Sir Bruce Keogh Calls for a Crackdown
At Safer Cosmetic Surgery we have naturally followed all developments pertaining to the Keogh Review and the subsequent report very closely. Now the Government and regulatory bodies are discussing the proposals in the report that urge for restrictions to be put in place upon this burgeoning £2.3billion industry, which has tripled in size within half a decade.
The unregulated nature of dermal fillers has been much considered and discussed by the members of Safer Cosmetic Surgery. Now Sir Bruce Keogh would like to ensure that all fillers - which can at present legally be bought on the internet and injected by anyone - are treated as a medicine, becoming available on prescription only.
His essential, post-PIP scandal review has also called into question the competence of some surgeons notably in regard to the ‘fly in, fly out’, or ‘FiFo’ surgeons, who are not based in the UK.The report also notes the liability insurance issues that have arisen from untraceable FiFos, leading in some cases to patients being unable to seek redress.
At the heart of the report lies the understanding that there is an urgent need to regard those who undergo cosmetic surgery as patients rather than mere customers, as well as powerful belief in the duty of surgeons, associated bodies and the Government to protect the vulnerable.
Sir Bruce Keogh said:
“We have heard terrible reports about people who have trusted a cosmetic surgery practitioner to help them out but, when things have gone wrong, they have been left high and dry with no help, these people have not had the safety net that those using the NHS have. This needs to change."
The Keogh Report calls for approved training for all cosmetic surgeons and anyone who is carrying out a procedure. The Royal College of Surgeons has backed this and would like the Government to move forward with the proposals.
We also fully support any legislative steps that will ensure greater safety, probity and efficacy in the cosmetic surgery industry.
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COSMETIC SURGERY IN THE RECESSION
As we continue to try to recover from a double-dip recession, it would appear nonetheless that cosmetic surgery is still on the rise.
One BAAPS (British Association of Aesthetic Plastic Surgeons) member, a breast surgery specialist at the Spire Cheshire Hospital has said:
“We’re seeing more and more surgery because it’s being talked about more…There are two kinds of people who want surgery; those who want to change, which is often a younger age group, and older patients who want to improve.”
He goes on: “Banks used to mention cosmetic surgery in loans adverts but then they stopped lending money to younger people and we started to see more older people coming in instead to have rejuvenation surgery. A lot of people have saved up now since the recession so we’re seeing them coming back into the frame.”
There is also an argument to say that rather than diminish the overall figures relating to instances of plastic surgery, the PIP scandal and other cases of bad practice have resulted in increasing numbers of people turning to reputable surgeons to repair the damage, therefore pushing up the number or procedures.
During 2012, male brow lifts rose by 19%, eyelid surgery and fat transfer rose by 13%, facelifts were up 14%, compared with abdominoplasty (tummy tucks) rose by 12% and liposuction by 14%. Breast augmentations dropped slightly by 1.6%, but remain the most popular procedure, despite the PIP scandal. Overall there were a total of 43,172 cosmetic surgery operations carried out.
At a glance, these figures seem surprisingly healthy considering the major economic downturn that the UK, much like its European neighbours, is working its way through. However, some BAAPS surgeons have surmised that in addition to the increase in repair work, following sub-standard surgery by FIFO surgeons for example, the rise in figures can partially be put down to people longing to feel better during these harder times.
Whether motivated by economic pressure or having made a carefully considered decision, prospective patients always need to take time to consider the best options. In all cases, we recommend that anyone considering cosmetic surgery should undergo a consultation with a reputable, qualified, BAAPS-registered and experienced surgeon such as those at Safer Cosmetic Surgery.
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THE INJECTION QUESTION – BAAPS VIEW IS BEST
The Keogh review has postulated a number of ideas and one which is being discussed at present is that anyone who is to inject a patient, e.g. with a dermal filler, should have a special qualification. The idea would be that this would apply to beauticians as much as doctors. Whilst broadly this would be a step in the right direction, we agree with the standpoint of BAAPS who have only ‘cautiously received’ this suggestion. Rajiv Grover, President of BAAPS says:
“We welcome the recommendation…however, we would go one step further and insist that the people performing these procedures should be medical professionals.”
