I spotted this advert in the Spire Hospital recently and it led me to again consider the important question ‘is facelift surgery safe?’ The safety of cosmetic surgery is a topic much beloved by the media and professional organisations. The media in particular revel in tales of ‘botched ops’ and ‘rogue surgeons’ but of course this is cheap sensationalism. For what it is worth, here is my take on it.
The first point to make is that the vast majority of cosmetic (and indeed all) surgery and anaesthesia today takes place safely and uneventfully. Patients in the UK benefit from a regulatory system which affords a high degree of protection from harm during routine surgical procedures. All sites where cosmetic surgery is undertaken must be approved by the Care Quality Commission and an inspection by the CQC is a massive undertaking (my wife is a former dental practice manageress who has been through the inspection process; her comment is “An inspection is a !%*&*^%$ big undertaking and **%*&*$£” stressful!) So although the system is open to ‘gaming’ and ‘box ticking’ it is really is quite a feat to have a ‘fully compliant CQC report with no recommendations’. The CQC does a pretty good job of ensuring that at least minimum safety standards are met, although no system can ever be completely robust.
All doctors and surgeons working in the UK are regulated by the General Medical Council whose fundamental role is to protect the interest of patients by overseeing the conduct of doctors. Continuing registration with the GMC is dependent on annual proof of satisfactory professional conduct and continuing education. In addition there are any number of professional bodies that constantly strive to improve safety standards. More importantly, the vast majority of doctors go to work each day determined to do their very best for their patients. Except Howard Shipman, of course.
If you were listening to the charts in 1979 you may remember a prophetic ditty by Elvis Costello called ‘Accidents will happen’ My view is this is at the very heart of it all. The problem is that in surgery and in particular anaesthesia everything is fine until it is not. Anaesthetic risks, whilst uncommon, can be highly significant and lead to devastating consequences, including brain damage and death. It is my view that you should elect to have your facelift in a setting that has all the facilities typical of a ‘proper’ hospital, including an intensive care unit or at the very least a high dependency unit. An alternative of course, is to have treatment under sedation; however, even this cannot be 100% safe because of the ever present risk of an allergic reaction.
Finally, you may have read my post on The focused factory approach to surgery. In 2010 NCEPOD (an influential independent committee which examines safety and outcome for the surgical patient) produced a review of the organisational structures surrounding the practice of cosmetic surgery called ‘On the face of it’. It concludes: “One would expect patients to choose a surgical team that performs a particular procedure say 100 times per year as opposed to 10 times. Experience and competence run hand in hand. Patients should enquire how often the procedure they wish to have is carried out at the sites they are considering attending.” Quite.
Of course, if you are considering surgery abroad you are going to have to check the relevant safety standards yourself. The (very significant) cost of this safety infrastructure is of course borne by the consumer, which is one of the reasons surgery abroad can cost less than in the UK. You pays your money, you takes your choice.