Are we letting our patients down, or is the Australian system failing society?

Are we letting our patients down, or is the Australian system failing society?

How to choose a Surgeon you can Trust?

Thousands of Australians every year choose to undergo cosmetic surgery. Many women want to look and feel in proportion and feminine. However, access to cosmetic surgery, in-particular breast augmentation is all smoke and mirrors. As with any business the objective is to make money. This is done in 2 ways. The first works on volume, like a fast food shop and the second works on quality, as with a designer boutique. Cosmetic Surgery is sadly no different. We as consumers make 5 fatal assumptions;

    1.Our trust in the government and regulatory agencies leaves us vulnerable. Few people can believe, you do not require any formal qualifications to use the title “Cosmetic Surgeon”. A tradesmen cannot call himself a tradesman without finishing his trade, would you let him build your house? And if he had no qualifications and the house fell apart, would you sue him for misrepresentation? Fraud?

    Every time you go to dinner you assume we are in a first world country with mum, dad, grandma and the very young eating out. This is done without fear of fatal food poisoning because we trust the appropriate authorities have accredited the restaurant and it is safe. Have you ever asked, when was your last inspection? And what are your chef’s qualifications? We trust the system and in relation to Cosmetic Surgery, the system fails us.

    2.Social Media - Social platforms are great for being social and having a sense of community. But social media is not a surgeon or clinic popularity contest. Hence the amount of likes or followers does not reflect genuine patients, nor does this reflect surgical ability. What is even more disturbing is, snap chat’s audience, is predominantly young people aged 13-25. Yet there is no regulation stopping a clinic from “educating” minors. A 13-year-old can watch a breast augmentation from within theatre. We then gasp in shock when at 18, our daughter has her heart set on a surgeon and is determined to have surgery. Are we not desensitising our youth? Having a presence is one thing, promoting calls to action and competitions to drive traffic and increase followers is not glamourizing but should it be legal?

    3.Price - Price driven consumers feel they have a great deal because surgery is financially easy to access. But where is the business cutting costs to maintain a profit? This is logically a volume based model. There is no buffer in the $5990 when something goes wrong. Are you sacrificing qualifications, limiting your range of implants, not utilising the vector or keller funnel, restricted to only seeing a nurse for post op visits? Without covering costs there is no business, so at a low-cost point, you are sacrificing on quality.

    4.Skill mix - from a Specialist Plastic Surgeon, Plastic Surgeon, Cosmetic Surgeon, Facial Plastic Surgeon, who can really tell the difference. Even though we have ASPS, ASAPS and ACCS ect… we still have surgeons working without any training from anybody. So, is it legal to work and utilise the title cosmetic surgeon without any formal training? YES. There are also ENT surgeons performing breast augmentation with the FRACS title and Cardio thoracic surgeons using the FRACS yet performing breast augmentation, neither of which have had formal training in breast augmentation. Cosmetic surgeons without any memberships or formal training run successful marketing campaigns promoting “Fully qualified cosmetic surgeon registered with APHRA”. A Registered Nurse or Physiotherapist is also registered with AHPRA but they are not performing breast augmentations. Very misleading to the unsuspecting public.

    5.The boobie get away - for less than $5000 AUD you can go on a holiday to Thailand, all inclusive; accommodation, flights, hospital, anaesthetic fees, implants, and surgery. Many of these surgeons have training, qualifications, and experience. What a tour cannot control is the resistant bacteria and infections from a foreign bug. The most common complication is not simply aesthetic but rather the underlying issue is the infections which are not only soul destroying but life threatening. Meanwhile our public system manages these complications on tax payers money.

Having worked with all types of complications, I know firsthand the emotional toll on a patient when everything goes wrong. The patient of a conveyor belt system receives a list in consultation, of the possible complications, such as symmastia, double bubble, bottoming out, infection, haematoma, capsular contracture, incorrect placement, animation, scarring, striae, seroma, and delayed seroma. I have literally managed every one of these mentioned complications (numerous times). Yet not once has a patient expected the complication, not once did the patient feel informed and not once did the patient feel it fair to pay again for corrective surgery. My job was to listen, to empathise and to work on a solution. Even more tricky, was when a solution could not be reached within the scope of practice. For example, the patient was not a suitable candidate prior to augmentation, the skin integrity was lost due to chronic infection, and most often, the therapeutic relationship was destroyed as the patient was not aware the surgeon was not qualified. Yet despite the long list of patients, no one has actively done anything. People whisper and moan, but is anyone actively educating the public?

Surely, a frustrated nurse, is not the only person willing to impart insight and actively promote the institution, fraternity and prestigious plastic surgery specialty.

Below are links to various articles published within Australia, these are only a few of the many available. The point is when will The Australian Medical Board make a conscious effort to regulate the industry?