Lessons to learn

Many wonder whether the PIP scandal needed to happen, in order for the industry and regulators to take stock and realise that better scrutiny was the way forward for the industry. Dr Grover says there are valuable lessons to learn, and these will have great benefit in the future, but he says it is a matter for regret that events turned out the way they did. ‘Our focus must now be on the 40,000 women with the PIP implants.’

Reviews ongoing

On a positive note, a UK expert committee has been set up and will next meet in May 2012 to review findings. The UK Department of Health has also set up two reviews to look at 1) how the PIP situation occurred and 2) the issue of regulating the cosmetic surgery industry as a whole. The first report, led by Lord Howe, the Minister for Quality, was due to be submitted to Mr Lansley by the end of March 2012.

The second, led by the NHS medical director Sir Bruce Keogh, is to be concluded by March 2013. His comprehensive report will look at whether the cosmetic surgery industry needs to be more effectively regulated.

Dr Grover notes the absence of European regulations or quality marks for cosmetic procedures, but CEN, the European Committee for Standardisation, is looking to establish requirements for each procedure. Its own report, on the European Standard for Aesthetic Surgery Services (CEN TC403), is out for consultation and will likely be released in 4–5 months. Taken together with the UK reviews, much regulation is on the cards for cosmetic procedures. Dr Grover approves. ‘Anything that increases confidence is good,’ he says.

UK procedure volumes in 2011

The UK market appears strong, as BAAPS figures for 2011 show. In fact, last year all the leading cosmetic surgery procedures saw increases of magnitudes that, surprisingly, meant no change to the ranking. ‘No procedures swapped around in 2011. This has never happened before,’ Dr Grover notes. Rises among the most common procedures averaged 2–5%.

Other elements to note from the 2011 UK audit are that:

• Breast augmentation still leads the field, as it has for some 10 years
• Male surgery is increasing in importance with steady growth (though it will never be as big as the female market)
• The market is seeing more loose skin surgery — this is related to consumer weight-loss: in some cases, people are losing 3–5 stones (19–32 kg), thus requiring abdomen, arm or thigh surgery
• The market for facial rejuvenation is growing increasingly as the population ages — people are more ready to undergo invasive procedures in the facial area or skin peels. ‘They are not so nervous anymore,’ says Dr Grover.

The number of surgical procedures for men rose by 5.6% to 4298, with all categories, led by rhinoplasty (1043 procedures, +5%), increasing.

‘This shows that, even in times of recession, people are now prepared to invest in what makes a difference to them,’ believes the BAAPS representative. ‘It’s not like buying a handbag — that’s not part of you; cosmetic surgery is something that gives internal confidence and offers true psychological benefit.’

In this regard, BAAPS has begun to fund research on the psychological benefits of cosmetic surgery, and is also discussing methods for clinics to ensure that their patients are actually ready and willing to have surgery, for the right reasons. This theme has gained in importance since the PIP scandal, and there is now increasing recognition of the need to do a proper psychological assessment of patients before they have an operation. ‘The basic remit is to ensure we do things right.’

However, Britons have clearly not lost faith in the benefits of cosmetic surgery. The PIP scandal and economic downturn have not created a rush towards medical tourism. Dr Grover says: ‘There is no great evidence for this. Some people are swayed by advertising and price, but there have been no bankruptcies in the UK — so confidence has not gone too low. The UK is high on quality, with CME and safety records featuring highly among surgeons.’

As to ‘lunchtime procedures’ — non‑surgical procedures such as face‑lifting (the biggest procedure in this segment), and neck tightening and thread-lifting that can be conducted fairly rapidly — they do not have a significant, long-lasting effect. ‘New’ is not always tried and tested, says Dr Grover. On the other hand, surgical procedures are not new, but they have proved their value. He adds: ‘If you want to see a significant improvement, it has to be with surgery. It’s a more permanent result.’