QUESTIONS TO ASK BEFORE CHOOSING A COSMETIC SURGERY CLINIC OR SURGEON

Once cosmetic surgery was something of a taboo subject, with the general consensus being that its use was confined to narcissistic Hollywood movie stars with too much money and not enough sense.  In more recent times, however, attitudes have changed significantly in this country, as has the cost of many procedures.

This combination of increased social acceptability and financial affordability has resulted in cosmetic surgery becoming far more common in Ireland in recent times.  Unfortunately, as with any activity where it is perceived that a ‘quick buck’ can be made, the industry attracts more than its fair share of shysters and charlatans.

Unlike in conventional medical practice, where practitioners recommend procedures purely on the basis of patient need and benefit, the vast majority of cosmetic surgery procedures are not clinically necessary and are performed because of a subjective sense of need rather than an objective one.  When you bear in mind that most procedures are carried out by private profit-orientated companies, the suspicion arises that many procedures are being advocated – or even ‘pushed’ where they might be strongly discouraged in a setting where economic gain was not the driving dynamic.

Because of the risks posed to the public by unscrupulous practitioners in this area, you’d be forgiven for thinking that there would be a strict regulatory framework in place.  In fact, the complete opposite is the case – there is a woeful absence of any effective control of the sector in Ireland.  This lack of regulation applies not only to the level of expertise of practitioners, but also to the marketing techniques and materials that are used, meaning that outlandish claims about what can be achieved can be trotted out with impunity.

All of this means that anyone who has decided to undergo such treatment must be especially vigilant when deciding which clinic to use.  The following are just a few of the issues you should consider before making any decision on the procedure which you have in mind.

Does the surgeon hold the proper qualifications?

Does the surgeon have sufficient experience?

Have the risks associated with the procedure been clearly explained to you?

Have you been given an adequate opportunity to consider all of the relevant information?

Is the surgeon based in Ireland?

Does the facility where the procedure is to be performed look up to scratch?

Does the clinic provide adequate psychological support?

Is the clinic offering adequate aftercare facilities?

Has the surgeon ever been found guilty of misconduct?

Is the clinic trying to entice you by using inappropriate financial incentives?

Does the surgeon hold the proper qualifications?

It may come as something of a shock to you but anyone who holds a basic medical degree in this country can give themselves all sorts of grand titles such as “cosmetic specialist”, “aesthetic surgeon”, “cosmetic consultant” and the like without possessing any specialist training whatsoever.

Ideally your surgeon should fully trained in plastic, reconstructive and aesthetic surgery with an officially recognized medical body and should be listed on the Irish Medical Council’s specialist register of plastic surgery.

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Does the surgeon have sufficient experience?

When seeking a response to this question you should ascertain not only how many of the procedures which you are considering the surgeon has carried out so far in their professional career but, equally if not more importantly, how frequently do they have occasion to undertake them? The research which has been carried out suggests that problems are most likely to arise where surgeons aren’t carrying out specific procedures regularly.You really have to ask yourself the question: are you willing to allow someone who has no significant experience of carrying the kind of procedure you are considering to “give it a lash” and see how things work out?

Apart altogether from experience, have they received procedure-specific training? The fact that certain unscrupulous so-called surgeons are willing to “have a go” and to pick it up as they go along is particularly worrying bearing in mind that it is the more potentially problematic procedures that are undertaken least frequently.

You should therefore ask your surgeon to tell you how many of the procedures which you are considering they have carried out in the last twelve months.

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Have the risks associated with the procedure been clearly explained to you?

If the clinic staff and surgeons are clearly mounting a pure sales exercise rather than attempting to explain the pros and cons of the procedure you’re considering, you should be more than a little apprehensive.  Medical practitioners have a clearly established duty to explain to their patients what problems and side effects could flow from any procedure they’re proposing to perform.  This duty exists even where the practitioner believes that procedure in question is necessary to safeguard the health of the patient.

