Royal College of Surgeons weigh into the cosmetic surgery debate

The PIP breast implant scandal that first came to wider public notice in 2012 shone a light on cosmetic surgery and the problem of maintaining standards in a largely unregulated industry. It prompted the Government to order an investigation under Sir Bruce Keogh, the results of which were published in April 2013 in the Review of the Regulation of Cosmetic Interventions.

One of the recommendations of the Keogh Review was for the Royal College of Surgeons (RCS) to establish a Cosmetic Surgery Interspecialty Committee (CSIC) which would be in charge of setting standards and last month the RCS announced the changes they hope will help patients make an informed decision about their treatment.

Certified care

The RCS issued a statement that from spring 2016, surgeons can apply for ‘certification’ which demonstrates that they are competent and qualified to perform a particular cosmetic surgery procedure, such as a tummy tuck or breast augmentation.

Under the current system, any doctor can perform cosmetic surgery and it can be challenging for the patient to determine whether they have the necessary experience and expertise.

So, what will surgeons need to demonstrate to gain certification?

  • they have to be on the General Medical Council specialist register in a specialty that requires training and experience in the cosmetic surgery procedures they are offering
  • they need to have performed a minimum number of surgical procedures and an audit of their outcomes
  • they are required to have indemnity insurance for the UK
  • they should have undergone successful revalidation by the GMC, the legal requirement for all doctors, that takes into account their cosmetic practice
  • they must have attended a cosmetic surgery skills masterclass from an accredited provider
  • they must confirm knowledge and adherence to relevant guidance from the GMC and RCS

Patient safety is a priority

Mr Steve Cannon, Chair of the Cosmetic Surgery Interspecialty Committee (CSIC) explained, “It will make cosmetic surgery safer for patients, who for the first time, will be able to identify a highly qualified, experienced surgeon to perform a procedure through a register of surgeons. It will also make it simpler for hospitals to check the qualifications, experience and training of the doctors who work there. All eligible surgeons should apply for certification.”

Although these are steps in the right direction in terms of protecting patients, this certification is not compulsory so the emphasis is still on the patient to carefully check their cosmetic surgery provider. Plastic surgeons are still the only surgeons that have undergone the necessary training and have the experience to perform aesthetic surgery in the UK; to check whether your surgeon is a plastic surgeon, visit the General Medical Council’s Specialist Register.

I was one of the first Consultant Plastic Surgeons to submit himself to the full Revalidation process when it was introduced in 2014. I successfully achieved Revalidation with the General Medical Council. This lasts 5 years and I shall go through the same process in 2019. Meanwhile, I also undergo an annual Appraisal process, successfully doing so in 2015, for the first time in the private sector; this was very rigorous and undertaken by an Assessor who had never met me before. A further Appraisal will occur in 2016.

Alcohol and cosmetic surgery should never mix

A major part of our job as plastic surgeons is to fully prepare our patients for their surgical procedure and I always ensure my Leamington Spa cosmetic surgery patients are well-versed in what they should and shouldn’t be doing, both before and after their surgical procedures.

If you’re considering a drink before your surgery to calm your nerves or raising a glass afterwards to celebrate a successful procedure, here’s five reasons why you should refrain from alcohol consumption when undergoing cosmetic surgery.

Before cosmetic surgery

1 Alcohol may make your pain medication less effective; you may think that a drink will settle your nerves, but it can also make you more susceptible to the pain and discomfort you’ll feel immediately after your procedure. It also makes the anaesthetist’s job more challenging as alcohol may alter the effect of sedatives and anaesthetic drugs.

2 Alcohol dries out the skin; many cosmetic surgery procedures involve stretching and redraping the skin and dry, cracked skin can be harder to manipulate. It also goes without saying that any positive benefits of rejuvenating facial surgery will be undermined by the quality of your skin.

Recovering from cosmetic surgery

3 Alcohol dilates the blood vessels; they can leak clear fluid, causing your body to swell. After any cosmetic surgery procedure there will always be a degree of swelling and you’ll be keen for this to disappear as soon as possible so don’t make it worse by drinking. The nose is particularly susceptible to swelling due to alcohol consumption so drinking after a rhinoplasty is a definite no-no.

4 Alcohol is dehydrating; this causes the body to hold onto any water it can and this can contribute to a feeling of being bloated and swollen.

5 Alcohol thins the blood; this can increase the risk of excessive bleeding both during and after surgery and compromise your safety.

I advise my cosmetic surgery patients to refrain from drinking for a couple of days before their operation and for at least a weeks after, preferably two, to ensure optimal recovery and results. This advice on alcohol is just part of the comprehensive instruction I give all my patients at consultation on what they should and shouldn’t be doing before and after undergoing cosmetic surgery. The verbal advice is backed up with a detailed letter to reinforce and ensure full information.