An increasing number of people have undergone Cosmetic surgery in recent years in Ireland. There can be significant benefits if done properly, but there can be risks. It is important to consider all cosmetic procedures carefully if one wants to maximize the benefits, and minimize the risks. This includes both cosmetic surgery and what are known as non-surgical procedures such as fillers, botulinum toxin and laser treatments.
The Department Of health and Children in Ireland, have issued Guidelines for those considering Cosmetic Surgery.
The International Society of Aesthetic Plastic Surgeons (ISAPS) recently devised of the Safety Diamond. This concept of safe surgery is based on 4 factors, the patient, the surgeon, the procedure and the facility.
The patient must be a good candidate for the requested surgery, in good health.
The surgeon must be properly trained and credentialed.
The procedure must be appropriate for the patient.
The facility or hospital should be accredited and a proven safe venue with properly trained staff and emergency facilities, and using the World Health Organisation (WHO) Safe Surgery Saves Lives protocol.
The patient should expect to be asked about their full medical history including current medications, allergies and smoking habits. Their reasons for requesting the surgery will be explored and an examination will be undertaken. Only then can the surgeon evaluate the benefits and risks of the proposed surgery, and make a decision with the patient about the most appropriate treatment. This process cannot be delegated to an assistant, and should be undertaken by the surgeon who will be doing the procedure.
Operations are being carried out in Ireland by doctors without proper surgical qualifications. It can be very difficult for an individual to know what to look for in a surgeon or clinic, but it will be the single most important decision for your surgery. Your General Practitioner may be the best person to advise you about a fully qualified surgeon in your area, and should be able to offer advice in an impartial and non-judgmental manner. It is known that some patients approach a clinic directly without a referral from their GP. In that case it is even more important to check the Plastic Surgeons Qualifications. While many websites claim their surgeons are “experts”, the public can check if their surgeon is a Specialist in Plastic Surgery with the Medical Council. On this Register, beside their name, the Registration Type will say Specialist Registration, or General Registration. A doctor on the General Register has not completed training in Plastic Surgery, even if they describe themselves as “fully registered”.
The Irish Association of Plastic Surgeons only accepts members who are fully trained in Plastic, Reconstructive and Aesthetic Surgery. Many IAPS members are also members of other prestigious organisations such as the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS), or the International Society of Aesthetic Plastic Surgeons (IPRAS), which also have very strict eligibility criteria, insisting on full specialist training.
Your initial appointment should be with a named surgeon, rather than a clinic member or assistant. Your surgery should be carried out by that same surgeon, or else you will not have had an opportunity to check their credentials. Having checked the surgeons qualifications, there are some other reasonable questions to ask. Is the surgeon in the country if problems arise in the weeks following surgery? Who is the surgeons deputy if the surgeon is unavailable? Are they equally qualified?
Cosmetic Surgery and non-surgical treatments differ from other medical procedures, as often the patient will ask for a specific treatment. For example, a patient will attend an orthopaedic surgeon with a sore knee, rather than asking for a Knee Replacement. That may be the correct treatment but can only be established after full medical assessment and examination. In cosmetic practice, therefore, the patient should be aware that the surgeon may suggest an alternative treatment, or may deem the patient unsuitable for surgery on safety grounds.
The products used in treatments such as fillers, injections, and laser treatment should all have passed CE regulation. But unfortunately, there are reports of unscrupulous practitioners using materials which are not approved. Many treatments sound great in advertisements, but the individual should ask for proof that such a treatment is beneficial, as many such treatments prove too good to be true.
You should receive an estimate of costs prior to your treatment. Be wary of “free” consultations as this can be considered an enticement. You should not be asked for a non-refundable deposit at your first consultation, and should expect at least a two-week cooling-off period before your surgery. Cut-price deals, or reductions if you introduce a friend, are unlikely to be in your best interest as the clinic may be placing financial considerations ahead of assessing the patient for the appropriate treatment.
Surgery should take place in an accredited hospital or clinic, which has properly trained staff and facilities to deal with an emergency, including intensive care facilities in the unlikely event of a serious unexpected problem. Such accreditation is carried out by an independent body which adheres to international guidelines, such as JCI. There should be facilities for after-care and proper follow-up. For example, What is the infection rate for MRSA in the Hospital/Clinic? All accredited hospitals will check infection rates regularly but some clinics which do only cosmetic surgery may not even check this. If day-case surgery is planned, what happens if you cannot be discharged because of your medical condition or pain requirements? Does the hospital use the World Health Organization (WHO) Safe Surgery Saves Lives Surgical Safety Checklist.
A recent study published in the New England Journal Of Medicine showed that use of the 19‐question checklist reduced surgical complications by more than one third, and surgical deaths by almost half in the test hospitals as compared to control hospitals. This simple form is used much as a pilot uses a checklist before taking a plane onto a runway for takeoff. Patients need to ask if their surgeon and hospital use this tool. Are there resident doctors overnight?
The Medical Council advises that surgeons “should avoid using photographic or other illustrations of the human body to promote cosmetic or plastic surgery procedures, as they may raise unrealistic expectations amongst potential patients.” For that reason, we do not show “before-and-after” photographs on this website, but your surgeon at your consultation will usually be able to show you examples to illustrate an outcome of surgery. It is important to recognise there are many variables which influence the outcome of surgery and not all patients will achieve exactly the same outcome, even if performed by the same surgeon.