Latest complaints raise concerns about the lack of regulation governing plastic surgery here
ANOTHER COMPLAINT has been made to the Irish Medical Council about Dr Marco Loiacono, the Italian plastic surgeon who last Friday was found guilty of professional misconduct in relation to his treatment of a 33-year-old Dublin woman who attended him for a breast augmentation operation.
The fresh complaint is understood to be similar in nature to the one aired before the council's fitness to practice committee in recent weeks and alleges that Dr Loiacono – who has featured on The Cosmetic Surgery Showcurrently running on TV3 – failed to provide proper care for a patient when an infection set in following breast enlargement surgery.
The latest allegations concern an operation performed in 2008 on a patient who subsequently had to be admitted to a public hospital for treatment.
The Medical Council will have to decide whether or not to hold a fitness to practice inquiry into the latest allegations in due course, after it has received a response from the doctor.
A third party who contacted Dr Loiacono yesterday said he was unaware of another complaint against him.
In the fitness to practice case against Dr Loiacono which concluded last week, receptionist and mother of three, Catherine McCormack from Swords, Co Dublin, gave evidence that while she was initially happy with her surgery in October 2006, one of her breast implants eventually had to be removed when an infection set in.
She claimed the outcome after the surgery, which was to bring her from a B bra cup size to a D/DD cup, would have been much better had she received proper post-operative care.
She said she was left for nearly a year with two different size breasts until she had an implant re-inserted in her left breast at Dublin’s Mater Hospital.
Dr Loiacono denied any misconduct in relation to his treatment of Ms McCormack, who was given a discount on the cost of her operation on the basis that she opted for surgery within days of her initial consultation at the now liquidated Advanced Cosmetic Surgery (ACS) clinic in Dublin.
A three-person fitness to practice inquiry team found six of 12 allegations against Dr Loiacono in relation to his treatment of Ms McCormack proven beyond reasonable doubt.
They have recommended a number of conditions be attached to the retention of his name on the medical register, including that he undertake an appropriate professional development programme. Their decision must to be ratified by a meeting of the full Medical Council.
It was found that Dr Loiacono failed to arrange for adequate post-operative treatment for Ms McCormack when he became aware her left breast had become infected, failed to remove her left breast implant in a timely manner when an infection set in, failed to treat the infection appropriately, failed to maintain adequate medical records, and failed to apply adequate standards of clinical competence or judgment in her case.
Dr Loiacono said he was unaware Ms McCormack was offered a discount and had received her first consultation only days before the operation. He said he accepted there should be what’s referred to as a “cooling off” period between a patient’s consultation and the decision to proceed to surgery.
What appeared to be a wrong date on the initial consultation form gave him the impression she had her first consultation on August 15th, 2006, rather than October 15th, 2006, a few days before her surgery. The fitness to practice committee accepted this.
Dr Loiacono told the inquiry he had carried out more than 450 breast augmentations and in only two or three cases had infections set in.
The inquiry has drawn attention to a range of questionable practices at some private cosmetic surgery clinics, including giving surgeons commission depending on how much business they can generate. Dr Loiacono’s contract stated he would get 8 per cent commission if he earned the ACS clinic more than €25,000 a day.
It has also again raised the issue of lack of regulation of the cosmetic surgery industry here.
Dr Seán Carroll, a plastic surgeon at St Vincent’s University Hospital and the Beacon private hospital in Dublin, said this lack of regulation meant surgeons who were not properly trained were coming here from abroad to operate at private clinics.
He said he was not suggesting Dr Loiacono, who had qualified in Rome and did much of his plastic surgery training in Brazil, was not properly qualified.
Members of the Irish Association of Plastic Surgeons were seeing a few post-operative complications a month following treatment at private clinics here, he said.
“Complications occur with everyone. It’s the way they are treated and the number that occur is the worrying thing that comes out of the commercially driven cosmetic surgery clinics,” he said.
Furthermore, he said “cooling off periods” were not being adhered to. “I see it all the time. Sometimes patients get text messages saying they will be offered a discount if they hurry up and make their mind up. It’s akin to a second hand car dealership.”
His advice to the public is to have surgery performed by a competent doctor, preferably referred by one’s GP.
Dr Carroll said there were still no indications of when the industry would be regulated here, but it was a difficult area in many countries for legislators. “The only way it can probably be controlled is through inspection of the units,” he said.
Cosmedico in Co Wicklow – where Dr Loiacono worked for a period – is one of a number of private cosmetic surgery clinics in the State. Its manager, Ailish Kelly, said she also wanted to see the area regulated.
“I have a huge concern that this area is not regulated. It’s absolutely terrible. I have written to Mary Harney about it a number of times,” she said.
Doctors working in Cosmedico, she added, have to be on the Medical Council’s specialist register, but there were many “out there” and operating who were not on it, she said.
There had been no issues, she stressed, in relation to care provided to patients at her clinic by Dr Loiacono when he worked there.
A spokesman for the Department of Health said the department was “developing legislative proposals for a mandatory licensing system covering both public and private facilities, including private cosmetic surgery clinics” in line with the recommendations of the Commission on Patient Safety and Quality Assurance, which reported in 2008.
“The Minister intends to bring these proposals to Government by the end of the year,” he said.