Medical professional ethics at KEIT Day Hospital: when a procedure is not recommended

1 Why can't every surgical procedure be recommended?

Aesthetic surgery aims to improve physical appearance, but every surgical procedure requires a careful assessment of its potential risks and benefits. A patient's desire for an aesthetic change is important, but it is not sufficient on its own to determine whether the requested procedure is medically appropriate.

At KEIT Day Hospital, medical recommendations take into account the patient's overall health, anatomical characteristics and the balance between expected benefits and potential risks. If a procedure is considered unsuitable, specialists may recommend postponing it, modifying the treatment plan or deciding not to proceed.

Such decisions are part of the medical team's professional responsibility. Patients are informed of the reasons behind the recommendation and, where possible, the conditions that would need to be met for a subsequent reassessment.

2 How is patient suitability assessed at KEIT Day Hospital?

The medical assessment begins before the day of surgery and involves several stages that help specialists identify risk factors and determine whether the procedure can be performed.

• Medical questionnaire: Patients complete a questionnaire containing more than 60 questions about their medical history, existing health conditions, allergies, medications, previous surgical procedures and other factors that may affect treatment.

• Initial consultation with the surgeon: The patient's request, individual characteristics and the feasibility of the procedure are assessed. If clear contraindications are identified, the procedure may not be recommended even at this initial stage.

• Anaesthesiologist's assessment: For patients proceeding towards surgery, the anaesthesiologist evaluates their health and any factors that may affect the safety of anaesthesia.

• Preoperative examinations: The necessary tests and medical assessments are carried out, including laboratory tests at KEIT Day Hospital's in-house laboratory. Depending on the individual case, additional diagnostic examinations or specialist assessments may also be required.

Completing these stages enables the medical team to make a decision based on the patient's clinical information. If the findings indicate that further examinations or improvement of a health condition are necessary, surgery may be postponed pending reassessment.

3 Joint decision-making by the surgeon and anaesthesiologist

At KEIT Day Hospital, a patient's suitability for surgery is assessed by both the surgeon and the anaesthesiologist, each within their respective area of professional responsibility.

The surgeon evaluates whether the procedure is medically indicated, whether it can be performed given the patient's anatomical characteristics and what outcomes can reasonably be expected. The anaesthesiologist assesses the patient's overall health and the risks associated with anaesthesia and the perioperative period.

Surgery is confirmed only when the relevant medical assessments support proceeding with the procedure. If either specialist identifies a risk that makes the procedure unsuitable, the patient's wish to proceed does not override professional medical judgement.

4 When might KEIT Day Hospital advise against a procedure?

The reasons for postponing or advising against a procedure vary depending on the type of surgery and the patient's individual circumstances. They may include uncontrolled medical conditions, factors affecting tissue healing, body weight, age or expectations that do not align with achievable outcomes.

For example, in hair transplantation, insufficient density in the donor area may limit the number of grafts that can be harvested without compromising its appearance. In such circumstances, the surgeon may recommend a more limited treatment plan or determine that the patient is not a suitable candidate.

In the case of a Brazilian Butt Lift (BBL), insufficient fat reserves may limit the possibility of achieving the desired result. Suitability for the procedure also depends on an assessment of its specific risks.

For patients with medical conditions requiring treatment or stabilisation, surgery may be postponed until their health is more favourable. Smoking, significant weight fluctuations and other individual factors may also influence surgical planning.

In every case, the decision is based on an individual assessment rather than a single isolated criterion. When a procedure is not recommended, the patient is informed of the reasons and any available alternatives or next steps.

5 Selecting the surgeon according to the patient's needs

Professional responsibility also involves selecting an appropriate specialist for the planned procedure. Surgical procedures differ in their techniques, complexity and the specialist expertise they require.

KEIT Day Hospital works with surgeons from various specialties, including plastic, aesthetic and reconstructive surgery, otorhinolaryngology and maxillofacial surgery. Surgeon selection takes into account the nature of the procedure, the characteristics of the individual case and the relevant professional competencies.

This approach aims to ensure that patients are assessed and treated by specialists with the appropriate training for the procedure they require.

6 Medical consultation and respect for patient decisions

An important aspect of professional medical ethics is clear communication and respect for the patient's right to make decisions about their treatment.

At KEIT Day Hospital, the initial consultation is provided free of charge and does not create any obligation to undergo surgery. During the consultation, patients have the opportunity to discuss their needs and expectations, receive information about the procedure and understand the limitations of potential outcomes.

The surgeon's recommendation is based on medical assessment, without creating unrealistic expectations or pressuring patients into making an immediate decision. Patients may choose not to proceed with surgery, just as specialists have a responsibility not to recommend a procedure when it is considered unsuitable.

In this way, professional medical ethics at KEIT Day Hospital are reflected in well-founded medical decisions, transparent communication and respect for the patient's health and well-being throughout the treatment process.