Cathy Newman checks it out
The scandal of the French breast implants given to more than 40,000 British women has shone a light on a cosmetic surgery industry which is burgeoning – and not wholly regulated.
Government officials trying to get a handle on the failure rate of implants made by the French company PiP aren’t getting the kind of clarity they would like. And that’s because data is scarce on breast enhancements – which can be carried out by hundreds of different practitioners in hundreds of different clinics, a number of which could have gone out of business since the operations took place.
The FactCheck team has been looking at the rise of plastic surgery in Britain, the kind of aggressive marketing tactics used by the industry, and the lack of proper regulation.
What’s the most popular op?
In 2010 the number of surgical procedures rose 5 per cent to a total of 38,274, according to The British Association of Aesthetic Plastic Surgeons (BAAPS). By far the most popular op is breast augmentation, which almost 10,000 women signed up for – up 10 per cent on the previous year.
But the sharpest rise recorded was in surgery for men – which overall climbed 7 per cent to 3,864. The ‘man boob’ operation, or gynaecomastia, saw an impressive 28 per cent rise to claim almost a quarter of all operations on men.
Meanwhile, the only procedures to go down in favour were tummy tucks, down 7.5 per cent, and pinning back ears, down 17 per cent.
Who’s selling the dream?
An alarming rise in “extreme marketing tactics” was noted by BAAPS last year, with boob jobs being raffled at a nightclub, discount coupons for nose jobs listed alongside cat food, and unproven procedures promoted as ‘cosmetic surgery’ on daytime television.
Clinics in Britain are more than twice as likely in fact, to offer financial incentives such as prize draws, BOGOFs (buy one get one free) and ‘rewards’ for booking surgery as they are in the US.
Complaints were made as recently as November over a Groupon email, which offered a 50 per cent discount on operations in a Manchester clinic if consumers booked before midnight on the day of the deal.
Who regulates cosmetic surgery?
The average patient in the UK spends longer choosing their bathroom tiles than choosing their surgeon, BAAPS President-Elect Rajiv Grover claims.
Yet there are “gaping holes” in the regulation of procedures. Nearly three quarters, or 70 per cent, of clinics in the sector operate effectively unregulated.
The problem is that in recent years, beauty treatments – such as facial peels – have been lumped together with surgical procedures under the umbrella of “cosmetic surgery”.
As implants count as “medical devices”, they are regulated by the Medicines and Healthcare products Regulatory Advisory (MHRA), but any doctor can perform the operation. Botox is only available by prescription, but thanks to “remote prescribing” by email or over the phone, it can be injected by beauty therapists.
Other anti-ageing “dermal fillers” aren’t listed as medicines and can therefore be administered by anyone. So there are plenty of non-specialists, such as hairdressers or beauty therapists, cashing in on what they see as the “cosmetic” industry.
How bad is it?
BAAPS checked out the top 50 websites offering “cosmetic surgery” in Britain to see how credible their qualifications were, and compared its finding with those in the US.
While 94 per cent of America’s top 50 websites offering surgery listed the surgeons’ accreditation, for example a Board certificate, only 64 per cent of UK sites did so.
This means that more than a third of Britain’s providers of “cosmetic surgery” didn’t have qualifications, they weren’t on the specialist register or even listed on the GMC at all – so they were not licensed to practice medicine in this country.
There are hundreds of clinics that are not regulated, and they don’t want to be. The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) warns that while 212 clinics were happy to take part in their 2010 report on the industry, 619 were not.
Of these, one in ten declined to take part because within the year that the NCEPOD collected the data, these clinics had gone bust. The remainder didn’t answer or refused to take part. In which case you can only assume that they were not adhering to the rules of the Care Quality Commission, BAAPS told FactCheck.
Many clinics do register with the Care Quality Commission, which is now required to inspect all NHS and independent clinics. But the CQC doesn’t differentiate between clinics that offer cosmetic surgery and any other private hospital – that could, for example, only offer knee operations. So while say, dentists have their own category, cosmetic surgeons do not – and therefore we have no real way of knowing exactly how many cosmetic surgery clinics there are.
What else could go wrong?
The rising number of “rogue providers” of anti-ageing fillers has prompted the Independent Healthcare Advisory Service (IHAS) to call for “dermal fillers” to be listed as medicines, as they are in the US. In America, the FDA has approved just eight or nine fillers or “injectable treatments” as medicines.
But in Britain, where they are not regulated, around 140 different fillers are used.
This means that fillers in Britain carry the same “CE mark” provided by the European Commission that a teddy bear or a washing machine might be stamped with.
With an estimated 1.5m filler treatments carried out in the UK last year, efforts have been made to help consumers – with the establishment of Treatments You Can Trust – a directory of regulated doctors, dentists and nurses who meet safety standards.
But with no enforced regulation, there’s nothing to stop people buying fillers online and injecting themselves. The IHAS has warned that some unidentified fillers leave permanent effects and could lead to the “next disaster”.
By Emma Thelwell
