‘Cosmetic cowboys’ targeted by NHS

The review into plastic surgery by NHS medical director Sir Bruce Keogh is understood to suggest a new law targeting people who carry out dermal fillers – injections under the skin to smooth wrinkles – and laser treatment for wrinkles or hair reduction.

These treatments make up 90 per cent of the sector – worth a total £2.3bn in 2010 – but are largely unregulated, in contrast to Botox, which is only legally available on prescription.

Speaking ahead of the release of his review later this month, Sir Bruce said that patients were being exposed to “unreasonable risks” and “permanent damage” because of a lack of appropriate training for those carrying out such treatments.

“All too often we hear of cases that shine a light on poor practices in the cosmetic surgery industry,” he said. “I am concerned that some practitioners who are giving non-surgical treatments may not have had any appropriate training whatsoever.

“This leaves people exposed to unreasonable risks, and possibly permanent damage.

“And our research has shown that the public expect procedures that are so widely available to be safe whereas they are largely unregulated.

“There is a clear need for better quality, recognised training for the people performing these operations. My review will make a number of recommendations for making sure people who choose to undergo these procedures are in safe hands.”

Specialised training

The new law is understood to mean cosmetic staff would need either a qualification to perform and supervise aesthetic treatments, or a qualification to perform aesthetic treatments under the jurisdiction of a qualified clinical professional.

The British Association of Aesthetic Plastic Surgeons (BAAPS) gave a cautious welcome to the idea, but said that it wanted only medical professionals to be allowed to perform treatments.

Its president, Rajiv Grover, said: “Non-surgical does not mean non-medical.

“Treatments with dermal fillers have clear benefits but also risks – it is not just about who can wield a syringe but who will have the capabilities to deal with any possible complications.

“We agree that specialised training is required and certainly more extensive than the many widely-promoted weekend courses currently available, but aesthetic injectables should only ever be provided by medical professionals.

“It is known that dermal fillers have a physiological (‘biological’) effect on skin – such as stimulating the production of collagen, and many of them also contain local anaesthetic.

“These factors make these substances, in essence, a medicine.”

Breast implant scandal

The review into the cosmetic industry, requested by then health secretary Andrew Lansley last year, was launched after around 40,000 women in the UK received implants manufactured by the now-closed French company Poly Implant Prostheses (PIP), mostly in private UK clinics.

The implants were filled with non-medical grade silicone intended for use in mattresses.

Several other measures have been suggested to the review team by the public, the industry itself and patient groups.

They include a ban on cut-price deals, and a clampdown on aggressive sales techniques and a two-stage consent process for potential patients to allow them time to reflect before making a final decision.

The ideas were released in an interim report in December but the Department of Health said at the time that the review is not bound to adopt them and can come up with its own recommendations.

Conservative health minister Dr Dan Poulter said: “I am pleased that Sir Bruce Keogh’s review has been looking at what training people are getting before they perform cosmetic operations – people under the care of cosmetic firms need to know that they are in medically skilled and safe hands.

“I await Sir Bruce Keogh’s recommendations in full, but am clear that we must ensure that people undergoing cosmetic procedures are in the hands of someone with the right skills and training.

“The days of cosmetic cowboys must become a thing of the past.”