Cosmetic surgery: medicolegal considerations

AbstractCosmetic surgery is one of the two branches of plastic surgery. The characteristic of non-necessity of this surgical speciality implies an increased severity in the evaluation of the risk-benefit balance. Therefore, great care must be taken in providing all the information necessary in order to obtain valid consent to the intervention. We analyzed judgments concerning cosmetic surgery found in national legal databases. A document of National Bioethics Committee (CNB) was also analyzed. Conclusion: The receipt of valid, informed consent is of absolute importance not only to legitimise the medical-surgical act, but it also represents the key element in the question concerning the existence of an obligation to achieve certain results/use of certain methods in the cosmetic surgery.

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Dissecting Medical Litigation: An Analysis of Canadian Legal Cases in Plastic Surgery

Plastic Surgery ◽

10.1177/22925503211034835 ◽

2021 ◽

pp. 229255032110348

Author(s):

Hassan ElHawary ◽

Ammar Saed Aldien ◽

Andrew Gorgy ◽

Ali Salimi ◽

Mirko S Gilardino

Keyword(s):

Informed Consent ◽

Head And Neck ◽

Plastic Surgery ◽

Cosmetic Surgery ◽

Legal Cases ◽

Monetary Value ◽

Significant Difference ◽

Medical Litigation ◽

Legal Databases ◽

Qualitative Analyses

Introduction: Plastic surgeons are more likely to face medical litigation, compared to other specialists. Although this has been previously studied in other countries, there is a paucity of data regarding legal medical cases within Canada. The goal of this study was to compile and analyze all medical litigations in plastic surgery in Canada and identify themes associated them. Methods: A systematic search of the 2 largest Canadian online legal databases, LexisNexis Canada and WestLawNext Canada, was conducted to retrieve all legal medical cases against plastic surgeons in Canadian courts. Quantitative and qualitative analyses were performed to dissect the characteristics of plastic surgery litigation in Canada. Results: A total of 105 legal cases were included in this analysis, including 81 lawsuits and 24 appeals. The preponderance of cases was related to breast surgeries (47.0%), followed by head and neck surgeries (18.1%), with 76.5% being related to cosmetic surgery; 64.2% were ruled in favour of the surgeon. The lack of preoperative informed consent was highly associated with a final ruling in favour of the patient ( P < .0001). The average monetary value of damages awarded was $61 076. There was no significant difference in monetary value between cosmetic and reconstructive cases. Conclusion: The majority of medical litigation in plastic surgery in Canada is associated with cosmetic surgeries, most commonly of the breast. Lack of informed consent is associated with judicial rulings in favour of patients. By understanding the themes underlying these legal cases, we hope to highlight the main issues that lead to litigation in plastic surgery.

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Techniques of Onyx Embolization of Arteriovenous Malformation: 2-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opab061 ◽

2021 ◽

Author(s):

Kathryn M Wagner ◽

Visish M Srinivasan ◽

Peter Kan

Keyword(s):

Informed Consent ◽

Surgical Resection ◽

Arteriovenous Malformations ◽

Preoperative Embolization ◽

Great Care ◽

Endovascular Techniques ◽

Definitive Therapy ◽

Feeding Vessels ◽

Multiple Feeding ◽

Staged Treatment

Abstract Advances in endovascular techniques and tools have allowed for treatment of complex arteriovenous malformations (AVMs), which historically may have posed unacceptable risk for open surgical resection. Endovascular treatment may be employed as an adjunct to surgical resection or as definitive therapy. Improvements in embolization materials have made endovascular AVM treatment safer for patients and useful across a variety of lesions. While many techniques are employed for transarterial AVM embolization, the essential tenets apply to all procedures: (1) great care should be taken to cannulate only vessels directly supplying the lesion, and not en passage vessels, prior to injecting embolisate; (2) embolisate should travel into the nidus, but not into the draining veins; (3) embolistate reflux proximal to the microcatheter should be avoided. There are several techniques that accomplish these goals, including the plug and push method, or using a balloon to prevent embolisate reflux. We use controlled injection of liquid Onyx (Medtronic), with increasing pressure over multiple injections pushing the embolisate forward into the AVM. This is repeated in multiple feeding vessels to decrease or eliminate supply to the AVM. Here, we present a 36-yr-old female with a right parietal AVM discovered on workup of headaches. After informed consent was obtained, she underwent preoperative embolization using this technique prior to uncomplicated surgical resection. The video shows the endovascular Onyx embolization of multiple feeding vessels over staged treatment.

