepared to ask questions and make sure you understand the outcome.

Avoid having surgery abroad. The standards of care can be very different to the UK and you could have problems if something goes wrong.

What does this mean to me?

If you're considering cosmetic surgery or corrective eye surgery, it is vital to do your homework, find a reputable consultant and ensure that the procedure really is what you want. For more on the issues to consider when choosing such surgery, Bupa has an article on considering cosmetic surgery.

Choosing a trained consultant who's an expert in the speciality you require is crucial said Dr. Vallance-Owen, Bupa Group medical director. "Problems, whether physical or psychological, are more likely to occur if you go to someone who isn't really a specialist in the field," he explained. If you're unsure, always be prepared to ask.

"Although not mandatory it is recommended that you should be allowed at least a fortnight - what we call 'cooling off time' - to think about it," Dr Vallance-Owen added. "The key thing is, don't be rushed. Have a discussion with your specialist, think very carefully, try and consider the options, and go away and think about it."

"It's important to take time and weigh up the risks and benefits," said a spokesperson for the British Association of Plastic Surgeons (BAPS).

It's equally important, the association pointed out, to not dwell obsessively on the negative possibilities, as there are many excellent surgeons in existence and they can help make a difference to people's lives.

Summary

The idea of modifying your appearance may sound appealing, but it's important to consider the risks and benefits before making a decision. Additionally, before putting your body in the hands of a surgeon, it's vital to choose someone reputable, otherwise the results might not be the ones you'd hoped for. For more on the issues to consider when choosing such surgery, Bupa has an article on considering cosmetic surgery.