Introduction

In the ever-evolving world of aesthetic medicine, the allure of enhancing beauty often overshadows the challenges aesthetic practitioners face, particularly when complications arise. Despite the strides in technology and techniques, aesthetic complications are an inevitable part of medical practice. Yet, discussing these complications remains a sensitive and often avoided topic. 

If you are reading this article now, you’ll learn the importance of openly discussing and reporting complications in aesthetic medicine, emphasising the benefits for patient safety, professional regulatory development, and fostering a culture of support, openness, and ethical practice in aesthetics.

The Stigma Around Aesthetic Complications

Complications in aesthetic treatments are often shrouded in silence, primarily due to the stigma attached to them. Aesthetic practitioners fear being judged by their peers or facing professional backlash, which can deter them from openly discussing their experiences. 

This stigma can lead to underreporting of complications, depriving the medical community of valuable learning opportunities. The fear of judgement can stifle innovation and improvement, as aesthetic practitioners might avoid discussing their experiences and the lessons learned from complications.

In the year 2023 alone, the British College of Aesthetic Medicine (BCAM) has seen a notable increase in aesthetic complications. A significant portion of these complications (69%) originated from treatments by beauticians, therapists, and podiatrists, an increase from 60% in 2022. Dermal fillers remain the leading cause of complications (44%), followed by botulinum toxin (30%), threads (12%), and lasers/energy-based devices (9%). 

The increase in aesthetic complications highlights the ongoing need for better regulation and licensing schemes in aesthetic treatments to ensure patient safety. For instance, the CREAM guidelines are a significant step forward in enhancing transparency and standardisation in case reporting in aesthetic medicine. 

Importance of Discussing Aesthetic Complications

Openly discussing aesthetic complications is crucial for several reasons. First and foremost, it enhances patient safety. When aesthetic practitioners share their experiences and insights regarding complications, they contribute to a collective knowledge base that can help others avoid similar issues. This shared learning can lead to the development of improved treatment methodologies and safety protocols. 

Furthermore, discussing aesthetic complications helps set realistic expectations for both practitioners and patients. Patients who understand the potential risks and complications are better prepared for their treatment journey, leading to higher satisfaction and trust in their aesthetic practitioners.

From a professional development perspective, openly discussing complications is a cornerstone of continuing education. It provides aesthetic practitioners with real-world scenarios that can enhance their skills and knowledge. Moreover, it fosters a sense of community and support among aesthetic practitioners, as they realise that complications are a common aspect of their practice and not a personal failure.

If you are unsure about reporting a concern or complication from a procedure, remember these points:

• You have a duty to prioritise your patients’ interests and protect them, which is more important than personal or professional loyalties.
• The law protects individuals from being victimised or dismissed for revealing information to raise genuine concerns and expose workplace malpractice.
• You don’t need proof to raise a concern. It’s justified if done honestly, based on reasonable belief, and through proper channels, even if you’re mistaken. 

For advice on aesthetic complications, you may visit 

• ACE Group
• British College of Aesthetic Medicine (BCAM)
• General Medical Council (GMC)
• Royal College of Surgeons (RCS)
• British Association of Dermatologists (BAD)
• Nursing and Midwifery Council (NMC)

Creating a Culture of Safety and Support

Developing a supportive environment where any aesthetic complications can be discussed without fear of judgement is essential. Regular team meetings and peer reviews can create safe spaces for aesthetic practitioners to share their experiences and learn from each other. Establishing forums or networks for sharing experiences can also be beneficial. 

Professional bodies and regulatory agencies play a crucial role in supporting this cultural shift. By promoting open discussions and providing platforms for sharing, they can help normalise the conversation around aesthetic complications.

Download a copy of the JCCP and CPSA Guidance for Aesthetic Practitioners and learn how to set realistic expectations and obtain informed consent, adhere to current safety protocols, consider patients’ overall needs, and avoid conflicts of interest that could compromise patient care.

Leadership and management for all aesthetic practitioners and staff alike

Early identification of problems in aesthetic treatments is crucial to protect patients, requiring aesthetic practitioners to participate in regular reviews and audits of their teams. 

All aesthetic practitioners must be familiar with clinical governance, risk management processes, and reporting procedures for adverse incidents or near misses in their workplaces. They must adhere to national and local guidance on patient safety and inform patients of potential adverse outcomes, including less serious side effects. 

An open communication about risks should be clear, balanced, and in simple language, ensuring patients understand the seriousness and likelihood of any adverse outcomes. Using written or visual aids can help patients make informed decisions and engage safely with their treatment and aftercare.

