3rd September 2012
There is a lot happening in the world of aesthetic medicine at the moment. A government review of cosmetic surgery services, led by Sir Bruce Keogh, is finally happening in the UK. This is in light of the recent PIP breast implant scandal. The review will examine not just surgical but also nonsurgical practices in the UK. Sir Keogh will examine multiple facets of practice, including staff training and appropriateness of premises.
This review has to be welcomed. It seems that at present, anyone can do whatever they want, wherever they want. That is, at least until there is a problem.
In the last month alone, I’ve been consulted by three patients that had received treatment with other practitioners in Bristol. The practitioner was happy to take their money but when an issue arose, they were left high and dry. I did my best to help.
Allergan are probably the largest pharmaceutical company involved in cosmetic medicine at the moment. They produce amongst other products, Juvederm Ultra.
They recently launched a ‘Quality is Key’ campaign. This campaign seeks to educate potential patients about important questions to ask their practitioner prior to having any cosmetic procedure. This is helpful but it only focuses on the products being used. While this is of vital importance, it is one of several points to be raised with your practitioner.
1. What are your exact qualifications?
- It takes a minimum of 5 years to train as a doctor and in most countries in Europe, only doctors are allowed to carry out injectible procedures.
- Specifically ask what training your practitioner has in the procedure for which you are consulting.
- How many has he or she done?
2. Where will the procedure be carried out?
- Remember that these are medical procedures. They may carried out for beautification and preservation but they are still medical in nature. They should be carried out in a medical clinic, not a hairdressers or a beauty salon.
- Seek out clinics registered with the Care, Quality Commission.
3. What products do you use and why?
- This is where the Allergan ‘Quality is Key’ campaign is helpful. Ask your practitioner about the products that they use?
- Be aware that there are over two hundred dermal filler products available in the UK. This compares with only a handful in the US. It would appear that it is far easier to obtain a CE mark for approval in Europe versus obtaining FDA approval in the USA.
- PIP breast implants had a CE mark. They were approved in Europe. They were, however, a fraction of the cost of most other implants. It is interesting how many plastic surgeons chose not to use them, even though they were ‘approved’. I’m reminded of the launch of Novobel, an entirely new class of dermal filler, at a conference in Paris a number of years ago. It lasted only a few months on the market before serious concerns about safety meant it was withdrawn. This should never have happened in my opinion. With proper testing prior to launch, these issues would have never arisen.
- Dermal fillers should be prescription medicines as far as I’m concerned. They should go through the same testing as other medicines, as opposed to being classed as medical devices.
4. What do I do if I have a problem?
- As I’ve said before, these are medical procedures. There are inherent risks, however rare, with any procedure. Ask your doctor, what complications has he/she seen? What happens if you have a problem?
I am a great believer in cosmetic medicine
I firmly believe that this new specialty of medicine will continue to evolve and to improve patients lives. I am genuinely hopeful that the current government review will improve patient safety.
As doctors, this is what we all want.