Is it time the cosmetic surgery sector get a regulatory nip/tuck?


Is it time the cosmetic surgery sector get a regulatory nip/tuck?
Calls for greater regulation of Ireland’s cosmetic surgery industry are growing, writes Ali Bracken
Halina Ashdown Sheils of the Advanced Cosmetic Surgery clinic in Dublin
Why are we asking this now?

The Irish Association of Plastic Surgeons (IAPS) has been calling for uniform regulation of the private and public sector for many years and the issue now seems to have finally been put on the political agenda. The IAPS and the Royal College of Surgeons in Ireland (RCSI) separately wrote to the Medical Council last week outlining their concerns about the lack of regulation of cosmetic surgery clinics in the state.

What prompted those moves?

A French surgeon at an Advanced Cosmetic Surgery (ACS) clinic in Dublin, who split his time between Ireland and France, has been suspended from the Medical Council’s register on foot of a High Court order pending a full fitness-to-practise inquiry. The IAPS and RCSI told the Medical Council complicated procedures such as gastric banding (complex anti-obesity surgery) should not be carried out at facilities other than major hospitals. They also voiced concern about aftercare for patients at some private clinics.

Last Sunday, a national newspaper published an article stating that a woman died after she underwent gastric banding by the French surgeon at an Advanced Cosmetic Surgery clinic. This claim has been strongly denied by the clinic, which told the Sunday Tribune it was now taking legal action against the newspaper that initially published the story.

“What has been said about that surgeon is completely untrue. That patient had blood tests and an investigation with a camera to see if she was suitable for the procedure. The surgeon found cancer cells, so she would not have been suitable and the clinic informed her GP. Unfortunately, 12 hours later she died from sleep apnoea, which was unrelated to the investigation by the surgeon, ” said ACS managing director Halina Ashdown Sheils. “His suspension had nothing to do with his work, but was a minor issue over documentation. He’s one of the most experienced gastric-banding surgeons worldwide. He’ll come and give evidence at the inquiry and most likely be given his licence back.”

What problems have been identified due to lack of regulation?

Some cosmetic surgery patients are at serious risk because of the lack of regulation, according to Dr Jack Kelly, a Galway-based member of the IAPS. “There is very little regulation in the cosmetic surgery industry in terms of qualification of doctors, training and ongoing professional development, ” he told the Sunday Tribune. “There is an issue with auditing of activity in some clinics and a major problem at some clinics with aftercare service.”

Kelly said there were few members of his association who had not seen some complications arising out of treatments provided in cosmetic surgery clinics. “Just 10 days ago, a woman came into the A&E; at Galway University Hospital with significant complications from abdominal plastic surgery [tummy tuck]. She had an infection;

it was a very serious post-operative complication. She had the procedure at a private clinic but she couldn’t get anyone there to see her after the operation. I’m not trying to damn the whole private sector;

some of them deliver a well-delivered service. But some of them don’t and it can have very serious consequences.”

The RCSI also has serious concerns, according to its director of consumer affairs, Arthur Tanner. “The surgeon in question was performing major surgery and then leaving the country, and thus left the patient unattended on the same day as the surgery had been carried out. The concerns were relayed to RCSI by certain surgeons who were forced to deal with urgent surgical complications relating to the surgery that had been carried out as the patients were unable to contact the surgeon who had carried out their original surgery, ” he said.

Meanwhile, Ireland’s cosmetic surgery magazine, Rejuvenate, will call for “urgent regulation” of the industry in its next edition after being “inundated” with calls from people who’ve had bad experiences.

According to Ashdown Sheils, her clinic provides an excellent aftercare service, but she faced criticism last week that the French surgeon could not provide adequate care as he was not permanently based in Ireland. She said she had full confidence in the surgeon’s abilities and that she herself had a gastric band fitted by the surgeon last April before introducing the procedure at the clinic.

She suggested Irish plastic surgeons had a vested interest in keeping foreign plastic surgeons out of the market. “All of the doctors who work at my clinic are on the Medical Council’s register. This call for regulation is something I would welcome and agree with. But it’s really about some plastic surgeons here not wanting surgeons from outside this jurisdiction to come into this country and work.”