PATIENT INFORMATION
General Information
When looking into treatment, you have the right to be informed and educated about your treatment in order to make an informed decision whether or not you wish to undergo actual treatment. You have the right to read a consent form and the technical literature that should be provided to tell you more about your treatment, ask any questions that you might have and have them answered to your satisfaction prior to receiving any treatment.
The active substance used in these injections, phosphatidylcholine, is a natural compound produced from the soya bean. The body uses the same substance in a number of chemical pathways, including fat metabolism. Thousands of treatments have been successfully given in Europe and in South America , where the treatment was pioneered 20 years ago. Lipodissolve injections should not be regarded as a new miracle drug for weight reduction. However in the case of fat deposits which cannot be removed by diet or exercise then these injections help the natural metabolic process during which fat is melted away and then eliminated from the body. The medication is directly injected into the area concerned. Areas suitable for treatment include the face, buttocks, abdomen, and thighs. Using different techniques Lipodissolve is also effective in the treatment of cellulite and reducing the size of lipomas (fatty lumps), without resorting to surgery.
The number of treatments differs from person to person, depending upon body region and body size. Due to the differing structure of the connective tissue and fat cells, it has been found that men do not respond to the therapy as well as women. As a rule, 2-4 treatments in intervals of 6-8 weeks are necessary to successfully complete the treatment. We have found that more than 80% of the patients are very satisfied with the results after 2-3 treatments.
Although a relatively new treatment, many thousands of treatment courses all over the world have now been completed, and no serious side-effects have been recorded. Nevertheless, it is considered essential that the therapy should only be carried out by medical experts trained in this field. In order to obtain successful results knowledge of the anatomical distribution of fat deposits in the body, the correct injection technique and the right dosage for the treatment are of the utmost importance.
Although they have been used for years elsewhere, these injections have not yet been officially approved as an aesthetic (cosmetic) therapy in the UK . This is in common with many other treatments, including muscle relaxing injections for fine lines and wrinkles, which is used world wide in aesthetic medicine. In the case of Lipolysis, this substance has been widely used for other medical applications such as the prevention of fat embolism, without significant problems.
The success of Lipodissolve injections is also a permanent one but does not occur directly but after a certain time. Patients who underwent a follow-up examination still show a definite reduction of their circumference, and this even after seven years. This therapy is suitable for patients who do not want to undergo a surgical intervention. Anaesthesia is not necessary for this treatment. Over dosage or intoxications have not become known to occur. The intervals between the treatments are different per individual patient and depend upon the body region; they may amount to 6-8 weeks. Again depending upon the body region treated and other factors, the number of treatments may amount to 2-4 sessions.
It should be noted that Lipodissolve injections should not be expected to result in weight loss; they rather help to modify body contours. The effect of Lipodissolve injections must not be compared with liposuction, a surgical method permanently removing also greater amounts of fat by means of one intervention.
Other Issues
You should have the opportunity of discussing the treatment with your physician be advised of possible alternative options, and be given enough time to take your decision. The injection of Lipodissolve into the fatty tissue represents a new cosmetic treatment not yet given approval in the UK . As it is the case in all medical /cosmetic therapies, there is a treatment failure rate, and even when treated to the highest standard and following existing clinical protocols, that exists the possibility that the results achieved may be less than anticipated, i.e. results are not guaranteed, the efficacy of the treatment varies from individual to individual, and a number of treatments may be necessary to give optimum improvement. You must give the doctor providing the treatment all the relevant medical details prior to treatment. Pre-treatment assessment can include body measurement and photography.
"When you have mesotherapy or lipodissolve, let us know who your physician is -- whether you're happy or disappointed with your results. If you know what program/physician/society trained them, let us know that too. (If you don't know, I might.)
Perhaps we can then build a data base of physicians with excellent records for either or both procedures.
I think that would be great for folks contemplating in undergoing the procedure!"
Before undergoing any cosmetic procedure, it is essential to do a lot of homework!
Don’t rush into anything. Read as much as you can about cosmetic surgery, and note down the names of surgeons who are mentioned or quoted. Remember that all surgery has risks. Think carefully about why you want the procedure done. For example, cosmetic surgery is unlikely to improve a relationship that is going nowhere. If you are going through a life crisis, don’t make any decisions about cosmetic surgery.