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Anaesthetic complications in plastic surgery

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.118626 ◽

2013 ◽

Vol 46 (02) ◽

pp. 445-452 ◽

Cited By ~ 3

Author(s):

Soumya Sankar Nath ◽

Debashis Roy ◽

Farrukh Ansari ◽

Sundeep T. Pawar

Keyword(s):

Patient Safety ◽

Plastic Surgery ◽

Operating Room ◽

Cosmetic Surgery ◽

Patient Positioning ◽

The Elderly ◽

Morbidly Obese ◽

Morbidity Risks ◽

Unnecessary Complication ◽

Key Aspects

ABSTRACTAnaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist′s concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients′ experience and surgical outcome.

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Plastic Surgery: Review on Screening of Psychiatric Disorder

Open Access Indonesian Journal of Medical Reviews ◽

10.37275/oaijmr.v1i5.567 ◽

2021 ◽

Vol 1 (5) ◽

pp. 91-94

Author(s):

Angeline Fenisenda

Keyword(s):

Psychiatric Disorder ◽

Plastic Surgery ◽

Cosmetic Surgery ◽

Psychiatric Patients ◽

Emotional Adjustment ◽

Aesthetic Surgery ◽

Well Being ◽

Pilot Studies ◽

Cosmetic Procedure ◽

Poor Outcomes

Recently the popularity of plastic surgical procedure has been increased. Many people surgically alter their physical appearance with the intent of boosting their social and psychological well-being; however, the long-term effectiveness of aesthetic surgery on improving well-being is unconfirmed. To have successful cosmetic plastic surgery result, it is imperative to assess candidates for predictors of poor outcomes. These include the following factor : psychiatric disorder, demographic factors (male and younger age), relationship issues, unrealistic expectations, previous dissatisfied surgery, and minimal deformity. For psychiatric patients, despite having technically satisfactory cosmetic surgery, poor emotional adjustment and social functioning were seen post procedure. Proper screening and evaluation of these patients could save money and resources. In this brief review we discuss about psychiatric disorder screen on plastic surgery to prevent unwanted outcome. A literature review was conducted in the electronic database PubMed using keyword “Psychiatric Disorder”, “Plastic surgery”, “Prevention” and “Screening”. All type of studies were included for this study, such as controlled trials, systematic reviews, literature reviews, and pilot studies published between 2011 and 2021. Articles which not written in English were excluded from the study. This search resulted in 18 papers. Some patient who undergo cosmetic surgery suffer from underdiagnosed or untreated psychiatric disorder. To avoid unnecessary expense and resource it is advisable that all patient who seek cosmetic procedure undergo psychiatric screen such as PHQ-9, GAD-7, BDDQ and other test to avoid un-necessary expense and resource.

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Cosmetic Surgery: A Subspecialty That Needs Specialized Training and Recognition

The American Journal of Cosmetic Surgery ◽

10.1177/07488068211051859 ◽

2021 ◽

pp. 074880682110518

Author(s):

Kamran Dastoury ◽

Jacob Haiavy ◽

Jane Petro ◽

Martha Ayewah

Keyword(s):

American Academy ◽

Plastic Surgery ◽

Cosmetic Surgery ◽

Training Programs ◽

Aesthetic Surgery ◽

Fellowship Training ◽

Subspecialty Training ◽

Plastic And Reconstructive Surgery ◽

Surgery Training ◽

American Society

Introduction: This study was performed to provide a comprehensive review of the breadth and depth of fellowship training provided by the American Academy of Cosmetic Surgery (AACS), with direct comparison with other current aesthetic surgery training programs available in the United States. We hypothesized that this subspecialty training provides essential experience and confidence to perform aesthetic procedures, which are likely not adequately imparted during traditional residency training. We also address the notion that Cosmetic Surgery is not under the sole ownership of one specialty, but rather a subspecialty that flourishes by collaboration between multidisciplinary surgical backgrounds. Materials and Methods: We performed a cross-sectional study of survey data from 2 distinct groups—current fellows in a 1-year AACS program and surgeons who completed an AACS fellowship between July 2008 and June 2017, who have been in active cosmetic surgery practice ranging from 6 months to over 6 years. A survey was administered via email and distributed by the AACS central office. The responses were compared with data published in the Annals of Plastic Surgery concerning Recent Trends in Resident Career Choices after Plastic Surgery Training. Results: The Accreditation Council for Graduate Medical Education (ACGME) requirements for aesthetic surgical cases in a 6-year Plastic Surgery program are 150 cases, but 50% of graduating seniors feel inadequately prepared to transition straight into aesthetic surgery practice, whereas among AACS graduating fellows, 100% feel very prepared to go on the aesthetic surgery practice, having completed an average of 687 cases within the yearlong training program. We note that the survey response rate was 81% among current fellows versus 35% among practicing surgeons. Discussion: We believe that focused subspecialty training in cosmetic surgery after completion of a primary surgical residency in a form of a structured fellowship through AACS, American Society of Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, Commission on Dental Accreditation, and American Society of Ophthalmic Plastic and Reconstructive Surgery (Oculoplastic) is the ideal preparation for the future. As we learn from each other through fellowship training, academic conferences, and research, this will further advance the subspecialty and ultimately improve patient care and outcomes. There is no evidence that these training programs provide less adequate preparation, although they are not accredited by the ACGME. To the contrary, the additional experience and knowledge gained during these fellowship training programs result in better outcomes and more competent practitioners. Conclusions: The development of subspecialty training and board certification for surgeons committed to cosmetic surgery yields the highest level of qualified providers. The diverse backgrounds of these providers continue to allow us to expand and innovate in this field. This study is aimed at moving this conversation forward in a positive direction.

