FAQs on cosmetic surgery claims and compensation for negligence

Over 30,000 cosmetic procedures were undertaken in this country last year. Nine out of ten procedures were carried out on women, with breast augmentation, eyelid surgery and face and neck lifts ranking as the most popular choices. While many are happy with the results, the multi-million pound cosmetic surgery industry remains one of the least regulated areas of medicine. Negligent surgery or treatment performed without the necessary care or skill can result in physical or psychological damage and have a devastating effect on patients.

Below are some frequently asked questions covering important points to note before deciding on surgery, steps to take if you are dissatisfied with the results, the process involved in bringing cosmetic surgery claims and the types of cases where compensation can be obtained.

What things should I consider before having cosmetic surgery or treatment?

Check the experience and qualifications of the person providing the treatment
You must use a reputable practitioner who is properly qualified. It is important to ensure that a surgeon is registered with the General Medical Council (GMC). The Royal College of Surgeons recommends choosing a surgeon who is on the GMC’s specialist register in the area of practice relevant to the procedure as surgeons will specialise in different types of cosmetic procedures. You should also check with the British Association of Aesthetic Plastic Surgeons (BAAPS) and the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), the leading registered bodies in this field, to make sure that your surgeon is indeed qualified and has no outstanding complaints. Ask if he or she does work for the NHS and in what position.

There is no requirement for providers of cosmetic treatments that do not involve surgery to be registered with the Care Quality Commission (CQC), the independent regulator for health services in England. However, to work as a beauty therapist, you usually require a qualification. There are a number of resources available online to check the qualifications of a therapist. Aesthetic nurses, often found in high street clinics, must be registered with the Nursing and Midwifery Council.

Check that the hospital, clinic or salon has a licence to carry out the treatment
If you are having surgery, this needs to be done in a hospital or other accredited surgical facility. In order to make sure that you are getting the best and safest possible treatment, there are legal requirements in place for those who carry out the procedure. Clinics offering certain procedures which are not run by the NHS are required by law to register with and be monitored by CQC.

Be fully informed about the treatment and know what to expect
You should ensure that you know what the procedure involves, what the possible complications and side effects are, and who you should contact if you have any issues afterwards. Anticipate improvement not perfection. If you expect cosmetic procedures to turn you into a movie star, you are bound to be disappointed. Prior to surgery make sure you speak to the surgeon directly and that he or she answers all of your questions. Points to cover include:

• what you want to change and why
• what your expectations are
• the treatment options available
• the procedure and what it will involve
• whether you are a good candidate for that procedure
• who will be carrying out the surgery
• the likely results
• the likely recovery time
• the potential risks and complications
• whether there might be any additional costs
• how long the results will last
• what your options are if you are dissatisfied with the results
• what happens if anything goes wrong

What are my options if the results are not as I expected?

Most people who undergo cosmetic surgery or treatment hope for the perfect result, but complications can occur. We recommend that you follow these six steps if something goes wrong:

• Talk with your surgeon. Be honest and open and expect the same from your surgeon. Try to understand what happened and, if possible, why it happened - without assigning blame.
• Give yourself time to reflect. Be objective. Try not to let emotions such as fear and anger interfere with your thinking. Realise that many problems will resolve in time as your body heals.
• Consider a second cosmetic procedure. If the healing process has completed and you're still not satisfied, talk with your surgeon about a second procedure. You should discuss in detail the risks, the worst-case scenario, the costs, and the plan of action if the revision fails. Some surgeons will not charge a fee for revision surgery, but you may be charged facility and anesthesia fees. You may prefer to ask for a second opinion at this point, which could help ease your doubts and provide a new perspective for both you and your surgeon.
• Consider finding a new cosmetic surgeon. When trust and communication are lost, it might be appropriate to find a new surgeon. You’ll need to follow all the normal guidelines recommended in choosing a good cosmetic surgeon, plus overcome some surgeons' reluctance to take on people who haven't been happy with the outcome of a procedure.
• Consider making a complaint. If you feel your surgeon did something inappropriate, you should consider making a formal complaint to the surgeon and the hospital or clinic where the procedure took place. They will probably have a protocol for dealing with complaints and may offer to meet with you to discuss your concerns. Be aware that most patients are dissatisfied with the outcome of their complaint.
• Consider legal action. We would encourage patients to try to resolve any issues with the surgeon or clinic directly but on occasions this may not be appropriate and you may wish to seek independent legal advice on the cosmetic surgery claims process. Our specialist cosmetic surgery solicitors are happy to discuss any concerns you might have and advise you on the options that might be available to you.

In what types of cases can I bring a cosmetic surgery claim?