It follows that in the case of cosmetic surgery, where a procedure is not truly necessary and is entirely elective, there is an even greater onus on the surgeon to ensure that the consent to the procedure is truly meaningful by having first clearly set out the associated risks and answering questions in this regard well in advance of the surgery so that the patient can consider whether or not to proceed armed with this knowledge.

If your meeting with the surgeon before the procedure feels more like a marketing exercise than the glossy brochures some of these clinics circulate you should really ask yourself if you’re in the right place.

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Have you been given an adequate opportunity to consider all of the relevant information?

As has been pointed out above, a diligent and professional cosmetic surgeon will ensure that you are made aware of all potential risks and complications before agreeing to perform the surgery.  Telling you this just before you are about to go under the knife, after you have psychologically committed yourself to going ahead with the surgery, is simply not good enough.

Ideally you should have had an initial consultation where all of the risks have been spelt out to you and your questions answered, in writing if necessary.  If you are still inclined to go ahead your surgery should be scheduled to allow a decent time (a couple of weeks at least) for you to reflect on your decision and you should be asked again immediately before you are about to have the procedure performed whether you are still happy to go ahead.

If you feel that efforts are being made to ‘bounce’ you into having the surgery done within an unnecessarily pressurized timeframe you should extract yourself from the process in case you make a decision which you live to regret.

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Is the surgeon based in Ireland?

There is currently a disturbing practice engaged in by some clinics where multiple surgeries are block booked to be carried out over an intensive period by a non-resident surgeon who flies into the country at the start of the session and flies out again immediately after the last procedure.  This means that if you don’t choose carefully you could find out after you’ve had the surgery that the surgeon who performed it has left the country for some exotic destination well before your anesthetic has even worn off.

It goes without saying that for appropriate aftercare treatment the surgeon who carried out your procedure should be readily accessible by you at short notice.  You should therefore secure confirmation from them that they are resident in Ireland and available post-surgery should the need arise.

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Does the facility where the procedure is to be performed look up to scratch?

Obviously the extent to which a lay person can determine whether a facility is appropriately equipped for clinical procedures is limited.   But that doesn’t prevent you from asking to see where the procedure is going to be carried out so that you can consider whether it seems appropriate to you.   Does it look clean and well managed?  Would it be easily accessible by emergency services in the event that something serious occurred in the course of your treatment?

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Does the clinic provide adequate psychological support?

No-one likes to admit that their actions may be motivated by forces other than their free will or that they may be making a decision for the wrong reason.  But if this isn’t the case, then what’s the harm in having a professional confirm this after the necessary checks are undertaken? If the reason for seeking surgery is due to some ulterior psychological urge, the end result may well be dissatisfaction, even if the procedure is carried out with enviable expertise.   For this reason a well-run clinic will arrange for you to speak with an individual with appropriate psychological training to ensure that a procedure isn’t being undertaken for the wrong reasons.

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Is the clinic offering adequate aftercare facilities?

Apart from satisfying yourself that the surgeon who is to perform your procedure is based in Ireland and will be accessible after the operation if this proves necessary, you should also seek confirmation that there is medical and nursing back-up at the clinic on a twenty-four-seven basis so that if you do encounter any complications you will have access to competent trained medical professionals without delay.

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Has the surgeon ever been found guilty of misconduct?

Believe it or not the answer to this question may be ‘yes’ even thought they’re still merrily working away in the area.  While it might be argued that everyone is entitled to a second chance, you’ve got to ask yourself if you want to be entrusting your wellbeing to someone who’s got a disciplinary record.

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Is the clinic trying to entice you by using inappropriate financial incentives?

If offers are being made like “we’ll give you 20% off if you sign up by the end of the month”; “if you pay for two procedures now, we’ll do you a deal on the price of the second one”; or “if you get one of your friends to sign up for a procedure we’ll knock something off the price of your own treatment”, you should give the place a wide berth.

Conversely, if the terms and conditions of any contract you’re asked to sign attempt to impose onerous penalties on you if you decide not to proceed with the surgery after having signed up you should do yourself a favour and get out while the going is good.

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John specialises in personal injury and medical negligence claims. His practice focuses on high value compensation cases. He has extensive experience in this area of litigation for over 10 years. Read more