Cosmetic Surgery on Under 16/18s

Special care must be taken in providing cosmetic surgery to children under the age of 18 years.

THE PRASIS Code of Practice, written in collaboration with the Underwriting team advises:

Assessment of patients under the age of 18 years demands particular care to ensure that the proposed treatment is in their best interests. You should understand that:

There is no obligation to operate on any patient unless failing to do so would be negligent,
Final decisions about cosmetic procedures in young patients can be deferred.
If you consider that any proposed procedure is not prudent, do not proceed even in the face of compelling emotional pressure that might be brought to bear – your first instincts on whether to continue will usually be correct.
Remember that those with parental responsibility could bring an action on behalf of the child and therefore you are exposed to both the young persons’ interpretation at any stage of the process and also those holding parental responsibility.
If in doubt seek advice from a colleague or from your PRASIS medico-legal advisor.
You must follow GMC guidance on providing care for children and young people.

The GMC says:

32. If providing treatment to children, you should be familiar with the detailed advice in 0–18 Years: Guidance for All Doctors, which includes the key points set out in this section of guidance. You should take particular care if you consider providing cosmetic interventions for children or young people – you should make sure the environment for practice is appropriate to paediatric care, and work with multi-disciplinary teams that provide expertise in treating children and young people where necessary.

33. You must only provide interventions that are in the best interests of the child or young person. If a young person has capacity to decide whether to undergo an intervention, you should still encourage them to involve their parents in making their decision.

34. A parent can consent to an intervention for a child or young person who does not have the maturity and capacity to make the decision, but you should involve the child in the decision as much as possible. If you judge that the child does not want to have the intervention, then you must not perform it.

35. Your marketing activities must not target children or young people, through either their content or placement.

Guidance for Doctors Who Offer Cosmetic Interventions, GMC, 2016

The Codes of Practice from BAAPS and BAPRAS specialist associations are clear that:

Aesthetic procedures on patients under the age of 18 years should be exceptional and only undertaken after a full assessment of the risks and benefits, including the health and psychosocial consequences. It is recommended that the patient include their parents or guardians in the consent process. Parents/guardians written consent is not legally required above the age of 16 but their verbal agreement is recommended but not essential if the patient refuses.

British Association of Aesthetic Plastic Surgeons

Particular care should be taken when treating such patients to ensure that the treatment is in the best interest of the patient. The maturity of the patient and their understanding of issues relating to treatment are particularly important. You must ensure that all legal requirements in relation to consent are satisfied.

British Association of Plastic Reconstructive and Aesthetic Surgeons