Growing numbers of patients are suing plastic surgeons over mistakes during operations designed to improve their appearance, according to the Medical Defence Union, which represents over half of Britain's doctors and surgeons when they are accused or malpractice or negligence.
Its data shows that breast surgery, facelifts, eyelid operations, nose reductions and weight-loss procedures account for 80% of the rising number of legal actions, with blunders leading to damages payouts of more than £500,000. Cosmetic surgery compensation claims are upheld in 45% of cases, compared with 30% of cases for medical compensation claims in general.
The MDU said the increase was due to "a huge rise in both the number of procedures and patient expectations of a perfect outcome" as well as surgeons failing to get proper patient consent and doing substandard work. It refused to disclose more details of the research, citing commercial confidentiality, but said the rise in cosmetic claims over a five-year period was "significant".
Surgeons' leaders said the data underlined the need to regulate cosmetic procedures. "These figures from the MDU bear out concerns raised by a major independent report in 2010 by the National Confidential Enquiry into Patient Outcome and Death and the longstanding call from surgeons that the cosmetic sector needs proper regulation," said Steve Cannon, a Royal College of Surgeons of England (RCSE) council member and chair of the college's working group on cosmetic surgery standards.
On Friday, the government said women who are concerned about breast implants made by the scandal-hit French company PIP should be able to have them removed for free, either by the NHS – in the case of reconstruction after breast cancer – or by their cosmetic surgery clinic.
The government set up the expert advisory group on breast implants 10 days ago after confusion about whether the rupture rate among PIP implants could be as much as 7%, far higher than the 1% originally thought. Now the government has investigated that issue, the Guardian understands it will consider regulation of the cosmetic industry as a whole.
The group, headed by NHS medical director Sir Bruce Keogh, includes Fazel Fatah, the president of the British Association of Aesthetic Plastic Surgeons, and prof Norman Williams, president of the RCSE, both of which are strongly pro-regulation. The group's focus will now shift to the possible introduction of independent scrutiny of an industry that has been causing concern for years.
In 2005, the then chief medical officer, Sir Liam Donaldson, published a report which concluded that regulation was necessary and made a series of recommendations, but little was done.
On Sunday a Department of Health spokeswoman said: "We will welcome any submission by the MDU, with a clearer picture of the data it holds, to NHS medical director professor Sir Bruce Keogh's ongoing inquiry into issues of safety and quality within the cosmetic surgery sector."
Dr Clare Gerada, chair of the Royal College of General Practitioners, said the unfolding scandal over PIP breast implants showed that regulation was needed to ensure that clinics had to offer redress to patients they had injured. Most firms have so far refused to comply with health secretary Andrew Lansley's call for them to remove the implants for free from women who are concerned about their safety after some of the implants burst.
"The use of cosmetic surgery has ballooned over the last few years," said Gerada. "It is important that whilst surgery might be deceptively easy to obtain, standards of care are always upheld, and that profit should never take precedent over high-quality care."
The MDU's findings are based on an analysis of lawsuits against plastic surgeons over an unspecified recent five-year period and appear in the latest edition of its journal. They include "a claimant who alleged that the surgeon had failed to obtain fully informed consent and a full medical history before carrying out a facelift. The patient suffered a post-operative stroke. The claim was eventually settled for over £500,000," it says.
During the same period the MDU also worked with more than 50 members working in plastic surgery who were under investigation by the General Medical Council.
The government's expert advisory group on the breast implants scandal will start discussing possible moves to regulate the cosmetic industry when it meets next month, the Guardian understands.
The study, which indicates large increases in cases through a graph but does not give exact numbers, cites examples of a 43-year-old man who won £25,000 damages after his face was burned after eyelid surgery; a patient who got £10,000 after his nose reduction left him with breathing problems; and a young woman who was given the wrong size breast implants.
Blunders in other cases left patients scarred or with features that were asymmetrical, and in several cases inquiries revealed that the patient did not undergo a thorough psychological assessment before going under the knife, for example women having a second or third breast enlargement operation, it adds.
Pre-surgery psychological evaluation should be mandatory in order to identify patients who have unrealistic expectations of the benefit they will receive, according to lawyers specialising in cosmetic surgery negligence. The study also recommends clinics be obliged to offer proper aftercare rather than being able to ignore patients' complaints, steps to stop surgeons vanishing after causing suffering and staff who undertake cosmetic work to have full liability insurance. Some staff who have accidentally burned and scarred patients with laser and hot wax treatments have not been properly insured.
The RCSE will shortly issue updated guidance for its members who perform such procedures in a bid to improve clearer advice about treatment, after it undertook an in-depth examination of professional standards in this area, Cannon added.
The government's health and social bill could lead to the NHS having to treat growing numbers of victims of cosmetic surgery in the future because it will extend the role of private healthcare, said Gerada.
"The NHS has for decades picked up the pieces of failed private care but now, with the expansion of the private sector and the positive encouragement of this in the health and social care bill, one wonders where the safety net will be in the future to protect patients when their private provider can not or will not intervene or where the patient cannot afford remedial treatment," said Gerada.
Peter Walsh, chief executive of the patient safety charity Action against Medical Accidents, said: "The government is putting its ideology about freeing up industry from red tape, bureaucracy and regulation ahead of patient safety, which is irresponsible. The harm from private cosmetic surgery can lead to disability and even death.
The whole cosmetic healthcare industry is a murky and dangerous area. Patients are suffering avoidable harm as a result of successive governments' failure to regulate this industry."