The Role of Reporting Systems

Formal reporting systems are vital for tracking and analysing complications. These systems can help identify trends and common issues, leading to the development of better safety protocols and training programmes. One example includes the Medicines and Healthcare Products Regulatory Agency (MHRA). The MHRA is a UK government agency responsible for regulating medicines, medical devices, and blood components for transfusion. Here’s how aesthetic practitioners can engage with MHRA reporting systems:

Reporting Adverse Events

• Unexpected side effects: Adverse reactions that are not listed in the product’s labelling.
• Serious adverse events: Events that result in hospitalisation, significant disability, or are life-threatening.
• Device failures: Issues with medical devices used in aesthetic treatments that could harm patients.

Yellow Card Scheme

The MHRA’s Yellow Card Scheme is a critical tool for reporting adverse events. It allows healthcare professionals and patients to report suspected side effects and problems with medical devices. This system is essential for:

• Tracking safety issues: Collecting data on aesthetic complications to identify patterns and potential risks.
• Regulatory action: Enabling the MHRA to take action, such as issuing safety warnings, updating guidelines, or recalling products if necessary.

How to Report

Aesthetic practitioners can report adverse events through the MHRA website or using the Yellow Card app. The process involves:

• Detailed reporting: Providing comprehensive information about the adverse event, including the product involved, the nature of the complication, and patient details.
• Follow-up information: Submitting additional data if requested by the MHRA to aid in the investigation.

When data is submitted to the MHRA, along with reports from pharmaceutical companies, they review it to ensure safety. The MHRA may update product information, adjust usage instructions, change dosages, restrict use for certain patients, alter the medicine’s legal status, or in rare cases, remove it from the market. This information helps healthcare professionals and the public make informed decisions about treatments and manage adverse drug reactions. Sometimes, pharmaceutical companies directly provide this information or training to healthcare professionals, patients, or carers (Royal Pharmaceutical Society, 2022).

Encouraging Open Communication

Encouraging open communication about aesthetic complications requires practical strategies. 

Aesthetic practitioners should choose appropriate forums for these discussions, such as professional conferences, workshops, or dedicated online platforms. Using non-confrontational language and focusing on constructive outcomes can help ease the conversation. It’s essential to frame discussions around learning and improvement rather than blame and judgement. 

Similarly, if you are running your own aesthetic clinic, you may consider a few strategies below to foster an open and positive environment with your staff where discussing aesthetic complications and concerns is encouraged:

Clear Communication and Expectations

• Set clear roles, responsibilities, and performance goals.
• Maintain regular communication and an open-door policy.
• Provide ongoing training and development.
• Offer regular training and industry conference opportunities to keep staff updated.

Foster a Positive Work Culture

• Promote teamwork, respect, and appreciation.
• Celebrate successes and address challenges constructively.
• Encourage feedback and employee involvement
• Seek input on clinic operations and improvements.
• Implement feasible suggestions to foster a sense of ownership.

Offer Competitive Compensation and Benefits to Attract and Retain Top Talents.

Emphasise Work-Life Balance (flexible schedules).

Set Realistic Performance Goals Aligned with Clinical Objectives in Manageable Milestones.

Implement Constructive Performance Reviews and Set New Team Goals.

Lead by Example – Demonstrate professionalism, integrity, and a strong work ethic.

Prioritise Employee Well-being with Wellness Programs and Resources.

FAQs

Q: How should I report an aesthetic complication?

Any aesthetic complications can be reported through formal reporting systems provided by professional bodies or regulatory agencies such as the MHRA UK. Ensure that the report includes detailed information about the complication, the treatment administered, and any corrective actions taken.

Q: Where can I discuss these issues?

Professional aesthetic conferences, workshops, and dedicated online forums are excellent places to discuss complex aesthetic complications. Peer review meetings and team debriefings can also provide a supportive environment for sharing experiences.

Q: How should I handle patient communications after a complication?

Transparency is key. Inform the patient about the aesthetic complication, the steps you are taking to address it, and any additional treatments that may be required. Maintaining open and honest communication can help build trust and reassure the patient.

To improve the field of aesthetic medicine, it is imperative to take proactive steps in promoting open discussions about complications. Aesthetic practitioners are encouraged to participate in or establish reporting systems within their practices. Engage in professional development opportunities that focus on learning from complications and enhancing patient safety.

Conclusion

Openly discussing and reporting aesthetic complications is not just about acknowledging the challenges in aesthetic medicine; it is about embracing a culture of transparency, support, and continuous improvement. By addressing complications openly, the aesthetic community worldwide can enhance patient outcomes, foster professional growth, and build a stronger, more supportive network of aesthetic practitioners.

Let us commit to transparency and continuous learning, ensuring that the aesthetic medicine field evolves to meet the highest standards of patient care and professional excellence. Through collective efforts, we can transform the way complications are perceived and handled, ultimately leading to better practices, improved safety, and greater trust between practitioners and patients.