Is your practitioner qualified?

Did you know that non-surgical cosmetic treatments, such as Botox and dermal fillers, are regularly being administered by non-medics with no training whatsoever? Dermal fillers, which are not regulated, can be bought and injected by anyone. Although Botox is a prescription-only medicine and so needs to be prescribed by a supervising doctor, it is often injected by people with no medical qualifications at all. More worryingly, they are not breaking the law.

Even training may be no guarantee of quality or safety. Dr Mervyn Patterson, a cosmetic doctor with more than 15 years’ experience, warns: “A training course can involve as little as half a day standing as part of a crowd watching someone else inject, yet everyone goes home with a certificate.”

Professor Sir Bruce Keogh recently led a government-backed review of regulation into cosmetic procedures. His final report said: “People need to be able to identify and choose a practitioner with the appropriate qualifications.”

So how can you ensure the person performing your treatment is “appropriately qualified”?

Dr Raj Acquilla, UK ambassador and global key opinion leader in facial medical injectables, says: “The term ‘appropriately qualified’ suggests the individual should be a cosmetic doctor, dermatologist, surgeon, dentist or nurse. They should be registered with their governing body, such as the General Medical Council (GMC), Royal College of Nursing (RCN) or General Dental Council (GDC). You can check their membership on the relevant websites.

“They should also have training in cosmetic practice and be mentored by an expert until they have completed 50 to 100 procedures. It is desirable if they also have post-graduate medical qualifications. Also look for membership of a professional body such as the British College of Aesthetic Medicine (BCAM) or the British Association of Cosmetic Nurses (BACN).”

The term ‘appropriately qualified’ suggests the individual should be a cosmetic doctor, dermatologist, surgeon, dentist or nurse

If you are looking for a surgeon, then different qualifications will apply. Rajiv Grover, a consultant plastic surgeon and president of the British Association of Aesthetic Plastic Surgeons (BAAPS) says: “Cosmetic surgeons should be on the Specialist Register of Plastic Surgeons maintained by the GMC. Ensure they perform the specific procedure you want at least 30 times a year. Members of BAAPS must be qualified, elected by their peers and be audited annually.”


Dr Nick Lowe, a consultant dermatologist and president of British Cosmetic Dermatology Group of the British Association of Dermatologists (BAD), adds: “Ideally a cosmetic doctor should have had training via a non-profit-making professional body and hold a medical qualification in dermatology. Askto see photographs of patients they have treated.”

Sharon Bennett, a cosmetic nurse and vice chairwoman of the BACN, says: “To work without a doctor, a nurse must be a ‘nurse prescriber’. The qualification for this is the V300 and this will appear under their name on the Nursing and Midwifery Council (NMC) register. Also, always ask to see proof of insurance. The BACN holds a list of registered cosmetic nurses.”

“You can ask your GP to check your doctor for you, particularly if you are considering surgery,” says Dr Patterson. “If you are being offered these treatments in someone’s home or at a party, stay well clear. Clinics don’t have to be registered with the governments’ Care Quality Commission, but if they are, it means the clinic follows protocols and is inspected. Beware flashy websites – they mean nothing.”

Dr Lowe concludes: “Do due diligence. Ask around. Take the time to check qualifications and training. This really is a case of buyer beware.”