April 24, 2013

expert reaction to the Review of Regulation of Cosmetic Interventions

Professor Sir Bruce Keogh, NHS Medical Director, led a Review of the Regulation of Cosmetic Interventions. The Review Committee gave a briefing the SMC to announce their findings and recommendations to Government, and the SMC gathered further expert comment.

Brendan Eley, Chief Executive of the Healing Foundation, said:

“The public may be surprised to know that whilst there are ongoing, systematic investigations into healthcare treatments and policy (such as the Cochrane Reviews), this has never before taken place in the area of cosmetic surgery. At the Healing Foundation we are delighted to launch the Aesthetic Research Institute in conjunction with the BAAPS, to help the profession, as well as the public, in a sector where the objectives of business and medicine have been known to collide.”

Rajiv Grover, consultant plastic surgeon and BAAPS (The British Association of Aesthetic Plastic Surgeons) President, said:

“We are pleased that the recommendations by the Committee so closely reflect our own views and initiatives over the last decade championing greater transparency for the benefit of patient safety. To this end we are delighted the report supports the creation of the ‘HF-BAAPS Aesthetic Research Institute’ which will be housed in the offices of the Healing Foundation at the Royal College of Surgeons. In a sector often derided for its unbridled expansion and unrestricted marketing, the HF-BAAPS Institute will play an important role in examining clinical evidence and analysing outcomes to separate fact from fiction. The use of stem cells in fat transfer – procedures already widely promoted to the public but lacking long-term study data – and the pivotal role of psychological assessment are all areas that this Institute is looking into and developing in depth, among others. Sir Bruce Keogh’s findings confirm that the cosmetic sector urgently requires detailed scrutiny, and the HF-BAAPS Institute will be the first to explore the evidence base for cosmetic treatments with a view to providing information on efficacy and best practice.”

Dr Tamara Griffiths, Consultant Dermatologist and British Association of Dermatologists representative to the review, said:

“As a Consultant Dermatologist I have myself seen the devastation that can be caused to a person’s appearance when intra-dermal fillers go wrong. In many cases the effects can be reversed – although it may take a long time – but in some the disfigurement will be permanent. Although I have never had to deal with this myself there are also reports of blindness and even death being caused by inappropriate injection of fillers. I am therefore very pleased to have been involved in the Review and glad to see that the recommendations coming out of it will make this area of cosmetic treatment safer for the public in the future.”

Professor Norman Williams, President of the Royal College of Surgeons of England (RCS), said:

“We welcome this report and the recommendations to address the vacuum of regulation and standards that currently exists in cosmetic surgery.  Over the past decade there have been numerous reports, a great deal of discussion but little action. The failure of PIP implants was a wake-up call that brought into sharp focus the desperate need for Government intervention to ensure commercial interests no longer take priority over patient safety. We call on Government to work with us to implement these recommendations without delay.

“We support the committee’s recommendation that only doctors on a General Medical Council specialist register should perform cosmetic surgery and work within the scope of their specialty specific training. This is a start to addressing concerns about unqualified practitioners engaged in this work including some overseas surgeons operating in the UK.   We welcome the opportunity to set clear standards for training and practice to ensure all surgeons are certified to the same standard irrespective of where they are trained.

“We are also pleased that, as a priority, the review proposes a National Breast Implant Registry should be operational within 12 months. The College has long pressed for mandatory databases for all surgical implants to improve patient safety by keeping an audit trail of device failures and complications. We hope this registry will be rolled out across surgery so that all medical devices are covered.”

Mr Stephen Cannon, Chairman of the Royal College of Surgeons of England (RCS) Professional Standards for Cosmetic Surgery working party, said:

“We welcome the review’s recognition of the multi-disciplinary Professional Standards for Cosmetic Practice the RCS published this year. These standards addressed the very real need for doctors, dentists and nurses to undertake appropriate training, to market and advertise their services responsibly and to professionally manage a patient’s expectations of how they will feel after treatment. These standards will lay the groundwork for a number of the Interspecialty Committee’s tasks including the code of ethical practice for cosmetic procedures proposed by the review. This should stamp out unscrupulous practices in the industry once and for all.”

Stanley Batchelor, Society of Radiological Protection, said:

“I welcome many aspects of this report – the recognition of the current complete regulatory inadequacies, which expose those individuals seeking non-surgical cosmetic procedures to potential harm, and the scale of the numbers seeking their doctor’s help after cosmetic interventions, which itself is a significant cost pressure on the NHS.

“I support the recognition that all those delivering laser / IPL treatments should be accountable to a professional regulator – we have witnessed that this works effectively in London and Nottingham, which are the only areas that already require non-surgical use of lasers and IPLs to be licensed.

“The creation of approved training schemes is also welcome as the law currently allows anyone to claim competence to run such courses. I do not believe in a blanket need for non-healthcare professionals to be supervised by healthcare professionals for laser / IPL treatments – this will introduce an unnecessary burden of expense to the cosmetic industry.”