Cosmetic surgery: out of a scandal must come proper regulation
The furore over breast implants has highlighted the need for the industry to put its house in order
Sat 7 Jan 2012 19.06 EST First published on Sat 7 Jan 2012 19.06 EST
On Friday, the expert group, headed by Sir Bruce Keogh, the medical director of the NHS, brought together to consider the ramifications of the breast implants made by the now defunct French company Poly Implant Prosthesis (PIP), delivered its verdict. The consequences of the advice the group has given to Andrew Lansley, the health secretary, is less than generous to the 40,000 or so women who received PIP implants.
While the French government has offered to remove implants from the 30,000 women affected in France, in the UK only those who have called on the services of the NHS will be helped. The majority of women who attended private clinics will have to fend for themselves or turn to the NHS in extremis if it transpires that the clinic has gone out of business or refuses to behave honourably (and forfeit profit in the process).
The expert group has decided there is a very small risk of rupture and none of cancer. However, the conflicting messages from abroad – Venezuela, Germany and the Czech Republic are also advocating removal – and the continuing haze of uncertainty is hardly reassuring for thousands of British women.
One should never take the offer of transformative invasive surgery at face value. But many of those who opted for PIP implants, often on very limited incomes, presumably took that decision in the belief that the industry, much of which gives itself a pseudo-medical camouflage, is staffed by highly trained surgeons and GPs and is properly regulated and trustworthy.
Thanks to the greed of Monsieur Jean-Claude Mas, PIP's founder, who now faces criminal charges around the world, today we know better. Organisations such as the British Association of Aesthetic Plastic Surgeons have long campaigned for greater professionalism and the ejection of the quacks and cowboys but only now might they receive a proper hearing.
Last week, for instance, it emerged that some lunchtime clinics are offering Bio-Alcamid, a potentially dangerous wrinkle-smoothing gel injected as a permanent facial filler. It's claimed that it can migrate elsewhere in the body and cause disfiguring lumps and infections that may be serious enough to require hospital admission. The manufacturer says this can only happen if not properly administered.
So what needs to be done? Almost 70% of the cosmetic industry is effectively unregulated. Cosmetic practitioners in the private sector, for instance, may be no more than jobbing GPs and former dentists, so better qualifications are required. The Medicines and Healthcare Products Regulatory Agency needs to be tougher, welcome more lay representation and be more open about its criteria for granting certification for products. The regular monitoring of outcomes and thorough inspections of clinics need to become the norm.
Advertisements for cosmetic surgery aimed at ever-younger audiences should be restricted since, in its present "wild west" stage of development, the industry can be highly damaging, psychologically and physically – if not lethal.
It might be advisable, too, if individuals who opt for cosmetic surgery were required to take out insurance to cover them for the sometimes less than benign consequences.