Be very clear what you are hoping to achieve. For example, if you want your breasts enlarged, what size do you want them to be? Having a clear idea is essential for a proper discussion with the surgeon.Find out as much as you can about the procedure itself . Even a simple-sounding procedure such as Lipodissolve or Liposuction requires a lot of skill. Look at the good cosmetic surgery websites. Locate a good, reputable surgeon. Don’t just answer a persuasive advertisement in a magazine or on the web; unfortunately any doctor can claim to be a ‘plastic surgeon’. The best plan is to ask your own doctor for a referral. If you think your doctor would be unsympathetic, contact the British Association of Aesthetic Plastic Surgeons (BAAPS) or International Society Of Aesthetic Plastic Surgery (ISAPS) for a list of their members and their different specialities.
- Check your surgeon’s qualifications in the appropriate countries ‘Medical Directory’. The letters MRCS or FRCS mean that that he/she is a Member or Fellow of the Royal College of Surgeons, having had several years experience and passed a stiff exam in general surgery. They do not signify special training in cosmetic surgery. Younger surgeons may have the more recently-introduced qualification ‘FRCS (Plast)’, which means that the surgeon has additional experience in plastic or reconstructive surgery and passed an extra examination. However, many experienced cosmetic surgeons do not have FRCS (Plast) because they trained before it was introduced.
- In the UK , most cosmetic surgeons will be members of BAAPS, the main organization responsible for maintaining high standards in cosmetic surgery. However, membership of BAAPS is not an absolute guarantee. To join BAAPS, surgeons have to have had 6 years training in plastic surgery and provide a log book of operations they have done, and other members have to testify to their experience. Once he/she has joined, there is nothing to stop the surgeon doing other cosmetic operations in which he/she is less experienced.
- Some surgeons are members of the British Association of Cosmetic Surgeons (BACS). This organization represents mainly surgeons in private clinics. To join BACS, they do not need to be qualified plastic surgeons, but have to show they have cosmetic surgery experience. Many BACS surgeons have good experience with certain procedures, but BACS membership is not a guarantee of anything.
- The General Medical Council has a list of specialist plastic surgeons who are eligible to work as NHS consultants in plastic surgery.
Make sure you have a proper consultation with the actual surgeon who will be operating on you. New UK government regulations insist on this. Be suspicious if you are not charged a fee for this consultation – a good surgeon’s time is valuable. A ‘free’ consultation will probably be with a counsellor, nurse or salesperson!
- Write down a list of questions beforehand. Make sure you ask them all (even if it feels embarrassing). If the answers are not absolutely clear to you, say so and ask for a further explanation. Don’t just think you are being stupid. Remember that you are paying for this consultation.
- Ask about any preparations you will need to make, what aftercare is provided, and what the risks are. Does the clinic have resuscitation equipment and doctors actually in the building 24 hours a day? Who will you be able to contact if you need advice after the operation?
- Find out about the recovery period. How much pain and bruising should you expect? How long will you need off work? When will you have stitches out? What will the scar be like?
- Ask how long the results will last.
- Ask the surgeon how many of these procedures he/she has done before. If you are shown ‘before-and-after’ photographs, ask if the operations were done by your surgeon personally. (You could be shown pictures of operations done at the clinic or some other clinic by a different surgeon.)
- Make sure you know how much the procedure will cost. Find out if post operative care is included in the cost i.e. after surgical change dressings etc ...
Shop around . Don’t just go with the first clinic that you contact. Make a short-list of several surgeons and clinics, and have a consultation with more than one. Although this will cost you, it is money well spent.
Allow yourself a ‘cooling off ‘period of about 2–3 weeks after the initial consultation, so that you can think clearly about the procedure before making the decision to go ahead. A respectable clinic will encourage this, and will not hassle you into making an immediate decision. New Government regulations from the National Care Standards Commission (set up to regulate private clinics) ban having the surgery within 2 weeks of the consultation, but you could still be pressured into making the decision too quickly. Go ahead only if you feel you can trust the surgeon, and that he/she has explained everything properly to you and understands what you are hoping to achieve.
