Dr.Adnan Gelidan MD,FRCS ( C ), FACS Plastic, 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  Voluntary  Capacity  Disclosure “ 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

ItemsPlastic Surgery ConsentNon-Platic Surgery Consent Surgery PerformedNot NeededAlways Needed Health Of The PatientHealthyCould Be Un-Healthy Affect Life Or FunctionNoYes Acceptance Of Complications Majority NoYes Type Of PatientHighly EducatedAny 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 procedure  Have 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