Aesthetic surgeries to be done by registered medical practitioners only: NMC guidelines

New Delhi: Aesthetic procedures including hair transplants should be carried out only by registered medical professionals having adequate training, the National Medical Commission (NMC) said and underlined they should not be attempted by watching demonstrations in workshops or on YouTube.

According to the Guidelines on Aesthetic Surgery and Hair Transplant Procedures and a related advisory issued by the NMC, such procedures should be done in facilities having adequate infrastructure and manpower to manage any issues and complications that can arise including basic life support and resuscitation measures.

The guidelines and advisory, issued on September 20, state that assistants or technicians should be from a medical background such as nurses, OT technicians and pharmacists and they should perform tasks only under the supervision of registered medical practitioners.

The centre where aesthetic procedures including hair transplant are performed should be registered as a day care centre or hospital with the local or state authorities and should have a well-equipped postoperative recovery room with facilities for monitoring of vitals including blood pressure, electrocardiogram and oxygen saturation.

The advisory to stakeholders informing them about harms of getting treatment from unqualified people stated that “ghost surgery” — substitution of surgeons without the patient’s knowledge and permission — would also constitute malpractice and violation of any of the guidelines will be seen as a misconduct and offence.

The advisory stated that aesthetic procedures including hair transplant are not an emergency surgery and hence there is no case for allowing any untrained person to do it under the pretext of “exceptional circumstances”.

“It may be noted that watching (procedures) in workshops or on YouTube or similar platforms is not adequate training to start aesthetic surgeries including hair transplant,” the advisory stated.

Further, unethical practices such as fee cutting and advertising with false or exaggerated claims should not be indulged in, the NMC said.

Underlining aesthetic surgery including hair transplant, as with any other surgical procedure, may sometimes have serious complications, the guidelines stated that “aesthetic procedures should be undertaken only by those RMPs (registered medical practitioners) who have adequate training to do these procedures as per their curriculum”.

The NMC advised patients to meet the doctor who is going to perform hair transplant or aesthetic surgery and know his qualifications and experience and also know about the place where such procedure is going to be performed to check whether OT facilities with proper protocols are there or not.

Patients should be well informed about the procedure, all needed preoperative investigations, complications and requirement of procedure to be repeated, etc.

According to the guidelines, hair transplant should preferably be undertaken only by those who have surgical grooming like formal surgical training such as MCh/DNB plastic surgery, MD/DNB Dermatology with adequate grooming in dermatological surgical procedures. It is also noted that the above-named specialties have hair transplantation as a core topic in their curriculum.

The minimum requirements in a hospital/clinic performing hair transplant surgery state that the daycare theatre should be equipped with facilities for monitoring and handling emergencies including stocking of emergency drugs, Boyles machine, intubation sets and ambu bag.

A plan for handling emergencies should be in place and all nursing staff should be familiar with the emergency plan. It is ideal to have a standby anaesthetist.

According to the advisory, aesthetic procedures including hair transplant should be performed only with an anaesthesia backup with the availability of all the requisite resuscitative equipment and drugs and with adequate preoperative clearances from the medical specialists and the anaesthetist.

By Payal Banerjee