Regulating invasive cosmetic procedures in the UK is “an absolute nightmare” with many of those claiming to be qualified to perform them not able to work as consultants in the NHS, a leading plastic surgeon has said.
Maniram Ragbir, the president of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (Bapras), urged people considering procedures to check their doctor was registered as a plastic surgeon on the General Medical Council’s specialist register, which lists those qualified to work as consultants in the UK.
“I would be willing to bet that a significant proportion, if not more than 50% of people who are claiming to be cosmetic surgeons, will not be on a specialist register or would be ineligible for a job [as a plastic surgeon] in the NHS,” he said.
Ragbir also raised concerns about the growing number of organisations with credible-sounding names that surgical and non-surgical practitioners can advertise themselves as members of. These do not necessarily check the credentials of applicants, he said, making it difficult for the public to identify reputable practitioners.
“The word ‘college’ is not a protected word. You could run a weekend course in liposuction, and then send [participants] away with a certificate – and that person can then advertise that they are a qualified, certified practitioner, which is unfortunately what is happening,” said Ragbir, who is also a consultant plastic surgeon at the Newcastle upon Tyne hospitals NHS foundation trust.
His comments come as research published in the Journal of Plastic, Reconstructive and Aesthetic Surgery raised concerns about the state of regulation within the UK aesthetics industry.
Researchers led by Afshin Mosahebi, a professor of surgery at UCL and consultant plastic surgeon at the Royal Free hospital in London, scrutinised the websites of 22 self-regulating organisations that oversee surgical and non-surgical cosmetic procedures within the UK. They concluded that a significant majority were not meeting best practices for effective self-regulation, as laid out by the government, potentially putting patients’ health at risk.
Marimo Rossiter, of University College London, the study’s lead author, said: “Customers want to see that the person taking care of their procedure is qualified and has done adequate training, and one way that a practitioner can make themselves seem credible is to say that they are a member of X organisation. But we found that a lot of these organisations are not checking they have registered practitioners that are qualified, have been trained well, currently practise to a high standard and ensure that patient safety is at the heart of their practice.”
The team called for additional mechanisms to help patients identify government-approved registers that do run more stringent checks and must meet certain standards , as well as tighter cooperation between the Department of Health and Social Care (DHSC) and registers to ensure that clinics are adequately checked.
According to an analysis of nearly 3,000 complaints about botched procedures received by the government-approved register Save Face during 2022, almost nine in 10 patients (86%) reported not being appropriately consented prior to treatment, while 93% were unaware that serious complications could occur. More than eight in 10 of these individuals (84%) were ignored or blocked by their practitioner when they tried to seek help.
Ashton Collins, of Save Face, stressed that many of the organisations covered by the UCL study did not claim to be self-regulatory bodies, but included professional associations and groups supporting continuing professional development. Also, while some of these organisations may include a practitioner finder on their website, they did not necessarily claim that members were checked – unlike Save Face’s register
However, Rossiter said: “When an organisation which looks to uphold values of patient safety and transparency lists practitioner members who aren’t checked, then this raises the question of the value of the organisation.
“Patients look to organisations and professional membership groups as a marker of quality. The membership of a reputable professional organisation is currently one of the few ways in which patients can appraise their providers, and as such we think it is important that patients are made aware of the diverse array of providers.”
Victoria Brownlie, the chief policy officer at the British Beauty Council, said: “As the study shows, there are some registers operating wholly responsibly and in line with the government’s criteria for these kinds of bodies, but this is by no means the norm. They should be maintaining the highest possible standards for ensuring the competence of practitioners who, at times, are performing procedures that carry potentially huge risks to the client.”