The following key points that Mr Cadier believes are vital for patient safety (they are discussed in more detail below):
- A passion for cosmetic surgery
- Commitment to patient safety
- Comprehensive pre-operative assessment
- Dedicated cosmetic anaesthetists
- Specialist nursing team
- Extensive and on-going training
- High volume surgery
- External audit of outcomes and complications
- Being a trainer and an examiner
- Involved in National regulation
Mr Cadier has been undertaking private practice for over twenty years. He has developed a passion for cosmetic surgery and is always striving to provide the highest possible quality of care and the best possible outcomes. However, patient safety is paramount.
He is committed to delivering a safe clinical practice ensuring that patients undergo aesthetic surgical procedures in as risk free manner as possible. This starts right from the initial consultation, with a detailed medical and surgical history being taken, and a careful assessment of the patient and proposed procedure to ensure that it is appropriate to proceed. All patients will additionally undergo a nurse led pre-operative assessment and where appropriate tests will be undertaken or a referral to the anaesthetist. Where a pre-existing problem exists that is being looked after by a Consultant within a hospital setting permission is sought to contact them. Additionally patients are encouraged to allow a letter to be sent to their GP just to check on their overall health.
During the in-patient stay dedicated nurses, often in association with a Specialist Cosmetic Nurse Practitioner, look after patients. The anesthetic is delivered in both Sarum Road Hospital in Winchester and The Harbour Hospital in Poole by Dr Aquilina who over the last 21 years has worked alongside Mr Cadier to provide a specialist anaesthetic service for patients undergoing cosmetic surgery. The importance of this aspect of care cannot be over emphasised.
Although Mr Cadier received extensive training in cosmetic surgery in his formative years, he still attends courses and training sessions to continue his professional development and maintain an up to date practice. He also lectures and trains cosmetic surgeons and is a Faculty member on several cadaveric courses on plastic and aesthetic surgery. He was the program director of the NHS based Reconstructive Cosmetic Surgery training program in the South West UK. In 2015 whilst President of the British Association of Aesthetic Plastic Surgeons (BAAPS) he established a national aesthetic training program for all UK plastic surgery trainees, in collaboration with the BAPRAS and run through the charity the Scar Free Foundation. Regular internal audit of his patients is performed, and Mr Cadier each year submits safety data to the BAAPS.
Mr Cadier also recognises the value of experience and runs a high volume cosmetic surgery practice with 2-3 all day lists in Poole, Winchester and Southampton.. He has personally performed over a 1500 face and neck lifts, and similar numbers for eyelid corrections and breast augmentations (the most popular procedures in his practice). For most procedures he maintains a practice that means that between 25 and 50 of the following procedures are undertaken yearly: abdominoplasties, breast reduction/uplifts, rhinoplasties and lipo-sculpture. There is increasing evidence that in all aspects of surgery with higher case loads the outcomes are better and the complication rates lower.
Mr Cadier in 2008 was invited by his peers to become an Examiner for the Royal College of Surgeons, and twice a year examines senior trainees in Plastic Surgery in their exit exam to ensure they are safe and competent to become Consultant Plastic Surgeons.
In 2008 Mr Cadier was also elected onto the Council of BAAPS. This is an organization dedicated to the education and training of Aesthetic Plastic Surgeons whose main remit is to ensure safe clinical practice nationally. In 2010 Mr Cadier was invited to be part of the first UK delegation to represent the Cosmetic Surgeons and Practitioners in setting standards for cosmetic practice across the whole of Europe. This has led to a Europe wide set of standards having been developed which are gradually becoming integrated into regulations that mandate good clinical practice.
In 2010 he was invited to chair the Clinical Quality and Outcomes group for the Cosmetic Surgery Interspeciality Committee (CSIC) within the Royal College of Surgeons. This followed several scandals in cosmetic surgery that led to the Department of Health sponsored Keogh Report, which itself recommended the setting up of the CSIC. After several years of work a national framework for regulation of cosmetic surgery in the UK has been developed. A credentialing of cosmetic surgeons ensuring that they are properly trained, that they maintain professional standards and on-going training is now in place. Additionally all Cosmetic Surgery cases are now recorded along with key data including complications and soon Patient Reported Outcome Measures (PROMs). This data is being published on the internet by the Private Healthcare Information Network (PHIN) and in years to come will be accessible by all. This UK model of care to maintain and ensure high quality cosmetic surgery is by far the most sophisticated system in the world.