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Surgeons put forward regulation proposal - 24 January 2012

Straightforward Plan Calls for Advertising Ban to Ensure Controls in the Sector

The British Association of Aesthetic Plastic Surgeons (www.baaps.org.uk) is delighted with the news of an enquiry by MPs to examine lax regulations which have allowed a ‘cowboy’ market to flourish in the UK. The BAAPS, which is the only organisation based at the Royal College of Surgeons solely dedicated to promoting education and patient safety in cosmetic surgery, today proposes a straightforward, six-point plan which if followed will instil tighter controls in the sector.

According to consultant plastic surgeon and BAAPS President Fazel Fatah; “Despite the unfortunate scandal which has brought this issue onto the agenda, it is an absolute joy for us at the BAAPS to hear that this year, the Government will be examining the lax regulations in our sector. We understand MPs will review areas such as psychological counselling for cosmetic surgery patients and the unscrupulous marketing activities of many firms which take advantage of the young and the vulnerable. These are problems that we have been highlighting for many years. We would like to offer the Commons select committee a simple, six-point plan that will not only aid their investigations but offer a straightforward solution moving forward that will help safeguard the public.”

Consultant plastic surgeon and former BAAPS President Nigel Mercer has been involved in drafting EU-wide standards currently being circulated to National Standards Bodies. He says; “The EU draft proposals – CEN403 – are designed to improve aesthetic surgery and medical services to enhance patient safety and promote consistently high standards for providers across Europe. Their scope includes the banning of cosmetic surgery being offered as a prize or via financial inducements, and allows only physicians with proven track records to perform specialist procedures. In addition to this framework, our tailored six-point plan will go a long way towards establishing the strict controls that are urgently needed in the UK.”

The plan consists of six main points:

- Ban all advertising of cosmetic surgery: as medical procedures, they should not be publicised – the same way that prescription medicines are not allowed to advertise

- Re-establish an implant register: for all sites, not just the breast – including all types if silicone implants including buttocks, pectoral, calves and others

- Re-classify dermal fillers as medicines: At the moment, these popular injectables just require a CE mark (the same as with a teddy bear or washing machine), which has allowed over a hundred to be marketed in the UK, when there are less than a dozen in the US as they require FDA clearance

- Compulsory registration of practitioners in aesthetic medicine and lasers: Currently, there is only a voluntary database for clinics, rather than the actual practitioners. Registration should be mandatory and management by an independent entity such as the Care Quality Commission

- Mandatory (BAAPS-style) Safety Audit: BAAPS surgeons are audited on an annual basis as a membership requirement. This should be established for all practitioners in the UK and a part of their revalidation to continue practicing

- Revalidation and Mystery Shopping in CE marking

Fazel Fatah adds: “Over the last decade the BAAPS has worked tirelessly to educate the public on the many aggressive marketing gimmicks that not only trivialise surgery but endanger the patient. We have warned against the unrealistic expectations set by reality ‘makeover’ shows and against crass competition prizes promising ‘mummy makeovers’ and body overhauls. In no other area of surgery would one encounter Christmas vouchers and two-for-one offers - the pendulum has swung too far, and it is time for change. Thus we are delighted with the upcoming enquiry and put forward our realistic and achievable proposals for consideration by the Government.”

Cosmetic Surgery’s Wild West: A Timeline

- 2004: BAAPS warn the public against unrealistic expectations set by new trend of ‘makeover’ TV shows, as well as against cosmetic surgery “vacations” increasingly advertised in magazines. BAAPS issues safety guidelines for people considering cosmetic surgery

- 2005: The BAAPS caution teenagers considering cosmetic surgery, warn against multiple surgeries being touted as ‘total body overhauls’ and surgical procedures offered as competition prizes by magazines and radio stations - also marketed via loyalty cards, discount and Christmas vouchers.

- 2006: Scheme offering travel vouchers in exchange for booking ‘summer body’ surgical procedures is launched, as well as a 'Divorce feel-good' package. BAAPS holds Annual Meeting on the theme of psychological readiness for surgery, highlighting top warning signs in patients

- 2007: A lottery is launched for people to win surgery abroad if they ‘text in’. The BAAPS cautions the public against this as well as the growing number of ‘medi-spas’ (Non-surgical does not mean non-medical). Website launches for women to post suggestive photos in exchange for donations for a boob job, and Botox is sold via clothing catalogue Grattan.

- 2008: Plans for deregulating lasers and intense pulsed light (IPL) treatments are announced. The BAAPS holds a press conference naming-and-shaming inappropriate advertising in cosmetic surgery. The BAAPS also publish the UK’s largest-ever breast augmentation survey.

- 2009: The BAAPS warns against growing complications from inexpert use of dermal fillers, with one in four surgeons having to correct problems, and injectables being bought off the Internet. BAAPS demands for regulation published in the British Medical Journal. Medical journal Clinical Risk publishes a special issue with articles by BAAPS surgeons, calling for tighter controls including banning advertising.

- 2010: PIP implant scandal breaks. BAAPS demand unenforceable voluntary register for injectables be shelved until EU standards become official. NCEPOD reveals 70% of clinics effectively unregulated.

- 2011: Injectables offered to passersby at consumer trade show. Breast augmentation and Botox offered as raffle prizes at a nightclub. Unproven procedures touted as ‘non-surgical’ ‘lunchtime’ treatments on morning chat show. Cut-price surgery offered via group discount websites such as Groupon. Magazine readers vote on which competition hopeful is ‘most worthy’ of winning surgery each week.