We see it on TV and in social media – the extreme examples of faces and bodies distorted and disfigured by cosmetic surgery. We question who could possibly be approving this surgery? Our medical negligence teams hear from many who suffer significant mental health issues after cosmetic or reconstructive surgery. The very issue that they hoped to improve can, sadly, become their sole focus if a procedure doesn’t go as hoped. A recent article refers to the potential introduction of a screening tool that would help to ensure vulnerable patients are provided with appropriate advice, information, and support. The tool can also help identify those who should not pursue surgery at all.
Dr Garry Buckland is a Surgeon, a hearing member of the NSW Medical Board and Director of the Australasian Foundation for Plastic Surgery (AFPS). Together with a team of psychologists in the UK, Dr Buckland has undertaken a five-year project to develop a world-first psychological assessment tool, designed to be used in the cosmetic and reconstructive surgery space. It may also used for any type of surgical specialty that involves an alteration to physical appearance.
The fact that it’s referred to as a world-first reflects, to us, a sad state of affairs. Consider, for example, that the first breast enlargement using silicone implants took place in 1962.
Medical negligence lawyers acknowledge that there are many excellent cosmetic and reconstructive surgeons. An experienced and ethical surgeon in the industry, as Dr Buckland points out, knows that some members of the public are simply not good candidates for surgery. The doctor states:
People who live with mental health conditions, abusive partners, or who have unrealistic expectations often become dissatisfied with the outcome of surgery, irrespective of how well the procedure has been performed. This can cause untold psychological harm to individuals.
Bad or unexpected outcomes also often result in litigation. Statistics show that in Australia, around 16% of all healthcare disputes relate to cosmetic surgery. Of these, 39% of patients claim the surgeon failed to explain the potential lack of benefit and 26% allege they were not adequately informed before consenting to the procedure.
The assessment tool will be available to clinicians only and contains questions which will capture issues like mental health, body image and relationship with social media. The stated aim is to help surgeons identify – in an objective and evidence-based fashion – which patients should be referred for psychological or psychiatric assessment before surgery is considered, and which patients should not pursue surgery at all (such as patients with body dysmorphic disorder).
This begs the question – why would some patients choose to answer honestly if they are fixated on cosmetic surgery? Apparently, the survey questions are designed in a way that maximises the chances of people providing honest answers. The survey is also designed to ensure that candidates who do have surgery are given appropriate information, higher levels of support and more realistic expectations.
Dr Buckland and his team are due to meet with Australian regulators soon. They hope the tool will be integrated into mainstream practice. The doctor stresses though that adhering to the tool will not be a legal obligation.
What remains of most concern to our team is that as it currently stands, pre-surgical assessments for issues like anxiety, depression and eating disorders are rare. It seems to us that’s it the non-ethical cosmetic surgeons who are the ones least likely to use this tool.
We will watch, with interest, the continuing developments in this space. See the article Click here.
