Plastic Surgery Practices Guidelines by NMC – A View Point of Dr Rajat Gupta, National Secretary To IAAPS

Recently, National Medical Commission (NMC) released guidelines and issued an advisory on aesthetic surgeries emphasising the fact that such surgeries must be carried out in fully-equipped medical facilities by board-certified and registered surgeons only. Dr. Rajat Gupta, a board-certified plastic surgeon and National Secretary of IAAPS (Indian Association of Aesthetic Plastic Surgeons), endorses the stipulation by NMC and applauds this much-needed intervention. 

“While patient safety and security are one of the foremost considerations in the realm of plastic surgery, such measures are needed to eliminate foul practices that compromise lives”, stated Dr. Rajat.  

Every medical practitioner believes patients deserve the best treatments and surgical options to achieve the desired results. By being at an equipped facility under the supervision of a registered surgeon, patients ensure that they are in the best hands. Such facilities are outfitted with adequate and qualified staff and modern infrastructures such as life support and resuscitation apparatuses to handle any complication that arises.  

These guidelines, issued on 20th September 2022, further enforce the elimination of malpractices in plastic surgeries where inexperienced and unqualified surgeons perform procedures at lower costs, putting the patient’s life at an unimaginable risk. The advisory also emphasises recruiting trained and qualified support staff, including nurses, OT technicians, and ward assistants. An unskilled staff will not know the measures to be taken in case of unforeseen situations and can push the patient into a detrimental state.  

Dr Rajat Gupta, a plastic surgeon with more than 15 years of experience in aesthetic procedures, also spoke about ghost surgery. Such unrecognised facilities often administer ghost surgeons brought in to perform the procedure without the knowledge of the patient, which poses higher life threats with no avenue to approach for rectifications. Such malpractices and violations stand to be eliminated by recent NMC guidelines.  

Many people approach unregistered practitioners practicing at substandard facilities to save costs under the pretext of an emergency need for treatment. NMC guidelines also addressed this by stating that aesthetic procedures that address body restoration needs are not emergency surgeries and, thus, under no circumstances should an unqualified or unskilled person be allowed to perform such procedures. 

To furthermore strengthen the guideline, NMC ruled out the unethical practices of offering discounts and making false result claims to allure patients.  

The line of surgeons who should be performing aesthetic surgeries includes MCh/DNB Plastic Surgery and MD/DNB Dermatology, with substantial grooming in aesthetic surgical procedures.  

The facility must be a day-care facility equipped with OT outfitted with modern infrastructure and required machinery, emergency drugs with preoperative clearances from medical specialists, Boyles machines, intubation sets, and Ambu bags. There must be a plan to handle emergencies presented to the patient before the surgery.  

“While such guidelines by topmost authorities aim to bring a paradigm shift in surgical practices, patient awareness and considerations put forward by those looking for such procedures will bring a major change”, said Dr. Rajat.  

A large part of the responsibility remains in the patients’ hands while choosing the facility and the surgeon. They must ensure they are approaching a qualified, board-certified surgeon practising at a facility renowned for aesthetic procedures.  

This can be achieved by looking for consistency in a surgeon's results for all patients who have undergone the procedure the patient is thinking about having. A patient must also be completely at ease with the surgeon and their staff. Two-three consultation sessions before the surgery can achieve such comfort and understanding. To further strengthen the credibility, patients can also look for the IAAPS authenticity shield to ensure the surgical practitioner is genuine and credible. This is another very strong measure to ensure safety and good results. 

Furthermore, learning about the anaesthetist improves the chances of safety. The anaesthetist is largely responsible for patient safety during surgery. Patients must learn about the anaesthetist’s credibility. Anaesthesia must be administered by a board-certified anesthesiologist for patient safety. 

Patients must also examine the operating facility before surgery. They must ensure surgery will be performed in a well-equipped operating room. A hospital, a daycare surgical centre, or an outpatient surgical facility could be used. A high-quality hospital upholds stringent standards for staff, sanitation, equipment, and patient care. Support personnel who are qualified, trained and experienced in a clean, sterile, fully equipped operating room are a must.  

Closing the session Dr. Rajat Gupta, a highly reputed aesthetic surgeon practising at a modern and fully-equipped facility RG Aesthetics exclaimed, “I am all thanks to NMC for helping the practitioners like me who have put their sweat and blood and years of experience in plastic surgeries to earn the trust of our patients. Such initiatives to eliminate malpractices is such a remarkable step to strengthen people’s belief in body-correction procedures.”