Most popular operations In the UK , approx 72,000 cosmetic surgery operations are done each year. The most popular operations requested by women are:
In the USA , the most popular operations are:
In addition, more than 2.5 million chemical peels and anti-wrinkle injections (e.g. Botox) were done in the USA in the year 2000. Information from Mintel, British Association of Aesthetic Plastic Surgeons and American Academy of Cosmetic Surgery. |
International Society Of Aesthetic Plastic Surgery (ISAPS) For a list of the current active ISAPS Members by Country - http://www.isaps.org/membersbycountry.asp
British Association of Aesthetic and Plastic Surgeons (BAAPS) will send you a fact sheet on cosmetic surgery, and a list of their members. The list is also on their website. The website is very informative. It gives details of the common cosmetic surgery procedures, and tells you the risks and limitations of each. Write to: BAAPS, Royal College of Surgeons, 35-43 Lincoln ’s Inn Fields, London WC2A 3PN (send an s.a.e.). www.baaps.org.uk
The Medical Directory is a two-volume book listing UK doctors and their qualifications. It is published every year, and should be available in your local library. Look up your surgeon, and check his/her qualifications. The Directory may also mention that he/she is a member of the BAAPS.
General Medical Council . For enquiries about the specialist register of plastic surgeons, tel: 020 7915 3638.
British Association of Cosmetic Surgeons (BACS) . Write to: 17 Harley Street , London W1N 1DA
Health Which? October 1997 (published by the Consumers’ Association and available in most local libraries) contains a report on cosmetic surgery and a useful checklist to help you make an informed decision.
The American Society for Aesthetic Plastic Surgery can provide the names and qualifications of surgeons in all areas of the USA . Its website has web pages giving information about various cosmetic surgery procedures. Some of the information may not be applicable to other countries. Tel: 1-800-635-0635. www.surgery.org
LETS FACE FACTS!
A celebrity-style new look without going under the knife could be tempting. But there's no guarantee that your practitioner knows what they're doing.
The hype surrounding Botox, lasers, dermal fillers and chemical peels would have you believe you can pop out for lunch and return looking years younger. Quick and easy cosmetic treatments have started hitting the high street, with clinics, salons and even your local gym promising to plump up wrinkles or peel back the years. If you want to spice things up a bit, some practitioners even offer champagne-sipping get-togethers so you can enjoy as they inject.
As you might guess, it's not as simple as it sounds. The treatments may be quick, but they can still go wrong. And there's a worrying lack of checks on safety. When we went undercover (see 'Our Investigation') we found doctors and nurses making exaggerated claims and failing to explain risks. We also came across illegal adverts and a doctor who was under investigation for a serious professional misconduct.
Each of our undercover researchers had a story. Our 59-year old said she wanted Botox for the lines on her forehead and between her eyebrows. The 34-year old said she was interested in dermal fillers to plump up her lips. Our 33-year old said she wanted to refresh her skin and get a healthy glow, and had heard chemical peels could help. Finally, our 58-year old wanted laser treatment to reduce the lines on her face.
Our experts felt half the consultations were poor. They criticised the grand claims made by a doctor at the London Cosmetic Laser Centre, 'Almost anything you want, I can do it, and that's a guarantee... it's fact, not fiction,' he told our researcher. We later found that this doctor is being investigated for misconduct following patients' complaints. See 'Laser in the dock'.
At the Yannis Alexandrides clinic, our researcher was left waiting 50 minutes before being charged £100 for a five minute discussion. She was told: 'Botox is a quick, painless, simple injection. You don't need a consultation.' In fact, Botox is a prescription-only drug that can have some pretty drastic side effects.
Consultations at the Lifestyle Clinic, Martindale Clinique, National Cosmetic Centres, Urveda and the Transform clinics in both London and Manchester were also judged to be poor.
Even some of the practitioners whose consultations were judged satisfactorily still made mistakes. The doctor at the Wimpole Skin Care Centre didn't listen to our researcher's needs but instead tried to sell her a whole package of procedures. In addition to £480 for four chemical peels she was advised to spend £250 on Botox injections and £450 on dermal fillers.
Our experts felt that only five of the sixteen consultations were good. The Heaven Spa, Harley Medical Group in Manchester and London, Hurlingham Clinic and Spa, and Liinzi James Clinic all took good medical histories and provided thorough details about risks and side effects.
If you want surgical treatment, such as breast implants and liposuction, you should see a specialist plastic surgeon. The treatments we were shopping for were less radical, but they're not so straightforward that beautician can try them. Most should be carried out only by a qualified doctor or nurse. For more on who should perform treatments, see 'choosing a treatment'.
Legally, Botox must be prescribed by a doctor yet, at Transform in Manchester, our researcher spoke only to a 'patient co-ordinator'. She was told a nurse would carry out the treatment, but there was no mention of whether she would see a doctor.
