Faculty of Medicine, University of Southampton, Southampton, UK.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, CA, USA.
J Plast Reconstr Aesthet Surg. 2014 May;67(5):640-3. doi: 10.1016/j.bjps.2014.01.009. Epub 2014 Jan 21.
Patient safety is a fundamental issue in aesthetic surgery. In an attempt to improve safety, the Department of Health (DoH) and Professor Sir Bruce Keogh published a review in 2013 of the regulation of cosmetic interventions. Proposals included: (1) Banning free consultations; (2) Restricting time-limited promotional deals; (3) Two-stage written pre-operative consent; (4) Consultations with a medical professional rather than a sales 'consultant'. The Cosmetic Surgical Practice Working Party (CSWP) recommended a two week "cooling off" period before surgery. This study quantified compliance with the above national initiatives by aesthetic surgery providers in the UK.
To replicate a patient searching for aesthetic surgery providers, "cosmetic surgery UK" was searched via Google. The top fifty websites of aesthetic surgery providers were included in the study. Websites were analysed for compliance with the DoH Keogh and CSWP recommendations. When clarification was required, aesthetic surgery providers were contacted via telephone. Pearson's Chi-squared test compared actual compliance with national recommendations of full compliance.
Fifty cosmetic surgery providers in the UK entered the study. Consultations with the operating surgeon occurred in 90% of cases. Mean compliance with all parameters from the national guidelines was 41%, significantly less than the desired level of full compliance (P < 0.001). The majority offered free consultations (54%) and promotional deals (52%), of which 27% were time limited. No provider stipulated compliance with two stages of signed consent.
This study demonstrated low compliance with national guidelines for aesthetic surgery. Aggressive sales techniques and enticing offers by aesthetic surgery providers were widespread. Statutory government guidelines on aesthetic surgery and increased public awareness into potential risks from inappropriate cosmetic surgery may improve patient decision making and safety.
患者安全是美容外科的一个基本问题。为了提高安全性，卫生部（DoH）和布鲁斯·基奥爵士教授于 2013 年发表了一份关于美容干预措施监管的审查报告。该报告提出了以下建议：（1）禁止免费咨询；（2）限制限时促销交易；（3）两阶段书面术前同意书；（4）咨询医疗专业人员而不是销售“顾问”。美容外科实践工作组（CSWP）建议在手术前两周的“冷静期”。本研究通过对英国美容外科医生的调查，量化了他们对上述国家倡议的遵守情况。
为了复制患者寻找美容外科医生的过程，通过谷歌搜索了“英国美容外科”。该研究纳入了前 50 家美容外科医生的网站。对网站进行了分析，以确定其是否符合卫生部 Keogh 和 CSWP 的建议。当需要澄清时，通过电话联系了美容外科医生。采用 Pearson's Chi-squared 检验比较了实际遵守情况与完全遵守国家建议的情况。
英国共有 50 家美容外科医生参与了本研究。在 90%的情况下，患者可以与手术医生进行咨询。所有参数的平均符合率为 41%，显著低于完全符合国家建议的水平（P<0.001）。大多数机构提供免费咨询（54%）和促销交易（52%），其中 27%是限时的。没有机构规定要遵守两阶段的签字同意书。
本研究表明，英国美容外科的国家指南的遵守率较低。美容外科医生广泛采用激进的销售技巧和诱人的优惠。政府对美容外科的法规和增加公众对不当美容手术潜在风险的认识，可能会改善患者的决策和安全性。
