All adverts for cosmetic surgery such as breast enlargement and tummy tucks should be banned, say leading plastic surgeons who warn that the industry is an under-regulated "wild west".
The surgeons are members of the British Association of Aesthetic and Plastic Surgeons (BAAPS), who work on reconstruction in the NHS and often perform cosmetic surgery at leading private hospitals.
The group, based at the Royal College of Surgeons, has been concerned for some years about standards in the private cosmetic chains, which advertise widely in the tabloids and women's magazines. They want a ban as part of a six-point plan proposing tighter regulation of the industry, including registration and audit of surgeons. The Guardian revealed concerns over the training and qualifications of some of those working in the private chains last week.
"Over the last decade the BAAPS has worked tirelessly to educate the public on the many aggressive marketing gimmicks that not only trivialise surgery but endanger the patient," said the organisation's president Fazal Fatah.
"We have warned against the unrealistic expectations set by reality 'makeover' shows and against crass competition prizes promising 'mummy makeovers' and body overhauls. In no other area of surgery would one encounter Christmas vouchers and 2-for-1 offers – the pendulum has swung too far, and it is time for change."
Fatah and fellow surgeons are offering their proposed reforms to MPs on the health select committee, who have announced an investigation into the cosmetics industry. An expert group led by the NHS's medical director, Sir Bruce Keogh, is also looking at standards and the need for more regulation.
Nose straightening and breast enlargement are medical procedures, BAAPS argues, and advertising should be banned as it is for prescription medicines. They also want dermal fillers reclassified as medicines, so they have to go through rigorous licensing trials. There are more than 100 injectable products on the market in the UK that require only a CE-mark of quality assurance in Europe. In the US, they point out, where exacting food and drug administration standards have to be met, there are less than a dozen.
BAAPS says there should be a register of all types of implants – not just those used to enlarge breasts but also those inserted into the buttocks, pectoral muscles, calves and other places. There have been widespread calls for a breast implant register following the scandal of the PIP implants, made with industrial-grade silicone intended for mattresses.
The call by surgeons comes as a private clinic of more than 60 leading psychiatrists, psychologists and psychotherapists released a survey on the emotional impact of the scandal on women who had PIP breast implants. The online questionnaire, by Clinical Partners, attracted a response from 120 women in 24 hours. It found that more than half had missed work due to stress over having PIPs, nearly eight out of 10 felt their self-esteem and self-worth had been affected, two-thirds were feeling severely depressed and anxious and 80% said they would need the help of a therapist or counsellor. Nearly all (92%) were suffering from insomnia.
Among the comments from women were: "I eat, breathe and sleep silicone, it's the only thing in my head, can't concentrate and [am] taking it out on every body". Others said: "There is only me and my son, I am in tears all the time, and upset at the smallest thing" and "I find it hard to discuss, as the more I do, the more anxious I get. I'm less confident with my body and find it hard to look at my breasts."
One woman said she felt as though she had an alien inside her. Another said: "I am back to feeling disgusted and unhappy with my body."
BAAPS' other recommendations are compulsory registration of those working in the cosmetic industry – rather than the present voluntary database of clinics, mandatory safety audits of surgeons and "mystery shopping" checks of CE-marked products.
"Despite the unfortunate scandal which has brought this issue onto the agenda, it is an absolute joy for us at the BAAPS to hear that this year, the government will be examining the lax regulations in our sector," said Fatah.
"We understand MPs will review areas such as psychological counselling for cosmetic surgery patients and the unscrupulous marketing activities of many firms which take advantage of the young and the vulnerable. These are problems that we have been highlighting for many years."