Along with BAAPS, we at Safer Cosmetic Surgery agree that only fully qualified and trained medical professionals and cosmetic surgeons should be permitted to inject substances such as dermal fillers. The legions of dermal filler disaster stories, there for anyone to see online, should be enough to warn prospective patients from entrusting the carrying out of an intrusive procedure to a beauty therapist with no medical training.
The stricter BAAPS (The British Association of Aesthetic Plastic Surgeons) standpoint on this issue would ensure that the highest standards are more closely adhered to, which must surely be a desirable outcome. As Rajiv Grover points out, it is not enough to be able to perform an injection – although to do this properly requires both knowledge and skill – but it is vital that the person who administers the injections also knows how to avoid and deal with any complications which may arise from the treatment.
BAAPS is quite clear that “non-surgical does not mean non-medical” and that dermal fillers and similar injectables should be regarded as a medicine. We agree entirely with this point of view and should it be embraced by the government, then it would be a great step forward within the industry.
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SCS SURGEON MR GRAHAM OFFER PERFORMS OUTSTANDING SURGERY IN EMBARRASSING BODIES
One of Safer Cosmetic Surgery’s surgeons, Mr Graham Offer, featured in an eye-opening episode of Embarrassing Bodies recently. In Episode 6, Series 6, which originally aired on 25th March he performed cosmetic surgery on a young woman called Anna. Anna, 25 had large amounts of excess, saggy skin around her stomach and abdomen area as a result of losing a remarkable 10 stone in weight.
Unhappy with the resulting sagging skin, which she found both uncomfortable and unsightly, she had turned to the programme for help. Dr Pixie examined her and she was referred for surgery.
Consultant Mr Graham Offer, based at the Spire Hospital in Leicester, talks Anna and the viewers through the planned surgery, a lower body lift which would involve removing a 360-degree section of the skin and fat from the patient’s stomach to the back, flattening the stomach and improving the waistline and buttocks.
Two months after her last consultation, which outlined the risk of heavy bleeding and infection, Anna returned to go ahead with the surgery, saying:
“It would mean the world to me to have this skin removed.”
During the major operation, Mr Offer, working with a colleague, had to perform liposuction to remove pockets of fat and then shrink the blood vessels with adrenalin. He went on to remove almost 4kg of excess tissue – which is in Mr Offer’s words “the size of a small baby” - during the massive operation which lasted over 7 ½ hours.
The surgery was deemed to have been an enormous success, with Mr Offer stating:
“Surgery went really well.”
Viewers are soon rewarded with the sight of Anna at her examination by Dr Pixie, 3 months after her surgery. Dr Pixie asks:
“Wow – where’s your tummy gone? It’s just…gone! That’s amazing…It’s lovely – it’s like you’ve got a brand new tummy, it’s a phenomenal result!”
The results are truly remarkable and Anna, now displaying a far smoother and more slender stomach, is clearly delighted with the results.
Dr Pixie asks about the impact of the surgery on her life. “What’s changed for you?”
Anna’s reply is heartfelt:
“Ah, everything, I’ve been on holiday, I wore a bikini for the first time – I’d never have done that…”
She ends “I’m really happy.”
We are delighted that Mr Graham Offer, a member of Safer Cosmetic Surgery, BAAPS (British Association of Aesthetic Plastic Surgeons) and BAPRAS (British Association of Plastic Reconstructive and Aesthetic Surgeons), provided such a great outcome for his patient. This case once more demonstrates the excellent results which are possible when patients are referred to the most experienced and reputable surgeons.
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DISASTROUS HARLEY MEDICAL SURGERY – FIFO SURGEON UNINSURED
The conduct of foreign Harley Medical surgeon Hicham Mouallem has been widely questioned in the media as the case of Bernadette Cini has come to light.
