Surgery During Coronavirus Crisis

If you are planning to have surgery, you may have some concerns about all of the measures in place around COVID-19 and might be wondering if it is safe to have surgery during coronavirus.

The risks of contracting the virus relate to the spread in an aerosol form hence the requirement for face masks and visors.

This means that you will find measures in place when you come to the clinic to reduce transmission in the same way that you would when visiting other shops and services.

However if you are considering surgery during this time you may have further concerns.

There are risks to the healthcare professionals delivering the surgery as well as risks to yourself having the surgery.

Risks to healthcare professionals

In my field of breast and body contouring, I do not do surgery that would be classed as high risk in producing aerosol which would be more related to surgery around your mouth such as ENT or dental surgery.

There is however a risk during intubation and extubation at the beginning and end of a general anaesthetic, however there are robust measures to protect everyone around these times.

Private hospitals aim to be COVID-free environments which is why you will be asked to self isolate, fill in a questionnaire and have a COVID test before admission.  It is also why, for the time being, visitors are being discouraged.

Unlike NHS Hospitals, Private Hospitals do not have an A&E Department and so do not accept direct admissions.   This means that they have much more control over their environment as all admissions are planned.
Everything is being done to make the hospital environment a safe environment to be in for both the staff and the patients during these challenging times.

Risks to you

In relation to the risk to yourself if you are considering surgery then this is by no means clear.

There was a study which suggested that if you have surgery and go on to develop COVID-19, then your outcome may be worse than if you hadn’t had surgery.

This study seemed to affect patients who are in higher anaesthetic risk category rather than the sort of patients who have elective cosmetic surgery . It also seemed to be in patients having longer and more complex surgery. which is why this has been discouraged at the moment.

The Royal College of Surgeons has produced this information leaflet.

It has not been suggested that we should stop during surgery during coronavirus and the guidance is that for most elective cosmetic surgery, it is safe to proceed although we will ask you to fill in a COVID-19 specific consent form before your operation.

Following surgery, you will also be given a specific postoperative instruction sheet for COVID-19.

The main issue that we have at the moment is with accessibility to theatres as all of the major private hospitals in the UK have been taken over by the NHS and are offering limited access to plastic surgeons.

However we like to solve problems and overcome challenges and so have adapted and there are more and more clinics in the UK who are offering local anaesthetic and sedation which is suitable for many plastic surgery procedures.

My clinic is not set up for local anaesthetic and sedation at the moment, but we have access to other clinics to use their facilities.

This is something that we have been doing on a small scale before the coronavirus outbreak and will be doing more of moving forward and I think it is actually a positive step.

The recovery after local anaesthetic and sedation is much quicker and it can be extremely well tolerated by patients.

However it is not for everybody and there will still be some larger operations that require a general anaesthetic and we have some access to general anaesthetic theatres.

The information that we are getting from the hospitals is that we will be back to normal capacity after Christmas although this is of course dependent on how things progress with the coronavirus pandemic.

We are trying to keep everyone updated as well as we can but unfortunately, we are getting theatre lists on an ad hoc basis, so it is difficult to plan and give you a lot of notice if you are on the waiting list for surgery.

These are challenging times for all of us all,  but I think it is important to recognise the significant benefits that can come from cosmetic surgery and I believe that it is safe to continue to perform surgery during coronavirus and still maintain our high levels of service given the limitations and restrictions imposed upon us.

If you have any questions or would like to talk about any of the issues around this please feel free to get in touch or join me on my Facebook and Instagram live Q&A every Tuesday at 7pm.

Resources:

The Royal College of Surgeons information leaflet
Specific guidance sheet for COVID-19
COVID-19 specific consent form