In our visit to Martindale Clinic for laser treatment, the practitioner called herself a beauty therapist, yet it wasn't clear if she was qualified to perform laser treatments. Check training and experience with the relevant professional bodies.
Most practitioners didn't fully explain the risks or side effects, some overlooked them completely, and some gave incorrect information. At the Lifestyle Clinic, the researcher who requested a chemical peel was told: 'You only need to use sun block when it's hot, but you'll be starting in the winter so you'll be fine.' This is wrong. As one of our aesthetic nurses explained: 'Any procedure which exfoliates the skin requires the client to wear sun block every day to prevent damage from the UV rays, which are present all year round.' On some occasions our researchers' expectations were completely mismanaged. The doctor at the Wimpole Skin Care Centre didn't discuss any risks or side effects of the multiple treatments she recommended - she simply said: 'From now until Christmas, you will look sensational... You'll look fantastic.
Practitioners should take a thorough medical history to find out whether the treatment is suitable. For example,if you're taking light-sensitising medications, you should avoid lasers. In most visits, our researchers were asked to complete medical questionnaires. But in four visits (at the Wimpole Skin Centre, the London Cosmetic Laser Centre, Art Medic and National Cosmetic Centres), there was no questionnaire and absolutely no discussion of medical history.
If the idea of spending your lunch hour fighting the ravages of time still appeals, don't rush into anything. See further information for our tips on picking a reliable practitioner.
If you're comfortable talking to your GP about the treatment, you could ask them for a referral or a recommendation. Alternatively, you could ask friends who have similar treatments.
Unfortunately, there's no central body that regulates all the clinics offering cosmetic treatments. The National Care Standards Commission (NCSC) in England regulates and inspects private health services, including clinics offering cosmetic surgery or laser treatments. These clinics must meet national minimum safety standards.
But loopholes in legislation mean that clinics offering non-surgical treatments such as Botox injections, dermal fillers and chemical peels don't need to register with the NCSC. As such, these clinics go completely unregulated and there are no inspections of care standards or staff's qualifications. There's currently no regulation of clinics in Northern Ireland, Scotland or Wales. The situation should improve a little in Scotland, thanks to new regulations for specialist clinics employing a doctor.
The lack of regulation means it's important to choose carefully. Make appointments with a few clinics, find out about quality standards and checks made on staff, and ask to see the complaints procedure.
Don't be scared to ask about their experience, expertise and qualifications. Ask how often they've performed the procedure, how they measure their success and the number of times their patients have had complications. If you're being treated by a doctor or nurse, check that they are registered with the General Medical Council or the Nursing and Midwifery Council.
The British Association of Cosmetic Doctors has a register of members to help you find a suitably trained and experienced doctors. The Royal College of Nursing is set to publish minimum professional standards for nurses performing cosmetic treatments, and there are moves to develop a specialist qualification for aesthetic nurses. The British Association of Beauty Therapy and Cosmetology (Babtac), the professional body for beauty therapists, vets its members' qualifications, so look for valid Babtac certification if you use a beauty therapist. You can also contact Babtac to find out whether somebody is qualified.
Read as much as you can about the treatment you're interested in. For example, visit the British Association of Cosmetic Doctors or the Consulting Room websites (see further information). Think about the results you want, whether you can afford any time off work needed to recover, what your budget is, and whether you're prepared to travel for treatment. If there's anything you're not sure about, prepare questions to ask the clinic later.
Make sure you ask plenty of questions about the treatment, how it works, how to prepare for it, any pain, risks or side effects, what results to expect and how long they will last, and what will happen if treatment goes wrong. Be wary of patient co-ordinators at clinics. They're not usually medically trained and may not fully understand the treatments. Finally, don't be pressured into having the treatment immediately.
If you're not happy with the results, complain to the practitioner or the clinic. If their response isn't satisfactory, contact the GMC if the procedure was carried out by a doctor, or the Nursing and Midwifery Council if it was performed by a nurse.
If the treatment has caused you personal injury, you could seek advice from the charity Action Against Medical Accidents, or from a specialist solicitor. If you want to make a complaint about a clinic that offers laser treatment or cosmetic surgery, contact the NCSC. To complain about misleading adverts, contact the Advertising Standards Authority or the Medicines and Healthcare products Regulatory Agency.
