Experts call for stricter regulation of invasive cosmetic procedures

The rise in invasive cosmetic procedures demands tighter regulation, better consumer protection, and greater awareness to protect patient safety and reduce cosmetic tourism, argue experts in The BMJ today.

The global market for cosmetic procedures is growing rapidly and is projected to exceed $180bn by 2033, note Danielle Griffiths at the University of Liverpool and colleagues.

Invasive cosmetic procedures typically involve the insertion of instruments or equipment into the body (eg, tummy tucks and breast augmentation), while non-surgical procedures are minimally invasive (eg, botox and dermal fillers), they explain.

However, they warn that non-surgical procedures are becoming increasingly invasive, blurring the distinction. And although deaths remain rare, evidence suggests that harms are increasing, particularly after cosmetic procedures abroad.

Side effects of botox injections can range from inflammation to anxiety, dry eyes, vision problems, or nerve damage, while the most common complications after breast surgery or tummy tucks are separation of a closed wound (dehiscence), infection, and seromas (fluid-filled bumps under the skin).

Calculated resulting costs to the NHS vary and are probably underestimated, and the authors point out that there is no UK-wide reporting or tracking system for complications from private cosmetic procedures, so many go unreported.

Recent proposals have been put forward by the government to control unregulated non-surgical cosmetic procedures in the UK, they write, but implementation is moving slowly and substantial gaps remain, with implications for patient safety.

As such, they call on the UK government to follow reforms adopted by Australia and other countries to safeguard patients and reduce cosmetic tourism.

These include consistent regulation across all four UK nations to ensure that high risk invasive cosmetic procedures (surgical and non-surgical) are performed by trained healthcare professionals only with standardised qualifications and oversight.

A single set of guidelines on non-surgical cosmetic procedures, applicable to all registered practitioners, should also detail requirements for training, assessment, consultation, and consent.

And broader interventions, including public education, advertising controls, and accredited registers, are essential to ensure reliable information, realistic expectations, and safe access to cosmetic procedures, they conclude.