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Patients need ‘cool off’ time for cosmetic surgery decisions

New GMC guidance on cosmetic surgery also say that doctors should not target patients under 18

Ingrid Torjesen

Tuesday, 09 June 2015

Doctors who carry out cosmetic procedures must allow patients time to think before agreeing to go ahead with treatment, according to proposed new guidance from the General Medical Council (GMC).

The GMC’s proposals, which are out for consultation, set out the standards expected of all UK doctors who carry out cosmetic procedures, both surgical and non-surgical. Final guidance is expected to be published in early 2016.

The guidance says doctors should be open and honest with patients and not trivialise the risks involved. They should seek consent from patients themselves rather than delegate this function, and they should give patients enough time and information before they decide whether to have a cosmetic procedure and allow them time to ‘cool off’. Patients who have had cosmetic procedures should be asked how they have been affected, both physically and psychologically, to check whether they are satisfied with the outcome.

Particular care is required working with children and young people, it adds. Doctors should not target people under 18 through marketing and, when young people are treated, advice should be sought from professionals whose expertise is in treating this group.

All services must be marketed responsibly, the guidance emphasises. Doctors must not make unjustifiable claims about the results they can achieve and they should not use promotional tactics that encourage people to make ill-considered decisions, for example, procedures given away as a prize.

Professor Terence Stephenson, chair of the General Medical Council, said: “Cosmetic practice is a huge and expanding area of medicine and patients, some of whom are vulnerable, do need to be better protected.”

The cosmetic sector has expanded rapidly in recent years, but there have been particular concerns about patient safety and whether some doctors operate in an ethical manner. In 2013, Professor Sir Bruce Keogh produced a report highlighting the risks associated with the cosmetic sector following safety concerns after nearly 50,000 women in the UK had had PIP breast implants fitted.

There are some patients who may be particularly vulnerable to being sold multiple procedures and may undergo unnecessary treatments, such as people with body dysmorphia, an anxiety disorder that causes a person to have a distorted view of how they look.

Professor Stephenson added: “We are producing this guidance because of the particular risks around this area of medicine. We are clear that doctors must not pressure patients to make rushed decisions they may end up regretting and they must give them enough information so they can make an informed choice.”

Professor Sir Bruce Keogh, NHS England’s Medical Director, said: “Those having cosmetic interventions - either surgical, such as face-lifts, tummy tucks or breast implants or non-surgical, such as dermal fillers and Botox - take their safety as a given and assume guidance is already in place to protect them. This consultation is a step in the right direction to tighten standards and protect people from potential risks.”

To further improve patient safety, the GMC is also working closely with the Royal College of Surgeons of England and others to publish information about which surgeons have the right skills to carry out cosmetic surgery. This would allow patients to check doctors’ qualifications on the GMC’s medical register.

Professor Stephenson said: “It is vital patients should be able to tell whether a doctor is competent to carry out these interventions and we have called for new legal powers to enable us to do this.”

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