Only fully qualified surgeons should be permitted to carry out breast enlargements and other forms of cosmetic surgery, while "Botox parties" and "filler parties" in homes should be banned, say new guidelines from the Royal College of Surgeons.
The college, issuing its guidance ahead of a major review by NHS medical director Sir Bruce Keogh, says the relaxed attitude towards cosmetic surgery of the past has to end. Those who carry it out must do so on medical premises and be properly qualified. Those who inject Botox or fillers should be doctors, dentists or nurses.
The profession has a responsibility to set standards to which it expected surgeons to work, said Professor Norman Williams, president of the college. "We have serious concerns that not all those who offer cosmetic procedures are adequately qualified, or that patients are getting accurate information prior to treatment."
Financial deals and discounts that act as incentives to patients to sign up for surgery should be banned. Doctors and surgeons should consider sending would-be patients for assessment by a clinical psychologist before they give them any treatment. Patients should be asked before surgery about eating disorders and the doctor should document any signs of Body Dysmorphic Disorder – where somebody is obsessed with what they believe is a defect in their appearance.
Doctors have a duty to manage their patients' expectations as to what the cosemtic surgery will do for them. "They should not imply that patients will feel 'better' or 'look nicer', and should instead use unambiguous language like 'bigger' or 'smaller' to describe what that patient is trying to change," says the college.
Only those who have qualified as a medical doctor and then undertaken post-graduate surgical training should carry out invasive procedures such as breast surgery or liposuction.