The head of a trade body representing plastic surgeons believes greater regulation is needed to stop financial promotions tempting people into having cosmetic surgery.
Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons (BAAPS), says the government should step in to control advertising for cosmetic surgery and ban all special offers and inducements.
Two years ago, BAAPS launched its own poster campaign featuring a giant scalpel to counter the effects of irresponsible marketing. But Fatah would like stronger action. "It's necessary for the government to step in and regulate the way cosmetic surgery is advertised," he says. "Companies see cosmetic surgery as a market to be exploited and gimmicks like 'recommend a friend' are stooping to the tactics of double-glazing salesmen. They're recruiting patients as agents to sell the treatments for a commission to friends who might never before have considered surgery."
The numbers of Britons seeking cosmetic surgery has more than tripled in the past eight years and, as competition increases, many providers are resorting to the sort of marketing ploys used by high-street stores and catalogue firms to win custom. Interest-free loans, gift vouchers, loyalty cards and promotional discounts are among the incentives offered by almost all of the biggest firms to minimise the financial barriers and to help project the image of surgery as a routine lifestyle choice.
"If you've been thinking about cosmetic surgery, make it your new year's resolution at BMI Healthcare," says the blurb from the company that describes itself as the UK's number one private hospital group. It is offering a 12-month interest-free period for cosmetic surgery clients who book before the end of June and use the BMI credit card (not to be confused with the credit card issued by bmi airline), which allows people aged 18 or older to borrow up to £20,000 to fund any of its medical procedures.
With an interest rate of 9.9% APR, the BMI credit card is cheaper than most high-street credit cards, which could encourage people wanting a new look to spend more recklessly on the procedures than they might otherwise dare. But, as Fatah points out, there is no such thing as an interest-free loan. "The payments that the company makes to its finance adviser will be absorbed into the price of the surgery," he says.
Moreover, anyone who borrowed up to the £20,000 limit and paid off the minimum 5% each month would spend nearly 10 years servicing their debt. BMI spokeswoman Linda Apeles says that 50% of applicants for the card are refused due to unsuitable credit ratings and that the £20,000 limit is very rarely granted. "We are very careful about our marketing because we don't want people to rush into surgery," she says.
BMI's sister company, Transform, is even more inventive in its promotions. On its website it says: "If 2011 is the year you plan to really change how you feel about yourself, we're here to help you do just that. What's more, if you book your procedure before the end of February 2011 you'll receive a £150 voucher to spend against your next summer holiday." The promotion (which has been running for several years with different deadlines), coupled with a loyalty scheme for returning patients (buy four ops and get a voucher towards the fifth), has earned the ire of medical groups, who claim it turns surgery into a commodity.
"These are businesses run by non-medics and they are reliant on people in the lower income bracket taking up their finance plans," says Dr Mike Comins, chairman of the British Association of Cosmetic Doctors. "These are vulnerable individuals who are seeking cosmetic enhancements because they have problems with self-esteem. Encouraging them to get into the stress of debt is just swapping once problem for another and when companies are that desperate to lure business you have to ask why."
Transform, where tummy-tuck procedures start from £4,700, offers 12 months' interest-free credit on a loan of any amount, or invites them to borrow the sum of their choosing and pay it off over 36 or 60 months at 19.9% APR.
That means, it says, that "a breast enlargement costing £3,695 financed over five years could cost as little as £84.95 per month". However, with 60-month loans available on the open market for as little as 7.2% APR, the Transform loan adds interest of nearly £1,500 to the cost of the operation.
"Debt is as emotive an issue as physical appearance," says Una Farrell, a spokeswoman for the Consumer Credit Counselling Service. "People would do much better to save up for an operation, which would give them time to consider whether it was what they really needed."
After your Transform operation, if you recommend a friend to follow suit, you will each get a £100 voucher against your next non-surgical procedure or £50 in cash (if they choose non-surgical treatment you'll only get vouchers worth £50 or £25 cash each). It's easily achieved: the recommend-a-friend button is prominently sited on the company website's home page.
At Surgicare, you can earn £200 for recruiting a pal if they opt for full surgery (or £60 for non-surgical treatments), plus a loyalty card that rewards repeat visits.
Then there are gift vouchers – perhaps not the most tactful present for a loved one. The Hospital Group ("Life-changing surgery for a whole new you") sells them in denominations of £100 and £500, although a substantial amount would be needed to fund any surgical procedure.
Transform's marketing director, Steven Taylor, insists its promotions are a "wee thank you" to customers and that the sums of money are too small to serve as inducements. But others worry that such promotions trivialise what BAAPS terms "serious and life-changing procedures" and encourage young people to have treatment they don't need and can't afford. "Younger people feel surgery is the answer to all their problems because the strong marketing approach has lost all sense of balance," says Professor Patricia Price, head of Cardiff University's School of Healthcare Studies.
BMI, whose parent company General Healthcare Group bought a major stake in Transform last year, says its patients are given a cooling-off period after their initial consultation and are offered psychological counselling.
"Although we are sister companies, we are very different," says Apeles. "BMI is very conservative. If a consultant thinks a patient's expectations are unrealistic they often turn them down."
Transform says it rejects three in 10 of applicants for surgery, although it does not provide psychological assessments.
Nevertheless, Fatah believes that all offers and inducements for surgical operations should be banned and procedures should be steered by the patient's GP. "The only time people should take a loan to fund an operation is if their quality of life is so impeded by their body image that they can't function to 100% capacity," he says.
"Cosmetic surgery can work wonders on the right patient at the right time, but loans and credit cards can never be justified as an inducement."