The buzzer sounds, the heavy door gives and you walk into a warm, light, carpeted environment with soft mood music where perfect people gaze at you sidelong from posters on the walls – the men flexing their pecs and the big-eyed girls draped and pouting over their partners. Young women – none over 30 – sit in the cosmetic surgery clinic reception area, each several seats distant from the next, each apparently absorbed in a magazine or mobile.
They look strangely alike – all in long boots, all stick thin and all of them already, to an outsider, very attractive.
It isn't the middle-aged woman, worrying about her crow's feet, who darkens the doors of the cosmetic surgery clinics. It's more often the young, searching for some sort of ideal beauty they think they lack. And according to a market report from Mintel in 2010, while concerns over safety have caused a drop in interest in surgery from adults, there is a growing willingness among teens to contemplate it.
"There has been a sharp rise in the proportion of teens who would consider having cosmetic surgery. The attitudes of today's teenagers could benefit the market for cosmetic surgery in the future. Younger people are more self-conscious about their appearance and more than six in 10 (63%) 16- to 24-year-olds would have surgery to make them feel better about the way they look," the report said.
In a letter to GPs and surgeons on 6 January, the government's chief medical officer, Sally Davies, noted the youth of many who seek cosmetic surgery. "I remain concerned, as chief medical officer, at the high level of cosmetic implants in young people. In particular, the apparent lack of real understanding by recipients of the associated risks," she wrote.
Cosmetic surgery is big business, worth £2.3bn in 2010 and expected to rise to £3.15m by 2015, Mintel said. About 19 million adults would like some sort of cosmetic treatment, the report said. And although the clinics were spending increasing amounts on advertising and promotion, they got enormous help from the media for free.
"Media promotion of unrealistic ideas of beauty continues to influence people's attitudes to their own appearance. However, the media are also improving acceptability of certain procedures, aided by celebrities openly discussing what surgery they've had done," said Mintel.
Because young people, with less money, are the consumers, an industry has grown up that is fiercely competitive on cost. In chat groups, girls exchange tips on what they were charged and how one clinic reduced their costs to match another's price.
But in this busy commercial marketplace, leading plastic surgeons and others worry that medical standards can slip. All the clinics are regulated by the Care Quality Commission, which inspects and approves the premises, including equipment and staffing. But a report from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD), also in 2010, expressed concerns at the fast turnaround of the clinics. In the time it took to carry out its inquiry, 71 out of 619 private clinics it had approached for information had closed. Of the remaining 548, 371 either did not answer or refused to take part. The investigators wondered whether the one-third of clinics that did respond were "more conscientiously organised" than the rest.
It called for more regulation of what had been called "a problematic cottage industry pattern of laissez-faire provision", saying that even people who eat in restaurants are not forced to inspect the kitchens before they sit down.
The breast implants scandal – and the refusal of the more commercial cosmetic clinics to replace substandard implants for free – has fired up the Department of Health to look at greater regulation of the industry.
That has happened before. This time, though, it may come to something.