Our team of cosmetic surgery solicitors specialises in a number of different types of cases involving cosmetic surgery and treatment, from procedures carried out by a surgeon in a hospital to those carried out in a high street beauty salon. Cases that we are frequently instructed on include the following:

• breast augmentation
• rhinoplasty
• abdominoplasty
• gastric band operations
• blepharoplasty
• liposuction and VASER treatment
• botox treatments
• dermal fillers
• laser treatments

We look at each case on an individual basis but there are common issues that do recur, including:

• recommending inappropriate surgery or treatment
• not advising on all of the treatment options available
• not informing you of all of the risks and potential complications
• substandard performance of the surgery or treatment

The consequences can be life-changing for some people. You may require further surgery or treatment or you may be left with permanent scarring which represents a cosmetic disfigurement. Our experienced team of solicitors will be able to assess your case and advise you at the outset whether any of the issues referred to above may apply.

I signed a consent form but I now know that I was not properly advised of all of the risks. Can I still bring a cosmetic surgery claim?

Whether or not a patient has provided informed consent has always been an extremely important issue, particularly in cases involving cosmetic surgery or treatment.

In 2015, the Supreme Court changed the law relating to consent. Historically, a surgeon or practitioner only needed to advise a patient of the risks they felt were appropriate. The Supreme Court has now ruled that a surgeon or practitioner must make sure that a patient is informed of all of the material risks and what reasonable alternative treatment options are available.

Just because you have signed a consent form does not mean that informed consent has been obtained. We deal with cosmetic surgery claims where patients were not advised of all of the material risks but still signed a consent form confirming that they were. We often hear that patients are asked to sign a consent form without understanding what it is or that they feel rushed and pressurised.

If the patient’s evidence is that they were not advised of all of the material risks and complications, and there is nothing documented in the notes to confirm that they were (even if a consent form was signed), we will carefully consider the case. If we feel that there is a claim to be pursued, then ultimately it will be up to the court to decide whether it accepts the patient’s evidence.

I elected to have cosmetic surgery or treatment. Can I still bring a claim?

Provided it can be established that the care provided by a surgeon or practitioner fell below an acceptable standard (ie was negligent), a patient is entitled to bring a claim against the surgeon regardless of whether or not consent was given. This applies to surgery or treatment on the NHS or undertaken privately.

All surgeons and practitioners must be fully insured and we recommend that you check this at the outset. If a surgeon or practitioner is not insured and something goes wrong, you may have limited recourse to pursue cosmetic surgery claims against them.

I paid for the cosmetic surgery or treatment on a credit card. Can I claim a refund?

The answer is yes. Under Section 75 of the Consumer Credit Act 1974, if you buy something over £100 and pay for any part of it on a credit card, the card company is jointly liable if anything goes wrong with the product. You can therefore claim a refund. It needs to be understood that usually if it has been over six years since you paid for the treatment, you cannot claim. The general rule is that you have to bring a claim within six years.

Are there any guidelines or regulations that protect those who have had cosmetic surgery or treatment?

Following a review of the cosmetic surgery industry by Sir Bruce Keogh in 2013, it was found that there are very few safeguards for patients, particularly for those undergoing non-surgical procedures such as Botox and dermal fillers.

Since this review, the GMC has been working with the Royal College of Surgeons and has recently launched its own set of professional standards for cosmetic surgery. The guidance aims to cover acceptable practice(s) for both surgical and non-surgical procedures.

The new rules specify that:

• doctors must make sure that patients are given enough time and information before they decide whether to have a procedure and patients should not feel rushed or pressured;
• a patient’s psychological needs must be considered before any procedures are undertaken;
• doctors must recognise and work within the limits of their competence;
• patients should be given written information about procedures being undertaken;
• continuity of care must be provided so patients know who to contact if they experience any complications;
• full and accurate records of consultations should be made.

I have had cosmetic surgery or treatment abroad. Can I bring a claim in the UK?

Medical tourism is a growing industry with the numbers of Britons going abroad for medical treatment, including cosmetic surgery, increasing year on year. The reason for this increase seems to be attributable to the difference in cost. However, travelling abroad for treatment is not without its problems.

If something does go wrong, your entitlement to bring a legal claim will depend on a number of factors, including where you can bring the claim, the time limits for doing so and whether there is even a right to claim compensation in that jurisdiction.

Our cosmetic surgery solicitors are seeing an increase in the number of new enquiries relating to treatment abroad. We work closely with members of our travel law team to provide clients with advice on the applicable law in the country where the treatment occurred.

It is imperative that anyone looking to bring a claim arising from treatment abroad uses a solicitor with specialist experience in dealing with international claims as well as expertise in cosmetic surgery claims and clinical negligence claims.

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