Should psychological assessments be mandatory for cosmetic surgery patients?

Posted: 26/01/2016

The Daily Mail has published another story about Josie Cunningham, whose multiple cosmetic surgeries - including breast enlargement funded by the NHS - have been well publicised by the media. The recent article noted that Ms Cunningham’s reasons for undergoing various procedures are due to a difficult childhood and the “demons” she still lives with. She was quoted as saying: “I just want to be pretty”. 

Did anyone, particularly those who have carried out the multiple procedures on Ms Cunningham (either privately or via the NHS), ever explore her reasons for wanting cosmetic surgery? Were there underlying causes which further assessment/ counselling could have helped to determine whether she was or is a suitable candidate for surgery? 

In the experience of the specialist cosmetic surgery claims team at Penningtons Manches, people who have issues with their self-esteem and/or body confidence can often have unrealistic expectations about how they will look after a procedure and, if these expectations are not met, they may feel depressed or want to have further surgery. 

The current debate is whether people electing to undergo cosmetic surgery should be psychologically assessed pre-operatively to determine whether surgery will benefit them or possibly put them at risk of psychological harm. 

A recent enquiry to the clinical negligence team involved a young woman with a history of eating disorders and self-harming who wanted to undergo weight loss surgery. Despite her clear history and those treating her being aware of this, no form of counselling/ psychological assessment was offered to determine if she was a suitable candidate for weight loss surgery at that time. Post-operatively, the young woman was unable to cope with the gastric band and subsequently had it removed. It is alleged that she was not a suitable candidate for surgery at this time and psychological assessment was mandated.

Amy Milner, associate in the Penningtons Manches clinical negligence team, comments: “We are seeing an increase in enquiries from people with pre-existing psychological problems. More often than not, their condition worsens and their self-esteem is further reduced after surgery, particularly if they do not get their expected result. Given how popular cosmetic surgery is now, it is imperative that more care is taken to thoroughly explore a patient’s medical history and consider whether counselling/ an assessment may be appropriate before consenting the patient for surgery.”

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