Intended for healthcare professionals


Government considers a national implant register in review of cosmetic procedures

BMJ 2012; 345 doi: (Published 16 August 2012) Cite this as: BMJ 2012;345:e5574
  1. Adrian O’Dowd
  1. 1London

The government has launched a national review of how the cosmetic surgery industry is regulated in England that could mean tighter restrictions on its practices.

A national implant register for products such as breast implants and other medical devices is also up for debate as part of the review 1 published on 15 August by the Department of Health.

The move follows the scandal over breast implants that came to light last year.

Around 47 000 women in the UK are thought to have received the former French manufacturer Poly Implant Prosthèse (PIP) breast implants, which were found to contain non-medical grade silicone, prompting concerns about their safety.2 3

As part of the response to the scandal, health secretary Andrew Lansley has called for this new review, to be led by England’s NHS medical director, Bruce Keogh and an expert panel that will look at the best way to protect patients having cosmetic interventions.

Cosmetic surgery interventions have increased over the last decade, and non-surgical cosmetic interventions, such as botulinum toxin injections (for example, Botox) and injectable dermal fillers, are part of the UK cosmetic interventions industry estimated to be worth £2.3bn (€2.94bn; $3.6bn) in 2010.

In the review, several issues will be looked at, including whether or not the right amount of regulation is in place, whether people have the right amount of information before deciding to have surgery, and how to make sure patients get appropriate aftercare.

People are being asked to give their views on:

  • the regulation and safety of products used in cosmetic interventions

  • how best to ensure that the people who carry out procedures have the necessary skills and qualifications

  • how to ensure that organisations have the systems in place to look after their patients both during their treatment and afterwards

  • how to ensure that people considering cosmetic surgery and procedures are given the information, advice, and time for reflection they need to make an informed choice

  • what improvements are needed in dealing with complaints so that they are listened to and acted upon.

The Department of Health launched the review alongside results from a survey it commissioned.

The survey of 1762 people found that 67% of people questioned considered cost as a factor when deciding whether or not to have cosmetic surgery, but only 54% for surgery and 50% for non-surgical procedures took the qualifications of their practitioner into consideration.

Keogh said: “The recent problems with PIP breast implants have shone a light on the cosmetic surgery industry. Many questions have been raised, particularly around the regulation of clinics, whether all practitioners are adequately qualified, how well people are advised when money is changing hands, aggressive marketing techniques, and what protection is available when things go wrong.”

The health secretary has also requested that the review consider a national implant register for products including breast implants and medical devices.

The information could include the date and place of the operation and the clinical outcome, as well as a method of identifying the patients who received the product.

Patient safety charity, Action against Medical Accidents, welcomed the call for evidence, but its chief executive Peter Walsh said: “The review must not dodge the central issue of the need to better protect patients through statutory regulation.”

1. Department of Health. Review of the regulation of cosmetic interventions: Call for Evidence. 2012:

2. O’Dowd, A. UK recommends PIP breast implants should not be removed. BMJ 2011;343:d8313.

3. O’Dowd, A. French women to have PIP breast implants removed for free. BMJ 2011;343:d8329.


Cite this as: BMJ 2012;345:e5574

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