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Beauty between Empires

Fashion and Beauty in the Time of Asia ◽

10.18574/nyu/9781479892150.003.0004 ◽

2019 ◽

pp. 69-102

Author(s):

S. Heijin Lee

Keyword(s):

Social Media ◽

Plastic Surgery ◽

Cosmetic Surgery ◽

Women's Bodies ◽

Non Profit ◽

The World ◽

Political Investments

This chapter examines how and why Korean plastic surgery consumption occupied the minds of Jezebel (a mainstream US feminist blog) writers, editors, and millions of readers as well as Womenlink’s (Korea’s premiere feminist non-profit organization) members, panelists, and forum attendees at roughly the same time from 2012 to2013—feminists from opposite ends of the world so to speak. By closely reading Jezebel’s coverage of the topic and juxtaposing it with Womenlink’s activism in Korea, this chapter examines first, the role of social media sites in US discourses about Korean women’s bodies. How have social media sites renewed fetishized interest in Korean bodies while fueling cosmetic surgery consumption in Korea itself? Second, both groups agree that Korean plastic surgery consumption is a feminist “problem,” yet their differing geopolitical locations and political investments affect their articulation and understanding of this particular problem. How might we think about these two feminist groups relationally?

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Surgeon, Media, Society, Patient

The Changing Scope of Technoethics in Contemporary Society - Advances in Information Security, Privacy, and Ethics ◽

10.4018/978-1-5225-5094-5.ch011 ◽

2018 ◽

pp. 197-225

Author(s):

Brett Lunceford

Keyword(s):

Plastic Surgery ◽

Cosmetic Surgery ◽

Full Range ◽

Ethical Considerations ◽

Respect For Autonomy ◽

The Media ◽

Media Society ◽

Ethical Failures ◽

The Relationship ◽

Made In

For many, cosmetic surgery holds the promise that one can reshape his or her body to remove perceived defects and thus have a more perfect body. However, the decision to undergo elective cosmetic surgery is not made in a vacuum, and it is easy to overlook the full range of ethical considerations surrounding cosmetic surgery. Many medical ethicists subscribe to an ethical code that centers mainly on the relationship between the doctor and patient, with a focus on respect for autonomy, nonmaleficence, beneficence, and justice. This chapter builds on this framework by extending the scope of actors to include not only the surgeon and the patient but also the media and the overall society. To illustrate this framework, the author uses the example of actress Heidi Montag, who underwent 10 different plastic surgery procedures in one day. The chapter concludes with a discussion of potential correctives for ethical failures in each of these areas.

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Understanding the Issue of ‘Informed Consent’ in Dental Treatment

Primary Dental Care ◽

10.1308/135576104773711264 ◽

2004 ◽

Vol os11 (2) ◽

pp. 41-47 ◽

Cited By ~ 1

Author(s):

Jeremy A Woodcock ◽

Mark V Willings ◽

Patrick VA Marren

Keyword(s):

United Kingdom ◽

Informed Consent ◽

Dental Treatment ◽

Department Of Health ◽

Valid Consent ◽

Consent To Treatment ◽

The Usa ◽

The Uk

The concept of consent to treatment is increasingly becoming contested in United Kingdom courts of law. Any practitioners who cannot demonstrate that a patient has properly consented to treatment are laying themselves open to litigation. This paper demonstrates that valid consent is not as straightforward as may be assumed and that a patient can easily challenge a standardised approach to obtaining consent. Current Department of Health guidelines on obtaining consent are discussed, and changes in the USA, Europe and Australia are brought into focus with regard to the situation in the UK.

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