BBC News

'Ban non-medics from giving Botox'

By Michelle Roberts
Health editor, BBC News online

media captionAlicia Douvall: ''I think plastic surgeons have turned so much into car salesmen now''

Only trained doctors, nurses and dentists should provide non-surgical cosmetic treatments such as Botox, say surgeons.

Currently people such as beauticians with no medical training can administer anti-wrinkle Botox injections, even though it is a potent neurotoxin.

The Royal College of Surgeons (RCS) wants to put an end to "Botox parties" and rogue traders.

The government has been assessing whether tougher laws are needed.


NHS medical director, Sir Bruce Keogh, has been conducting a review into the cosmetic industry and will report back to government in March.

The RCS in England wants a clampdown, and has set out a list of standards for the industry.

RCS president Prof Norman Williams said: "While the colleges and professional organisations involved in cosmetic practice are neither regulators nor legislators, the profession has a responsibility to provide standards to which we would expect our members to work.

"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. We hope these standards will feed into the ongoing review of the industry led by the NHS medical director, Sir Bruce Keogh, and improve quality of care for patients going forward."

The RCS makes several recommendations, including a proviso that anyone planning to have a cosmetic procedure should have a thorough psychological assessment beforehand.

Only those who have medically recognised qualifications and training and should carry out cosmetic procedures, such as breast surgery, liposuction and Botox treatment, and in a registered clinic with resuscitation equipment on hand in the event of an emergency, it recommends.

Practitioners have a duty to manage a patient's expectations of how they will feel after treatment, the RCS says.

They should not imply that patients will feel "better" or "look nicer", for example, and should instead use unambiguous language like "bigger" or "smaller" to describe what that patient is trying to change, it says.

The British Association of Aesthetic Plastic Surgeons (BAAPS), which represents about a third of plastic surgeons in Britain, would also welcome stricter controls.

BAAPS says all of its accredited surgeons are fully trained, vetted and qualified to carry out cosmetic procedures. But it cannot vouch for the rest working in the private sector.

Because of the lack of regulation, it is difficult to gauge the scale of the issue. Most cosmetic procedures are carried out privately, rather than on the NHS.

Estimates suggest that in 2011, there were 669,711 surgical and non-surgical cosmetic procedures carried out in the UK. BAAPS own figures show 43,172 surgical procedures were carried out by BAAPS members in 2011.

According to the Independent Healthcare Advisory Service (IHAS), about 200,000 anti-wrinkle injections, which includes Botox and dermal fillers, are carried out in the UK each year.

media captionConsultant plastic surgeon, Jonathan Staiano: ''The public don't view it as a medical procedure''

The IHAS runs a voluntary register of injectable-cosmetic providers aimed to help consumers find a skilled and trusted clinician.

A recent poll by ComRes of 1,762 people found many considered the cost of surgery more important than the qualifications of the people doing it or how they would be looked after.

Two-thirds of those questioned considered cost as a factor when deciding whether or not to have cosmetic surgery. Half said they would take the qualifications of their doctor into consideration and less than half would consider the quality of their aftercare when reaching a decision.

A Department of Health representative said: "The report from the Royal College of Surgery is timely as NHS medical director, Sir Bruce Keogh, is currently carrying out a review into regulation of cosmetic interventions, including cosmetic surgery.

"The review will be published in March. Its recommendations will be evidence-based, with the safety of the patient at the forefront."

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