Cosmetic interventions are big business in the UK, worth an estimated £3.6 billion, up from £2.3 billion in 2010.
But among all the procedures on offer, one thing is missing – the government scarcely has any provision to police non-surgical cosmetic practice.
Following the PIP (Poly Implant Prothèse) silicone breast implant scandal, NHS medical director Professor Sir Bruce Keogh carried out the 2013 Review of the Regulation of Cosmetic Interventions which included recommendations put forward by the British Association of Aesthetic Plastic Surgeons (BAAPS).
“Non-surgical interventions that can have major and irreversible adverse impacts on health and wellbeing are almost entirely unregulated,” he reported. “In fact, a person having a non-surgical cosmetic intervention has no more protection and redress than someone buying a ballpoint pen or a toothbrush.”
Just to be clear, cosmetic surgery is regulated by the General Medical Council (GMC). The Keogh Review used the umbrella definition of cosmetic interventions as those that “can either be surgical – such as face lifts, tummy tucks and breast implants – or non-surgical – typically dermal fillers, Botox, or the use of laser or intense pulsed light (IPL)”.
Why isn’t legislation happening when 73 per cent of adults surveyed agreed that it was important to have a qualified practitioner to carry out non-surgical procedures?
But there are areas where caution is vital. “In the case of dermal fillers, the treatments are almost entirely unregulated,” Sir Bruce warned. Although safe in well-trained and experienced hands, in the hands of the unskilled, fillers are “a crisis waiting to happen.”
“The market is still somewhat unregulated and this has passed into the consumer’s consciousness leading to a certain level of mistrust in the industry’s safety,” says Jack Duckett, consumer lifestyle analyst at research agency Mintel.
So why isn’t legislation happening when 73 per cent of adults surveyed agreed that it was important to have a qualified practitioner to carry out non-surgical procedures? But even this is a murky area as, according to the Keogh Review, anyone can set up a training course purporting to offer a qualification in non-surgical cosmetic procedures.
When it comes to surgery, cosmetic operations are taking a hit. BAAPS reported a 17 per cent rise in cosmetic procedures in 2013 compared with the previous year. However in 2014, the number dropped by 9 per cent to a total of 45,506 surgeries. But don’t shed a tear yet for cosmetic surgeons as the UK’s obesity crisis may buck this trend. “The government and health organisations continue to apply pressure on people who are obese to lose weight and this is likely to be a growth area for cosmetic surgery providers,” Mintel’s Mr Duckett points out.
Indeed, BAAPS reported that despite the overall fall in aesthetic operations, liposuction procedures have risen by 10 per cent in women and 7 per cent in men. In addition, according to the Harley Medical Group, weight gain was the number-one worry for 54 per cent of the 4,000 men and women it surveyed. “Surgical liposuction continued to rise which is unsurprising when so many non-surgical alternatives for fat removal seem ineffective,” says Michael Cadier, consultant plastic surgeon and BAAPS president.
However, alternatives to liposuction are still being sought with Allergan having paid an estimated $2.1 billion in June for Kybella, the first drug to win US regulatory approval for the treatment of double chins using a fat-melting injection – and who knows which body parts this drug will be approved for in the future.
But what happened to the idea of self-acceptance? Are cosmetic procedures liberating for women, given they make up the majority of clients, or subjecting them to sexist scrutiny? “We could see it that way,” says Susie Orbach, psychotherapist and author of the groundbreaking 1978 book Fat is a Feminist Issue. “[These procedures] are being normalised with women in Brazil having tummy tucks along with a caesarean [indicating] the body is for display not for living from.” As for ageing: “We need to reimagine ageing and move away from the viciousness of it being somehow a failure and a disgrace,” she says.
Cases in point include the “has she or hasn’t she?” circus around Renee Zellweger’s “new face” about which the Oscar-winning actress kept a dignified silence, and conjecture about whether reality star Kylie Jenner’s lips had been cosmetically enhanced. When Hollywood star Uma Thurman appeared at a movie premiere to have had “work” done, she felt compelled to appear looking “herself” on US TV with the quip, “I guess they didn’t like my make-up.”
Sharon Stone, however, has taken a bold stance becoming the face of Restylane fillers. “In 2001, after I had my stroke, I used Restylane fillers to help rebuild the damage done in my face,” she says. “It helped me heal physically, but also psychologically as it felt like I looked myself again, and I really support the concept of encouraging greater openness and awareness of aesthetic treatments.” With 20 million treatments of Restylane used around the world in almost two decades, Ms Stone is far from alone.
American TV personality Tyra Banks once said: “I hate it when models say ‘Oh, plastic surgery is wrong.’ You won the genetic lottery and you’re going to ridicule someone for getting plastic surgery?” Who would have thought a former super-model would be the one to stand up for the rest of us, you may ask?