Cosmetic surgery to carry health warnings?

Sandra Ryan reports on the Irish Association of Plastic Surgeons’ call for changes to advertising laws and more regulation of cosmetic surgery clinics
Strong new proposals from the Irish Association of Plastic Surgeons (IAPS), including the recommendation that advertisements for cosmetic surgery clinics should carry health warnings, could mean a radical change in the way private clinics operate.
There are no regulations or licensing in Ireland for private health clinics, which has led to a grey area for the numerous cosmetic surgery businesses that currently freely advertise their services.

h4. Ethical guidelines
According to the Department of Health, the need for regulation in the area is ‘currently under examination’. It believes it is the responsibility of the Medical Council to regulate the area of cosmetic surgery practices and the doctors providing the services. The Council is looking at ways to change its ethical guidelines (which are under review) to provide stricter rules for cosmetic surgery practitioners.
One group who has grown more and more concerned, meanwhile, is the IAPS. Former President and Consultant Plastic Surgeon in the Mater Hospital, Dublin, Mr Michael Earley believes the potential danger to patients seeking plastic surgery has gone on long enough.
The group has written a document, approved by the Royal College of Surgeons in Ireland (RCSI), that is calling on the Department of Health to introduce strict regulation in the area. The IAPS is particularly concerned about advertising.
“There is a duty upon the Government to impose a robust form of regulation in order to build public confidence and eradicate unscrupulous practices within this sector,” believes Mr Earley.
h4. Misleading campaign
“Over the past ten years, there has been a sudden increase in advertising of cosmetic surgery with no apparent guidelines being visible and there has therefore been a subsequent increase in non-regulated clinics. This has led to a definite and misleading campaign to define cosmetic surgery as being some type of separate specialty from the main body of reconstructive and plastic surgery.”
According to the IAPS, it is difficult to separate good surgeons from bad because there is no officially recognised training in cosmetic surgery. “We have had to face an increase in media coverage of cosmetic surgery, with the proliferation of several programmes concentrating on ‘makeovers’ and the enhancement of appearance,” says Mr Early. “There seems to be an insatiable appetite on the part of the public for such procedures and for programmes about them.”
The figures available back this up: according to the latest statistics from the British and Irish Association of Aesthetic Plastic Surgeons, some 32, 453 procedures were carried out in 2007 in private practices, up 12.2 per cent from 2006. The majority of procedures (91 per cent) are done on women, and the most popular are breast augmentation and rhinoplasty for men.The private clinics welcome the demand and many have extensive advertising campaigns.
h4. New code of practice
The IAPS therefore wants a new code of practice introduced, which should state: that it should be illegal for payment to be made to a clinic before a consultation with a surgeon; that the qualifications and relevant experience of a surgeon should be made clear to the patient; that initial consultations should not be done by a nurse or lay counsellor; that a recognised specialist training programme in cosmetic surgery be established; and that surgeons suspended for clinical reasons should not be allowed work in the private sector.
The IAPS also wants stricter rules for advertising and greater action to be taken by advertising standards authorities to remove misleading text from ‘offending’ ads.
“In an ideal world, there would be a total ban on advertising for cosmetic surgery,” states the IAPS document. “It is essential there is adequate legislation to deal with misleading advertisements for cosmetic surgery and with any other unfounded or misleading claims made for medical or surgical treatment.”
It is recommending that health warnings be placed on all advertisements for cosmetic surgery, highlighting the risks.“Photographs or other illustrations of the human body should not be permitted in ads for cosmetic surgery. They are generally misleading as the presentation of the apparently perfect human form may subconsciously influence the patients to believe that an operation will give them equivalent beauty. In most brochures, the usually unclothed bodies show little sign of ever having been touched by a surgeon’s knife or ever needing any enhancement,” states the IAPS.
It is recommending that a new body be set up to regulate the private healthcare sector. The body would be ideally paid for by the private healthcare sector and should be responsible for overseeing all regulatory matters related to the private healthcare sector.
“There is no good reason why private patients should be given less protection than public patients,” says the IAPS. “It is only right that people are given the greatest protection in this special marketplace dealing with people’s health, wellbeing and, in some cases, lives.”