Ella, from Ashurst, near Southampton, has been thinking of having cosmetic surgery since she was 11. She is now 18, and the therapist dealing with her low self-esteem issues has advised counselling before having her breasts enlarged. "She made it very clear that often cosmetic surgery doesn't fix everything," Ella told BBC's Newsbeat, "but I do feel like it would fix the large part of it in that I wouldn't feel ashamed any more."

Soon, surgery to address body confidence issues may be more common than therapy, as young women appear to be fuelling the increase in cosmetic procedures in the UK. Hard evidence is limited in a surprisingly unregulated industry but anecdotal evidence is everywhere, so much so that last week the British Association of Aesthetic Plastic Surgeons (Baaps) called for a crackdown.

The demand for surgery isn't new. In 2005, a magazine survey of 2,000 teenagers found that 40% of girls had considered plastic surgery. Since then, however, the industry has grown five-fold, an increase unaffected by the 2012 scandal over the PIP breast implants.

Born into the sexualised womanhood of Girl Power, the millennials have come of age in a society increasingly inured to the exploits of the surgery-enhanced reality TV stars. Leah Totton, the Apprentice winner who used Alan Sugar's money to set up cosmetic skin care clinics this year, says she has had to put a blanket ban on procedures for under-18s after one 14-year-old girl came into the clinic with her mother and asked for Botox.

In April last year, a report by NHS medical director Sir Bruce Keogh found that 41% of girls aged seven to 10 and 63% aged 11 to 16 said they felt some pressure to look the way celebrities do. Suggesting that surgery had become "normalised" in pursuit of a "designer" body, hHe called for tougher controls over who can offer treatments and how they can be marketed. The government ignored him.

Ash Mosahebi, a consultant plastic surgeon and council member of Baaps, calls the lack of regulation in the UK a "big problem". "The government's view is that restrictive practices are counterproductive to the economy. Our view is that they are important for patient safety."

So what are the rules about offering children cosmetic surgery? Similar to those for other "permanent" procedures such as tattoos. Any surgery on an under-18 needs parental consent, though there is a grey area after 16 in which parents can't insist on treatment, for example. The lack of regulation in an industry in which anyone can order dermal fillers online and set up shop suggests the grey area is wider than that. Not for nothing does the association call dermal fillers "a crisis waiting to happen". Do cosmetic surgeons demand proof of age? "I do, but there may be some less scrupulous people who don't," admits Mosahebi.

Guidelines suggest that teens must have reached certain milestones in growth and physical maturity as well as "emotional maturity", such as an awareness that plastic surgery is not a panacea for all ills, for example.

Increased regulation of the industry isn't a panacea either, of course. More rules govern who can perform cosmetic surgery in the US and yet 236,356 cosmetic procedures were performed on 13- to 19-year olds in 2012, according to the American Society of Plastic Surgeons.

Campaigners say more should be done to stop the media encouraging unrealistic body types. Lucy-Anne Holmes, founder of No More Page 3, says: "One gender is allowed to be fully clothed, look old and be overweight while the other isn't. The impact this has on girls and young women is sad and unfair."

Cosmetic surgery is increasingly the answer for young women, and men, who want to cosmetically "enhance" their bodies. Mosahebi says: "At some stage we will have another disaster and they might change their mind." By then, of course, it'll be too late.

• This article was amended on 30 April 2014. The original said anyone with a medical degree can order dermal fillers online. This has been corrected.