Not so long ago cosmetic treatments were the preserve of the rich and famous, but what was once a niche area of UK healthcare has expanded quickly. Wider availability means just about anyone can consider a nip here, a tuck there, or a quick injection of Botox.
But regulation hasn't kept pace with the rapid growth - particularly when it comes to non-surgical procedures - and the lure of large profits for companies and individuals make it vital that people are given as much protection as possible.
The need for the General Medical Council's new guidance for doctors was highlighted by Sir Bruce Keogh's review following the PIP breast implant scandal. It came to light that thousands of women had been given implants made using industrial grade, rather than medical grade, silicon.
Sir Bruce's review found evidence of a range of poor practices - people being hurried or influenced into making hasty treatment decisions, misleading advertising, poor discussion of the risks involved, little understanding of, or appropriate support for, those with psychological problems, and very poor continuity of care or support if something went wrong.
I was shocked by many of the stories that came to light, although I was also heartened by the professionalism of many doctors working in this field, and their determination to raise standards across the sector.
Among issued raised with us, as well as the lack of regulation, were the poor quality of the products and devices being used, problems with the level of aftercare, practitioners working beyond their level of experience, and advertising that was often misleading and inappropriate.
I believe our new guidance addresses the issues that have come to light, and will help to improve and drive up those standards. Also, importantly, it should help people feel empowered to ask questions about the procedure they're considering, and to walk away if they're not satisfied at the answers they receive.
The new guidelines apply in situations where the main aim of the procedure is to change a patient's physical appearance. This could be either a surgical procedure (such as breast enlargement or laser eye surgery) or a non-surgical procedure (for example Botox).
For people seeking cosmetic interventions, our new standards will help improve the experience they can expect. For example, doctors must seek their consent themselves, and not delegate to sales staff or anyone else. They must give people time to reflect, in effect a 'cooling off' period, take particular care if a person is aged under 18, and they must consider whether individuals have psychological needs or are vulnerable in any way.
Doctors must also market their services responsibly, no offers of procedures as competition prizes or packaged into 'buy one get one free' deals. They must make sure people have the right information, including explaining any medicines or implants used, and, as in all fields of practice, it is vital that they work within their competence, with appropriate supervision, and that they share information on outcomes and safety with colleagues and the appropriate regulatory authorities.
Of course, it is not only doctors who are carrying out cosmetic interventions. As the doctors' regulator we can only produce guidance that applies to them, but the principles are relevant to everyone caring for people who seek cosmetic interventions. We hope other professional groups will find it useful, and that it will play a role in raising standards across the sector.The guidance comes into force in June, and we are producing a short guide anyone considering a cosmetic procedure about what they should look for from their doctor, and what they should expect during and after their procedure.
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