In the unregulated sector of cosmetic surgery, people should conduct adequate research to ensure they get the best care available, writes Theresa Judge
A LEADING plastic surgeon has warned people against travelling abroad for cosmetic surgery and said that "people need to vet their doctors" in the unregulated sector in Ireland.
Consultant plastic surgeon Sean Carroll said he was treating "at least one person every fortnight over the past six months who required corrective surgery after poor cosmetic surgery procedures".
Carroll was speaking following calls for the sector to be regulated from the family of a woman who died within hours of a gastric binding procedure at a cosmetic surgery clinic in Dublin in February 2007.
An inquest into the death of Bernadette Reid (48) last week heard how her GP had advised her against getting the operation because of her chronic asthma and obesity. The clinic made no contact with her GP and the Paris-based doctor, Jerome Manuceau, who was doing the operation did not have access to her GP records.
The inquest also heard that monitors attached to Reid were not working properly. She died 10 hours after the gastric binding procedure had to be stopped when Manuceau found a tumour on her stomach. The coroner recorded a verdict of death by natural causes.
Manuceau later told RTÉ that Irish women were regularly travelling to his Paris clinic for the gastric binding procedure.
Carroll, who works at St Vincent's hospital in Dublin and at the Beacon Clinic, says people need to understand that when cosmetic surgery clinics say all their doctors are registered with the Medical Council, this does not mean they have specialist surgical expertise.
He says confusion exists because while plastic surgery is a registered specialty within surgery, cosmetic surgery is not and there are, therefore, no guidelines from any governing body specifying what one needs to do to become a cosmetic surgeon.
In the case of plastic surgery and other specialties, people have to complete specified training to gain expertise before being put on a specialist register.
He says people can call themselves a surgeon by getting a fellowship but this only requires sitting a "middle-grade exam". Membership of a specialist register is the only guarantee of specialist surgical expertise, he says. "A significant number of so-called cosmetic surgeons are not on any specialist register," he says, adding that in many cases they are people who have tried to pursue various specialties but who have "dropped off the training schemes".
He cautions people against believing it is safe to have minor procedures at cosmetic surgery clinics. "There is no such thing as a minor surgical procedure because minor procedures can lead to major complications."
He also says he finds it "illogical" that people would travel abroad for surgery considering the risks involved. "People say procedures are more freely available and that may be the case, but people should be taking care of themselves and trying to keep themselves safe."
He says going abroad for any kind of medical or surgical treatment is potentially unsafe because if a problem arises the patient is a long way from the provider of the initial treatment.
The death of Bernadette Reid, who was treated at the Advanced Cosmetic Surgery (ACS) clinic at Owenstown Park in Stillorgan, Co Dublin, has again highlighted the dangers that patients face given that cosmetic surgery is an unregulated sector.
Following the publicity surrounding the inquest, the Department of Health issued a statement on the licensing of private hospitals and clinics. It said the Commission on Patient Safety and Quality Assurance, which was set up in January 2007, would be making recommendations on "a statutory system of licensing for public and private healthcare providers and services". The department said the commission would report in July.
This statement was welcomed by the Royal College of Surgeons in Ireland. "Bringing all hospitals into the regulatory system, which includes the monitoring of standards and practice, is to be strongly supported and will ultimately benefit patients. The college endorses anything that results in the protection of patients and that defines clear terms for the provision of good quality care and outcomes," RCSI president Frank Keane said.
After last week's inquest Bernadette Reid's son, Michael, said the family had been unaware that the sector was not regulated. "We had no idea until after, that anybody can set up these clinics without a licence." He said they had "assumed that the State would give protection to its citizens". Saying the gastric binding operation had cost €10,000, he also accuses cosmetic surgery clinics of making millions from people with such health problems as obesity.
The Medical Council says it cannot comment on the case for legal reasons.
Carroll says the Department of Health is taking "a step in the right direction" but says he believes "all interested parties should try to do more". He says cosmetic surgery is also unregulated in many other countries, including the US and Britain, because of the difficulty in describing what training is required.
In the meantime, he says it is "up to patients to vet the doctors they go to" and he urges people to do a lot of research before going for any procedure. The best way of doing this is by going to a GP who will know if the surgeon is legitimate or by getting a recommendation from someone who has been a patient of the surgeon.
"You wouldn't buy a computer without doing a lot of research. If you are going to have an operation on yourself, wouldn't you want to go to the best person available? Why settle for someone who is not the best; why compromise with your own body?"