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Standards issued to curb rogue cosmetic surgery

Surgeons call for an end to ‘Botox parties’

Jo Carlowe

Tuesday, 29 January 2013

New standards issued today call for an end to cosmetic surgery carried out by those without medical training.

The guidelines drawn up by the Royal College of Surgeons (RCS) state that only surgeons should provide cosmetic surgery and only doctors, dentists and nurses who have undertaken appropriate training should provide non-surgical cosmetic treatments such as Botox.

Currently certain cosmetic treatments can be administered by anyone, anywhere with no medical training – hence the growth of so-called ‘Botox parties’.

The guidelines state that as standard practice, practitioners should discuss relevant psychological issues (including any psychiatric history) with the patient to establish the nature of their body image concerns and their reasons for seeking treatment. They should not at any point imply that treatment will improve a patient’s psychological wellbeing.

Aimed at all doctors, dentists and nurses involved in cosmetic practice, the comprehensive document entitled Professional Standards for Cosmetic Practice, focuses on the behaviour and competencies medical professionals should be expected to demonstrate when providing cosmetic procedures.

The standards state that financial deals such as time limited discounts should be banned and stringent psychological assessment promoted. They lay out the professional duty practitioners have to their patients, including the need to ensure they have a clear understanding of the risks of the procedure, outlining consequent aftercare and being transparent about costs from the outset.

Professor Norman Williams, President of the Royal College of Surgeons, said:
“We have serious concerns that not all those who offer cosmetic procedures are adequately qualified, or that patients are getting accurate information prior to treatment. We hope these standards will feed into the ongoing review of the industry led by the NHS Medical Director, Sir Bruce Keogh, and improve quality of care for patients going forward.”

Developed by a working group of key professionals including surgeons, psychiatrists, psychologists and dermatologists, key points in the professional standards include:

  • Practitioners have a duty to manage a patient’s expectations. They should not imply that patients will feel ‘better’ or ‘look nicer’, and should instead use unambiguous language like ‘bigger’ or ‘smaller’ to describe what that patient is trying to change.
  • All practitioners should consider whether they should refer a patient to a clinical psychologist before proceeding with further consultations or treatments. Pre-procedure discussions should include the disclosure of relevant psychiatric history such as eating disorders and the practitioner should document any signs or symptoms of Body Dysmorphic Disorder.
  • Marketing and advertising must be honest and responsible, using only real patient photographs that have not been air brushed or digitally enhanced.
  • Currently non-surgical procedures such as laser treatments or injectables can be administered by people with no healthcare qualifications whatsoever. The RCS recommends that only licensed doctors, registered dentists and registered nurses who have undertaken appropriate training should provide any cosmetic treatment.
  • Only those who have qualified as a medical doctor and undertaken post-graduate surgical training should carry out invasive procedures such as breast surgery or liposuction.

Mr Steve Cannon, Chairman of the working party and RCS council member, said: “As the majority of cosmetic procedures are not available on the NHS, we must ensure that commercial interests do not compromise patient safety. With the demand for cosmetic surgery and non-surgical treatments rising year on year, it is crucial that the highest level of professionalism is maintained amongst practitioners.”

The document concludes by highlighting that all cosmetic procedures should be carried out on licensed premises with resuscitation equipment readily available in the event of an emergency.

The concept of ‘Botox parties’ or ‘filler parties’ are entirely at odds with these standards, states the RCS.

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