Tighter restrictions on cosmetic surgery urged

Liposuction treatment Cosmetic procedures should not be sold aggressively, the report said

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Responses to a public consultation on cosmetic surgery have shown strong support for a ban on cut-price deals and aggressive selling.

A summary of responses from patients, the public and industry has been published as part of the review set up after the PIP breast implant scandal.

A final report, by Sir Bruce Keogh, the NHS medical director leading the English review, is due in March 2013.

Cosmetic surgeons said procedures should not be sold as "a commodity".

The health secretary asked Sir Bruce to look at the regulation and safety of products used in cosmetic surgery and the care given to patients both during and after their treatment.

The review came after concerns over health risks associated with Poly Implant Prothese (PIP) implants made by a French company surfaced last December. It is thought up to 40,000 British women have the silicone implants, mostly done privately rather than on the NHS.

'Price over quality'

Writing in the foreword to the summary of responses, Sir Bruce said the responses "send a clear message that the current regulatory framework doesn't do enough to support consumer rights or patient safety".

Of the 180 responses to the consultation, the majority were in favour of tighter restrictions on the advertising of cosmetic surgery.

"The proliferation of advertising for cosmetic surgery and its use in TV make-over programmes was felt to trivialise surgery and its risks, while making excessive claims of its impact on people's emotional wellbeing," the summary said.

'Once-in-a-lifetime chance'

Sabrina Elliott decided to have breast surgery 11 years ago, aged 23, following childbirth.

She says she feels the clinic she went to put "pressure" on her to sign up to the operation.

Ms Elliott says she was offered a "lifetime guarantee" at a consultation with a company secretary but was told the offer would expire within 48 hours.

She took up the offer after receiving a follow-up call on the same day telling her it was a "once-in-a-lifetime chance".

However, the firm went into liquidation two years later.

The implants she had fitted were PIP - and she says she now experiences pain on a daily basis. The NHS is currently refusing to remove them, she says.

"It's terrible. I'm a single mum now and a full-time student - sometimes it's difficult to pick up my two-year-old daughter because of the pain I'm in," she told BBC Radio 4's Today Programme.

There was also "very strong support" for the banning of financial inducements or time-limited deals, it said.

It added that such practices were seen as "unethical, placing undue pressure on the patient and emphasising price rather than quality".

Providing patients with photos of expected bruising, as well as more detail on the risks associated with surgery should be standard procedure too, some respondents said.

There was a "strong sense" that consultations should be with the person performing the procedure - or at the very least a medical professional - rather than a sales adviser, the summary said. Some respondents believed there should be a ban on free consultations.

Sabrina Elliott says she was put under "pressure" to sign up to a breast implant operation within 48 hours, so as to be entitled to a "lifetime guarantee".

Ms Elliott took up the offer but the company later went into liquidation and she says her PIP implants are causing a range of health complications, including a slow silicone bleed which means she is in pain on a daily basis.

"There was pressure. The pressure was to get that lifetime guarantee because it was really put to us that it was only with this company," she told BBC Radio 4's Today Programme.

She went on: "Unfortunately I paid nearly £4,000 to have harmful chemicals put in my body to which to date I am still suffering [from]."

Start Quote

It's time to scrub up and take action to restore confidence in our sector”

End Quote Rajiv Grover President, British Association of Aesthetic Plastic Surgeons

Sally Taber, director of Independent Healthcare Advisory Services, a trade body for the independent healthcare sector, said aggressive sales techniques were "totally inappropriate" and "all IHAS members have signed up to the fact that they don't do that now".

She agreed with the review panel that prospective cosmetic surgery patients should not have free consultations and the industry had "looked at policies and procedures to ensure this does not happen".

Good medical practice clearly states that consultations should take place with a medical professional - and the industry has been told that, she said.

"It's totally inappropriate to see someone that isn't qualified and gives pressurised advice," she said in an interview with the Today Programme.

She said there are some "rogue providers out there" but there are also "plenty of providers that do things correctly".

'Safer environment'

GP Dr Rosemary Leonard, the BBC Breakfast doctor and review committee member, said patients should always talk to a doctor first.

"It is wrong that the first consultation is with a sales person rather than a medical professional," she said.

"Surgery - indeed any cosmetic intervention - is a serious step, and a patient must be told about the immediate side effects after surgery as well as any potential long term effects on their health."

Rajiv Grover, president of the British Association of Aesthetic Plastic Surgeons (BAAPS) also welcomed the call to end the practice of sales people holding consultations.

Review panel member Vivienne Parry says "people are not made aware of the risks"

He said: "We're pleased that the report - and public opinion - so strongly reflects our own views.

"We have made the comparison between cosmetic surgery being sold as a commodity, much as a washing machine or off-the-shelf beauty products, many times before.

"Medical procedures simply cannot continue to be promoted in this manner and although it is tragic that it has taken a crisis of the magnitude of PIP to make the world sit up and take notice, it seems we're finally making headway towards a safer environment for patients.

"It's time to scrub up and take action to restore confidence in our sector."

Respondents to the consultation were asked a series of questions about the way the current regulatory system functions.

The review panel said they would be used to inform their final recommendations.

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