Cosmetic surgery has been held in a place of intrigue in the consciousness of the British public since its inception over a century ago. In more recent years, as the pace of innovation has increased and more cosmetic solutions have been introduced to the marketplace, this intrigue has only been heightened, not least by an increasing level of due scrutiny from the British media. In this piece I argue that, whilst the activity of a free press undoubtedly delivers fundamental benefits of transparency and accountability to the cosmetic industry, more can be done by the media and medical professionals to support the practice of a fully informed and balanced debate about the benefits, and potential pitfalls, of the cosmetic industry as a whole among the general public.
The issue at the heart of the problem is the understandable inclination to publish newsworthy items such as stories of cosmetic 'addictions', low quality surgery and 'botched jobs' that primarily serve to highlight the industry's failings to an interested, albeit slightly misinformed, general public. Whilst this coverage serves a key purpose by promoting open disclosure regarding the range of possible outcomes from such surgery whilst holding providers of poor surgery to public account, it over-emphasizes behaviours and practices at the very extremes of the spectrum at the expense of promoting a more balanced understanding of the normal distribution of expected outcomes. In effect, the lasting legacy is to overlook the actions of a qualified, ethical majority and to subject the entire cosmetic industry to a rather public 'trial by press' in which only its most negative elements have been called to witness.
The reality is somewhat more subtle than the peripheral depiction currently portrayed in the media. This narrative focusses solely on the dubitable actions of a distinct minority (what we call 'cowboy' surgeons in the industry), and requires substantial contextualisation from the activities of other side of the industry - the good guys so to speak -the vast majority of well-qualified, medically-oriented plastic surgeons.
The fact is that most of us regard ourselves as first and foremost medical professionals. This not only speaks to our broader surgical training (I first trained as a general surgeon before later specialization), but also a professional mind-set instilled during a long and meticulous apprenticeship. This means that we will simply not consider elevating commercial imperatives over our medical integrity, nor are we likely to make a mess of what are surgically-speaking relatively straightforward procedures. Put plainly, compared to the reconstructive work that most of us have been raised upon, a breast augmentation or liposuction procedure is fairly basic surgical fare.
By way of example, at the Cadogan Clinic, my cosmetic clinic in central London, we see it as our medical responsibility to evaluate each and every one of our patients to ensure that they are suitable for any procedure they express a desire to undertake. Each patient therefore undergoes a strict examination of their motives and expectations, as well as a full mental health evaluation. We believe that to ignore this obligation constitutes gross medical malpractice. We also have a negligible complication rate, which goes for many other private clinics and hospitals around the country.
As with many other industries, an inevitable variation in standards clearly exists amongst providers. However, unlike most industries, the ethical and medical connotations associated with poor standards in our industry are almost uniquely substantial. What we ask of the media is therefore a more responsible approach to the issue, which would seek to educate first rather than poke the fire. This would be to understand that there will always be people out there desiring surgical intervention to change their appearance, and likewise there will always be doctors willing to assist them. Faced with such a reality, we must work together to inform and protect the consumer by providing them with a better understanding of the range of options available along the cost/quality spectrum, and the related potential outcome/experience trade-offs occurring at each level. Consumers should also be encouraged to more comprehensively research the providers, clinics and surgeons to help them make better, safer decisions.
At heart, I strongly believe in the lasting, positive change that my discipline can uniquely deliver on a physical and psychological level to the vast majority of individuals who choose to engage with our expertise. But I believe it is incumbent on both the mainstream media, and indeed medical professionals, to do more to support potential consumers by providing the right information in a more balanced, accessible and constructive way. This requires more nuanced reportage from a more collaborative and responsible media that presents a more realistic reflection of the breadth of the industry as a whole, as well as a more articulate and concentrated industry voice in support. There is a very real physical and emotional dimension to these decisions, and it is in everyone's interest that we all take this seriously.