Ms. Cini, 62, opted to have breast reduction surgery on her large and uncomfortable G-cup breasts and believed that Harley Medical was a reputable name within cosmetic surgery. Mouallem reassured Ms. Cini that he was adept in techniques that would minimise pain and ensure that the greatest sensitivity was retained, which swayed her to move forward.
Shortly after surgery, Ms. Cini contracted a raging infection which threatened to effectively consume her breasts – it was necrosis, which is a flesh-eating disease that is caused by pseudomonas, bacteria typically occurring in soil.
The £5,700 procedure left Ms. Cini requiring five further operations to save her breasts. She was in prolonged and acute pain and she eventually found herself in such poor condition that she was unable to work and had to quit her job as a nanny.
Understandably, Ms Cini sought redress and enquired about compensation that she might be entitled to from Mouallem at Harley Medical. However, she was thoroughly shocked to discover that he was not properly insured for practice within the UK. He was a foreign surgeon working as a FIFO ‘Fly In, Fly Out’ – resulting in little accountability in cases such as this.
Ms. Cini was determined to follow this through. She tried to track Mouallem down for 2 years and eventually caught up with him, at which point he admitted that he had not warned her about the possibility of infection due to her excess weight. He settled out of court for £20,000.
Harley Medical is not new to controversy. It has also been named as the clinic which carried out the most PIP breast implant operations during the scandal that has rocked the industry in the past eighteen months. Meanwhile, the risks associated with FIFO surgeons continue.
We advise that anyone considering surgery should be mindful of such risks and be sure to choose a trusted and reputable surgeon who is fully insured within the UK, such as any surgeon belonging to BAAPS (British Association of Aesthetic Plastic Surgeons), BAPRAS (British Association of Plastic, Reconstructive and Aesthetic Surgeons) or SaferCosmeticSurgery.
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THE LOWDOWN ON “DESIGNER VAGINAS”
The procedures that come under the umbrella term ‘Female Genital Cosmetic Surgery’, or FGCS, form one of the fastest growing areas of surgery within the UK. Reports from BAAPS (British Association of Aesthetic Plastic Surgeons) indicate that this surgery may have increased by 300% in the past five years. Here’s a brief overview:
Also Known As…
Labiaplasty is the surgical term. It is also called genital or vulval reshaping, the Mommy Makeover, vaginal rejuvenation amongst many other terms and euphemisms.
Why the Sudden Popularity?
The fact that waxing, including the ‘Hollywood’ where all pubic hair is removed, is so commonplace means that women are noticing the detail of their genitalia as never before. With greater awareness can come more widespread anxiety about appearance.
Paul Banwell, member of SaferCosmeticSurgery and BAAPS (British Association of Aesthetic Plastic Surgeons) commented to the media:
"With labiaplasty people realise that they can change something they may have been worried about for a long time. It's empowering women with the ability to have choice. Choice is important."
Is this a Good Trend?
That remains to be seen, but it is also important to note that the ‘pornographic norm’ of hairless, very tidy genitalia seems to have become unnaturally popularised amongst ordinary women.
There is also the shocking reports that some children as young as 14 have undergone this surgery, which SaferCosmeticSurgery would contend is far too young for any female to consider such a procedure apart from in exceptional cases where it is medically required. BAAPS also asserts that under 18s should not undergo cosmetic surgery.
Michael Tyler, SCS surgeon and member of BAAPS comments, “Labioplasty is an operation very rarely indicated but its popularity in some circles signifies a demand beyond the traditional indications. All surgery carries risks and it is vital patients fully understand these prior to contemplating such surgery. I don't often see female surgeons offering this procedure.”
Is it a Complicated Process?
Beyond the surgical requirements, any potential patient will be required to attend two consultations at least. If a company or surgeon is suggesting operating without due consultation, do not proceed.
There is also the chance of complications from bleeding to thrush and in rare instances, clitoral damage.
The Benefits
Some women who have had labiaplasty claim that they feel greater self-esteem and enhanced sexual relations. However, as a relatively new procedure, there is no official data yet regarding the benefits of this surgery.
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