The 'wild west' of unregulated cosmetic surgery in the UK

There will be "more deaths and more disfigurement" if plans to regulate non-surgical cosmetic procedures, such as Botox and fillers, continue to be delayed, an aesthetic-medicine specialist has warned.

Dr Paul Charlson, a GP, teacher of aesthetics procedures and a member of the Joint Council for Cosmetics Practitioners (JCCP), told the BBC that the government must "get on with" enacting the regulatory legislation the industry has put forward.

What's the current situation?

In contrast to Europe and North America, there is "nothing to stop individuals in the UK with non-medical backgrounds" from carrying out Botox and dermal-filler injections, as long as they've "completed relevant training courses", said The Herald. The courses can be completed "in as little as two weekends". And, although only Botox can only be prescribed by doctors, dentists and prescribing nurses and pharmacists, it's clear non-healthcare practitioners are "buying cheap Botox online" or getting prescriptions for themselves and then "injecting it into customers".

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There have been warnings about the lack of regulations in the aesthetics industry "for years", said the BBC. A 2013 Department of Health review concluded that, because practitioners needed "no knowledge, training or previous experience", dermal fillers were "a crisis waiting to happen".

The 2022 Health and Care Act gave the government powers to introduce licensing for non-surgical cosmetic procedures in England but it is "yet to be enacted". It's now believed there could be "between 100,000 and 200,000 'aesthetic practitioners' operating in high streets and from homes around the country", said The Mirror.

The JCCP told the BBC that it's faced "an explosion" in the number local councils logging complaints about poor practice in the industry – rising from two in 2023 to 65 by the end of 2024.

Such regulation as there – for registered cosmetic surgeons – comes at a hefty annual cost, which is then inevitably passed on to customers. This means, Alastair Lowrie, an NHS plastic surgeon, told The Herald, that "to get treatment by regulated people", you "pay a lot of money", so "there's an increased incentive" to seek out "unregulated practitioners doing it on the cheap".

What do campaigners want?

In 2024, Alice Webb, 33, became the first person in the UK to die after a non-surgical cosmetic procedure; she'd had a "liquid Brazilian butt lift". Her partner has joined forces with the campaign group Save Face and the British Association of Aesthetic Plastic Surgeons to demand action to "stop devastating cosmetic procedures in Britain", said The Mirror.

They're demanding that liposuction, surgical face lifts and surgical eye lifts should only be carried out by properly trained surgeons on the General Medical Council specialist register. They also want all operations and high-risk procedures to be be surgically safe, and carried out in clinics and hospitals inspected by the Care Quality Commission.

And they want it to become a legal requirement for beauty clinics who offer non-surgical interventions to have malpractice insurance.

What does the government say?

A Department of Health and Social Care spokesperson told the BBC it was "unacceptable" that "inadequately trained operators in the cosmetic sector" were putting people's lives at risk, and said that the government was "urgently exploring options for further regulation".

Speaking to The Mirror, Health Secretary Wes Streeting admitted that he was "worried about the wild west in cosmetic surgery," both overseas and "here at home". Admitting the government has "a lot more to do on this", he urged the public to think twice if they see an "offer that looks too good to be true".