Fiona James had been unhappy for years about the shape of her nose. When she finally had the money and courage to go to a well-known cosmetic surgery chain, she was delighted at what she heard from the nurse.

"They tell you they can do what you want, which is what you want to hear," she said. "You think it is quite straightforward and it is not going to be painful. They ask you what it is you don't like and say they can do something about it."

She did her research, she said, browsing the many online forums. "I looked up the surgeon and couldn't find anything bad. One of the nurses had had exactly the same procedure not long before and she was happy with the results," said James (not her real name). "You put your trust in people because they have told you what you want to hear.

"I had the surgery and went back to the clinic to have the cast removed. As soon as they took it off, they said: 'It's lovely!' I remember thinking: 'Is it going to stay like that?' They said you determine how it is going to look by massaging it. You need to massage it."

Another surgeon James saw prior to taking legal action said the nose had been over-shortened, there was a dent in it and it was asymmetrical. Too much cartilage had been removed. For months she was massaging her nose and waiting for it to look as she had hoped. Whenever she went back to complain, she was told to massage it a while longer. "It gets to the point where you are quite obsessed with the massage," she said.

A further operation by the same surgeon did not help. "Neither procedure made it look as good as it was beforehand. It was better the way it was," she said.

If she was conscious of her nose before, she is even more conscious of it now, she said. She received a settlement from the surgeon and must now decide whether to have much more serious surgery involving transplanting cartilage from her ear. "It's been a really unpleasant few years," she said.

Her solicitor, James McNally, a partner in the clinical negligence department of Slee Blackwell dealing with cosmetic surgery claims, has had two similar claims from women given nose jobs by the same surgeon, who were both told to carry on massaging by the clinics. He suspects delaying tactics – liability runs out after three years.

Cosmetic surgery is sold like a new sofa, he says, often with an interest-free loan agreement. There are inducements to get people in and out as quickly as possible. It badly needs regulation but it has not happened in part because many people think the victims of badly done cosmetic surgery deserve all they get.

"But it isn't just people who are vain or Page 3 models – it really isn't," he said. "These are people who are uncomfortable about the way their ears stick out or their noses look and pay in instalments and get shafted as a result. It is really sad. They are vulnerable people and taken advantage of."

There can be very serious consequences when cosmetic treatments go wrong. Dermal fillers, injected in the wrong place, have caused retinal artery occlusion, causing people to go permanently blind.

But natural caution seems to have been allayed by what the Keogh review, published on Wednesday and recommending a major regulatory clampdown on the industry, calls "normalisation" through TV reality shows and magazine articles.

Research in focus groups of men and women for the review says this coverage "appears to be highly influential, with the result that the whole industry has gained both currency and topicality; it is no longer a 'taboo' subject, particularly for women. In particular, awareness of television coverage of cosmetic interventions was widespread, with much reference to programmes such as The Only Way Is Essex (Towie), and Sex and the City, and more dedicated programmes such as 10 Years Younger, Embarrassing Bodies and Extreme Makeover."

One woman who had undergone some surgical procedures herself told interviewers: "The majority of celebrities are having these kinds of things done and they all look fantastic.

"If you see someone, for example, who's had a tummy tuck, who's got a really amazing figure and a flat stomach and you're sat there and you're really not happy with yourself and you see X amount of celebrities that have all had this procedure done, that all look amazing, something is going to click where you think: 'I'm just going to spend the money and I'm just going to have it done.'"

Interviews with teenage girls showed they were very conscious of their appearance and considered some cosmetic treatments to be routine. "You can tell also by not only their faces, obviously their bodies, the curves – you can tell sometimes they have had treatment for boobs and bums, boob jobs and stuff like that, you can tell they are fake, but they also do look amazing," said a girl in Essex in year 13.

Those who lived in Essex were very much influenced by the TV show. "I've seen them get teeth whitening, Botox, boobs. I love Towie, it's one of my favourite programmes, I think it's so funny … I think they are [an influence] because they are not even celebrities. They are like us, they live round the corner from us. Like my sister knows some of them and that, it's just like normal people, so I think that influences you a lot because you know they are just regular people like your older brothers and sisters really," said another in year 12.

In Stockport, one year 12 girl cited Katie Price as a role model. "She was a no one until she had her breasts done and then she was on Page 3. They have all come from nobodies and by having cosmetic surgery they have become something."