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Know your eye surgeon

A recent article in the British Medical Journal on the 1st July 2017 was scathing about the lack of cosmetic industry regulation, and quite rightly so. The article was called Cosmetic Industry Oversight Is Only Skin Deep, and they recommended that legislation is urgently needed to protect the increasing number of people having procedures to improve their appearance, whether they be surgical or non-surgical procedures.
I am an oculoplastic surgeon at Clinica London. I am fully trained as a consultant ophthalmologist with higher surgical training and post specialist registration training in oculoplastic adnexal surgery, which includes eyelid surgery, tear duct surgery and orbit surgery. I have also had considerable experience over the last 20 years in Botulinum toxin, used both medically and cosmetically with dermal fillers used as non-surgical tear trough and facial rejuvenation. I have also had experience in liposuction and autologous fat transfer within the NHS as a consultant and privately as a reconstructive oculoplastic surgeon.
You should know your surgeon and know what their training and experience are when choosing who should do your cosmetic procedure. The reason is that for many of the common surgical cosmetic procedures there is only voluntary registration in place for practitioners performing face lifts, breast reductions, blepharoplasty, rhinoplasty, etc. and for non-surgical treatment, no certification is currently required.
Despite recommendations having been made in 2013 in a cosmetic report by Sir Bruce Keogh designed to make the cosmetic industry safer, many of their recommendations have not yet been implemented and remain inadequate. In particular, there are new procedures being introduced constantly into the cosmetic market whose risks have not been fully evaluated nor reported and for which the evidence of effect is very sketchy.
There is a multidisciplinary team being run by the Royal College of Surgeons between sub-specialities such as ophthalmology oculoplastics, ear, nose and teeth and head and neck reconstructive surgeons, maxillofacial surgeons, plastic surgeons, etc. who are working together to make possible a certification scheme that is compulsory.
We are hoping that in the not too distant future practitioners will have to be certified by the Royal College of Surgeon scheme in order to practice cosmetic procedures. This will help to cover surgical procedures, but it is more difficult to help cover cosmetic procedures. There is a loop hole where a cosmetic provider can call themselves an anaesthetic surgeon even though they are not qualified as a doctor, and as such misleads the public into thinking that they are seeing a doctor who is both safe, efficient and of high probity. In that respect, there is a joint council for cosmetic practitioners, created in January 2016, who are trying to launch a voluntary basis only registration later this year for certification in non-surgical cosmetic procedures.

British Journal of Opthalmology 2017 number 8112, page 11


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