Dr.Adnan Gelidan MD,FRCS ( C ), FACSPlastic, and Reconstructive Surgery

Consent refers to the provision of approval, particularly and especially after thoughtful consideration

Voluntary agreement or permission, can be

achieved passively; To express willingness, to give permission; To cause to sign a consent form

A patients oral and written agreement

Consent is based on full disclosure about treatment, its potential risks and benefits, alternative treatment, and any other information the patient needs to make the decision

For the consent to serve as a defense to allegation of either negligence or assult and battery, it must meet certain requirement

VoluntaryCapacityDisclosure “ Properly Informed

Consent “

Patient takes his own decision with out any external pressure From

Relatives or physician him self

Physician has to be sure that the patient is mentally fit to take his own decision :

No psychiatric concern Mental retardation Or any drugs affecting patient

decision making

The physician has the obligation to disclose all the necessary information about the procedure to the patient

With out bias toward certain procedure, or blind the patient about other options because he cant perform them

Items Plastic Surgery Consent

Non-Platic Surgery Consent

Surgery Performed Not Needed Always Needed

Health Of The Patient Healthy Could Be Un-Healthy

Affect Life Or Function

No Yes

Acceptance Of Complications

Majority No Yes

Type Of Patient Highly Educated Any Class

The Plastic Surgery consent should include all the following :The procedure it self in details All the expected complications from skin

incision expected changes which might happen years there after

Taking picture consent, before and after surgery

All Cosmetic surgical Procedures Head, & Neck : Forehead lift,

Blephroplasty, Rhinoplasty, Face, & Neck lift

Chest : Beast Augmentation, & Lift, Breast Reduction, and Gynacomastia Surgery

Trunk Surgery: Tummy Tuck, Belt abdominoplasty, Buttock, & Thigh lifts, Liposuctions

Writing all the possible complication from the above mentioned procedure in details in a special form consent or a plastic surgery consent

Pre-Operative pictures Is really crucial in medicolegal

situations or circumstances

As A ROLE Patient in a case of complication or

un-satisfaction denies, and forget all what was told or explained to him

WHAT YOU SAY AND YOU DON’T

WRITE DOSE NOT COUNT IN COURT

Almost 30% of the practice of any plastic surgeon is Non-Surgical is and unfortunately practiced by non-plastic surgery service i.e. Dermatology, Dentistry, Primary care physician

Which Include :All type of FILLERS permanent or non-

permanent BOTOX Implants Coloring creams anti-pigmentation creams

All these simple Office based procedureHave low rate of risk and complication

Infection, migration, asymmetry …ect

Which has to be explained to the patients and discussed or even showing doctor own per, & post Op pictures

Documented in a consent

And if possible a pre-procedure photo in the patient file

Big number of patients expect that plastic surgery don’t leave scars So:Location of the scar Shape Risk of Keloid or Hypertropic scars

Has to be explained in details

The big dilemma occurs: • You have an obese patient • In your office for

Cosmetic breast reduction surgery or abdominoplasty

When you discus all the possible complication in details which might include DVT or PE, loss of Umblicus or Nipple or even Death

You’re Cursing them and they leave thinking you’re a bad surgeon and they distribute this to all the people in their social circle

Which might affect your patient pool

So what do you do?

I think a detailed consent pre – made by the plastic surgeon listing the procedure in details, list with all the possible complication for any any cosmetic procedure including the Non-Surgical procedure with the expected out come, including consent for photos

IS THE WAY TO GO

Or even a hand written consent in the patient chart signed by the patient him / her self, witnessed by a patient relative

IS A VERY STRONG PROOF & WILL STAND WELL IN COURT