At the start to the New Year, many head down to the gym with the good intentions of getting their bodies back into shape. But increasingly people are also turning to cosmetic surgery to get the look they want.
From Harley Street professionals to high street beauticians, there are a range of procedures to smooth away wrinkles, remove unsightly hairs, or make us less rotund. But like all medical procedures, these come with risks.
Looking up
The cosmetic surgery industry has grown considerably in recent years, as more and more of us want to change the way we look. And for thousands of people in the United Kingdom, 2010 will bring a slimmer tummy, a new nose, or a more curvaceous figure.
According to the British Association of Aesthetic Plastic Surgeons (BAAPS) there were over 34,000 cosmetic surgical procedures in 2008, more than triple the number in 2003.
Women are far more likely than men to opt for cosmetic surgery - 90% of all cosmetic surgery is carried out on women - but procedures such as “tummy tucks” and eyebrow lifts are all proving increasingly popular with men.
According to Robert Wendin, head of the European Healthcare practice for broker Marsh in London, the cosmetic healthcare sector is increasingly diverse - with a range of procedures available from professional surgeons to high street beauticians.
Surgery - such as breast enhancements and tummy tucks - is regulated, although cowboy operators do exist, said Wendin. Laser treatments, and in particular injectables, are however causing more concern because they are unregulated and can be carried out by anyone, he explained.
And it is the popularity of these unregulated procedures that has grown the most in recent years, according to Nigel Mercer, BAAPS president-elect and consultant plastic surgeon.
More oversight needed
BAAPS would like to see a dedicated regulator put in place for cosmetic procedures, and would like to see a requirement for cosmetic products like dermal fillers to obtain Food and Drug Administration-like approval, said Mercer.
There is a lack of regulation across the sector, and some procedures that are available from beauticians-including increasingly popular laser treatments and facial fillers (injections or creams which can reduce the appearance of wrinkles and lines)-are completely unregulated he explained.
High street practitioners are unlikely to carry malpractice insurance, leaving consumers potentially uncompensated when things go wrong, he added.
In December, The Telegraph newspaper reported a tightening of cosmetic surgery rules in Italy, including a ban for girls under 18 from having breast enhancement or other plastic surgery.
However, anyone over the age of 16 can walk into a private clinic in the United Kingdom and request cosmetic surgery, as long as they are deemed competent, said Claire Petts, Associate Director at law firm Barlow Lyde & Gilbert. But a ban on cosmetic surgery for the under-18s in Britain is unlikely because of Human Rights legislation, she said.
Raising standards
Insurers can also help raise standards by insisting on accreditation to bodies like IHAS and BAAP, and by offering risk management, training and advice, said Wendin.
The cosmetic surgery sector has been working to remove bad practices, and the Independent Healthcare Advisory Services (IHAS) has been proactively promoting standards, particularly in the field of injectables, he said.
Insurance also has an important role in consumer protection, said Wendin. For example medical malpractice insurance can compensate patients when things go wrong.
Some surgeons will be better than others, but the sector’s poor reputation in the media is probably not deserved, Petts said. Alongside other surgeons, cosmetic surgeons in the private sector must be registered and are regulated by the General Medical Council, and most carry appropriate liability insurance, she added.
Managing expectations
The recent growth in aesthetic procedures requires careful underwriting, said Alex Wakeley underwriter and director with Marketform, a leading Lloyd’s medical malpractice insurer. Some people undergoing cosmetic surgery are going to be hard to please as they have unrealistic expectations, he said.
“Most claims today are about failed expectations,” said Wakely. “When it comes to ‘looks’ individuals often have higher expectations than are justified concerning the outcomes of a treatment.”
Insurers need to be aware of, and underwrite for, adverse outcomes of what at face value may be regarded as routine treatments. For example, in 2007 one of the largest reported compensation awards for routine liposuction of £300,000 was paid as a result of a serious blood infection, he said.
Insurers must build up and maintain detailed specialist knowledge, preferably in-house, of such adverse outcomes and causations in order to underwrite effectively and profitably, Wakeley said.
New range of beauty products
Cosmetic surgery is not risk free, and educating the profession, potential patients and the wider public of this fact is paramount, said Nigel Mercer, BAAPS President and consultant plastic surgeon.
Concerned over the relatively high cost of liability insurance, BAAPS has been working with insurers to provide policies that better reflect a practitioner’s claims record and risk profile, Mercer said. BAAPS is soon to offer its members a new medical malpractice policy backed by insurer WR Berkley, he added.
BAAPS also advised in the development of an innovative product launched by Lloyd’s insurer Marketform last year. Beautysure, which covers seven of the most popular cosmetic operations, including breast augmentation, liposuction and tummy tucks, can be purchased by surgeons to cover against possible medical complications.
