Unrealistic expectations and medical unsuitability for cosmetic surgery were cited as common reasons for declining to operate. Surgeons should also be mindful that their agreement to undertake surgery may be challenged when a patient's psychiatric history points to a possible body dysmorphic disorder.
Almost all BAAPS members reported having looked after patients whose initial consultation with a sales representative, rather than their operating cosmetic surgeon, left them inadequately informed about risks.
There is a duty on the doctor not only to warn of risks but also to satisfy themselves that the patient understands those risks, along with the nature and purpose of the proposed treatment and the alternatives to it.
An over-reliance on aesthetic nurse screening and information booklets may, therefore, leave doctors vulnerable in negligence. Best practice demands that patients are given ample opportunity to consult with their surgeon and that there is a suitable cooling off period between the consultation and treatment.
In the aftermath of the PIP breast implant controversy patients are rightly beginning to expect better.