CCR 2026 Resources
Updated: Oct 1
Patient Selection and Consent in Aesthetics: What Actually Protects Practitioners? | CCR 2026
Here you will find the resources from the Patient Selection and Consent in Aesthetics session presented by Brea Cannady at CCR 2026. This page brings together the slides, legal background, research and further reading. It also includes patient resources and information about taking part in the PREPÆRE™ practitioner pilot.
TABLE OF CONTENTS
Download Presentation Slides
Patient Resources
The Patient Hub offers clear, patient-friendly information about the psychological side of cosmetic procedures, including BDD, body image concerns, perception drift and eating disorders. It can be shared with patients who want to learn more and includes signposting to further help and support.
New resources are added continuously.
Session Summary
Psychological harm is a recognised risk in cosmetic practice, yet current safeguards focus heavily on identifying which patients may be psychologically vulnerable before treatment.
Practitioners must make reasonable enquiries and act on detectable warning signs. However, BDD, eating disorders, depression, anxiety and other forms of psychological distress may have no obvious outward signs. A patient may appear calm, coherent and clear about what they want, while disclosing nothing that gives the practitioner a reason to stop.
BDD is estimated to affect roughly 1 in 5 people seeking cosmetic procedures. Cosmetic treatment may change the feature the patient is concerned about without resolving the distress behind it. This creates a particular risk for practitioners because an objectively good physical result may still be followed by dissatisfaction, repeated contact, refund or revision demands, complaints and claims.
The session follows the same hypothetical patient through three different approaches.
SCENARIO 1: Professional Judgement
The first approach relies on consultation, experience and professional judgement. Research comparing surgeons’ assessments with BDD questionnaire results found that surgeons were highly confident in their ability to identify BDD, yet identified only two of the 43 patients who screened positive.
This does not mean practitioners should abandon professional judgement. It shows that a reassuring consultation cannot reliably exclude a hidden condition. If the patient later becomes more distressed, the physical result may no longer be the main issue. The complaint may focus on the decision to treat and the allegation that the practitioner should have recognised the patient’s vulnerability.
SCENARIO 2: Formal Psychological Screening
The second approach adds a standardised psychological questionnaire. This may appear more defensible, but it still depends on what the patient reports. Some patients may minimise or withhold concerns because they want treatment. Others may genuinely fail to recognise their difficulties or understand their relevance. Longer forms or in-person questioning do not remove that dependence on self-report.
Once a screening result is used to support a decision about psychological suitability, the practitioner may need to defend the reasoning behind that decision. The choice of questionnaire, scoring threshold, interpretation, training and referral criteria can all be examined. The questionnaire also becomes part of the evidence if a dispute later arises. It records what the patient was asked and what they reported. It does not ensure that the patient was warned about the psychological risks and limitations of treatment.
SCENARIO 3: Psychological Risk Disclosure
Screening collects information from the patient. Informed consent requires material risk information to be given to the patient.
The third approach provides every patient with the same core psychological risk information before consultation, regardless of what they disclose or how they appear. Patients should understand that cosmetic treatment cannot be relied on to improve confidence, relieve appearance-related distress or resolve BDD. They should be told that psychological distress may remain unchanged or become worse, even after a good physical result, and that effective help is available. This gives patients information they can use. They may recognise something relevant, raise it during consultation, pause, reconsider treatment or seek further help. If they later feel worse, they understand one possible reason and know where to find support.
Disclosure does not remove the practitioner’s responsibility to make reasonable enquiries and act on detectable warning signs. It provides evidence that the patient received clear information about the risk before deciding whether to proceed. The proposed disclosure standard has four central features: it reaches every patient, happens before consultation, names the risks clearly and creates a record of the information provided. Generic statements such as “results vary” or brief notes saying “expectations discussed” do not record the same information.
PREPÆRE’s Pre-Consultation Check-In™ was developed to make this practical. It gives patients the information in a short, accessible format, encourages an honest conversation with their practitioner and supports the consent discussion without scoring patients or deciding who should receive treatment.
PREPÆRE Practitioner Pilot
The pilot is free for participating practices. Practices will be asked to send PREPÆRE’s anonymous pre-consultation check-in to every cosmetic patient before consultation and provide brief feedback on how it works in practice. Registering your interest does not commit you to taking part.
Questions? Email brea@prepaere.com
Legal Background
Evidence and further reading
The sources below are grouped by the points they support. They are included for the specific findings described and do not all reach the same conclusion about screening.
BDD in cosmetic settings
Salari N, Kazeminia M, Heydari M, et al. (2022). Body dysmorphic disorder in individuals requesting cosmetic surgery: A systematic review and meta-analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery, 75(7), 2325-2336. View on PubMed
Kaleeny JD and Janis JE (2024). Body Dysmorphic Disorder in Aesthetic and Reconstructive Plastic Surgery: A Systematic Review and Meta-Analysis. Healthcare, 12(13), 1333. View on PubMed
Detection and insight
Joseph AW, Ishii L, Joseph SS, et al. (2017). Prevalence of Body Dysmorphic Disorder and Surgeon Diagnostic Accuracy in Facial Plastic and Oculoplastic Surgery Clinics. JAMA Facial Plastic Surgery, 19(4), 269-274. View on PubMed
Eisen JL, Phillips KA, Coles ME and Rasmussen SA (2004). Insight in obsessive compulsive disorder and body dysmorphic disorder. Comprehensive Psychiatry, 45(1), 10-15. View on PubMed
Outcomes following cosmetic procedures
Crerand CE, Menard W and Phillips KA (2010). Surgical and minimally invasive cosmetic procedures among persons with body dysmorphic disorder. Annals of Plastic Surgery, 65(1), 11-16. View on PubMed
Informed consent and patient information
Montgomery v Lanarkshire Health Board [2015] UKSC 11. Read the Supreme Court judgment
Cooter RD, Brightman LA, Deva A, et al. (2023). Developing an International Framework for Informed Consent in Plastic Surgery: A Focus on Cosmetic Breast Augmentation. Plastic and Reconstructive Surgery Global Open, 11, e5371. Read the paper
Parmeshwar N, Reid CM, Park AJ, et al. (2018). Evaluation of Information Sources in Plastic Surgery Decision-making. Cureus, 10(6), e2773. Read the paper
Recognised psychological risk
General Medical Council (2016, updated 2024). Cosmetic interventions: Professional standards. Read the guidance
Litigation and legal reasoning
Mussabekova SA, Menchisheva Y and Varela Morillas Á (2026). Litigation and Complications Arising from Aesthetic Body Surgery: A Systematic Review. Aesthetic Plastic Surgery, 50, 241-258. Read the paper
Bolitho v City and Hackney Health Authority [1997] UKHL 46. Read the House of Lords judgment
This page is provided for general information and does not constitute legal or medical advice. Last updated: September 2026.
