In 2013, Sir Bruce Keogh, the then NHS Medical Director, undertook a government-sponsored review of the cosmetic treatment industry. The government's response to his report baffled many including the British Association of Aesthetic Plastic Surgeons (BAAPS) and the British Association of Dermatologists because it sidestepped the two areas of most concern to medical practitioners, namely making dermal fillers prescription only and the registration of cosmetic treatment practitioners.
In February 2023, once again, the government rejected recommendations by the House of Commons Health and Social Care Committee (HSCC) to introduce a licensing regime for non-surgical cosmetic treatment after their survey on 'The impact of body image on mental and physical health' revealed the extent of suffering experienced by those seeking non-surgical cosmetic interventions by non-medical practitioners. In September 2023, the government has finally given itself an opportunity to atone for its bizarre decisions by launching an open consultation into the licensing of non-surgical cosmetic practitioners and procedures.
Non-surgical cosmetic interventions propelled by social media
Although the introduction to the consultation notes that "Recent years have witnessed a growing prevalence and normalisation of non-surgical cosmetic procedures" this is a rather disingenuous statement given that non-surgical cosmetic procedures have been firmly established on the high street for decades. What is certainly true is that the reach of social media and the rise of the influencer has contributed to more and more people, particularly younger people, taking 'advantage' of the techniques available to change the way they look. Lockdown proved to be an especially fertile time for individuals described as "untrained, unscrupulous, and untraceable 'ghosts''' who advertised their 'at home' procedures through social media ads only to disappear when the people they damaged sought redress. [Source: The Guardian]
Dermal fillers responsible for most complications
Non-surgical cosmetic treatment is popular because the variety of procedures on offer do not need to be administered by a recognised health professional and are less expensive than more complex procedures. Doctors' concerns about the level of competence demonstrated by some practitioners are fuelled by a growing catalogue of problems reported by people who have undergone treatment. This year's Annual Clinical Review by the British College of Aesthetic Medicine reported that 82% of their members had had to treat patients with complications following a treatment that had gone wrong. Of these, 60% were as result of treatments carried out by non-medical practitioners.
Dermal fillers caused the most – and most severe - complications, confirming that they are dangerous in the wrong hands. The ease with which dermal fillers can be obtained and administered poses a major health risk if the person administering the product is not subject to some form of quality control. Indeed, the original Keogh report stated: 'a person having a non-surgical cosmetic intervention has no more protection and redress than someone buying a ballpoint pen or a toothbrush.'
Distorted views of body image fuel rise in cosmetic procedures
The HSCC survey into body image looked closely at the role social media plays in promoting 'idealised body types' and fuelling a rise in body image dissatisfaction and the associated mental and physical health risks. Those groups identified as being particularly at risk were adolescents, people with disabilities and LGBT people. The committee concluded that professional healthcare staff needed to be more aware and better trained to respond to the needs of these groups who felt largely marginalised and consequently sought help from unregulated providers of non-surgical treatments.
Better regulation means more redress
Fast forward to September 2023 and the publication of this open consultation is an opportunity to 'ensure that consumers who choose to undergo a non-surgical cosmetic procedure can be confident that the treatment they receive is safe and of a high standard.' However, the introduction to the consultation notes that 'a balance needs to be struck between protecting the public' while 'respecting consumer choice and encouraging innovation'. A cynic might suggest that this will give the government wriggle room to water down the results of the consultation as and when it responds. Nonetheless, the proposed scheme to be operated by local authorities should ensure all those carrying out procedures are property trained and qualified; have indemnity cover; and operate from hygienic premises.
More regulation will mean that those suffering from botched treatments should be able to get proper redress. However, until such time as the recommendations are backed by legislation, it is up to individuals to carry out their own research and ensure that the person injecting the filler is reputable and qualified. In the meantime, anyone who has suffered from a cosmetic intervention, including use of dermal fillers, that has gone wrong may have a medical negligence claim but, legally speaking, the lack of regulation does make this a grey area. We are always happy to have an initial chat to see whether or not we can help.
In the meantime, the consultation closes on 28 October. We will await the response with interest.
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