Intended for healthcare professionals

Rapid response to:

Editor's Choice

Promoting cosmetic surgery

BMJ 2012; 345 doi: (Published 08 November 2012) Cite this as: BMJ 2012;345:e7535

Rapid Response:

Re: Promoting cosmetic surgery

In their head-to-head on the ban on advertising for cosmetic surgery Sally Taber and Fazel Fatah discuss whether self-regulation and industry standards in advertising of cosmetic surgery are sufficient to protect patients or whether these are better served through an outright ban on advertising.

The discussion neglects an important aspect of safeguarding UK consumers from direct marketing by cosmetic surgery providers to the public: an increasing number of UK patients travel abroad to receive cosmetic surgery.

In 2010, 63,000 UK residents travelled to access treatment abroad [1]. Our research indicates that around 30% - 18,300 - of these were cosmetic tourists. This echoes results of a survey conducted by Which? magazine that found 28% of medical tourists travelled for cosmetic procedures [2]. It is likely that this is a growing trend: a recent survey found that 97% of all people considering cosmetic surgery would consider travelling for these procedures [3].

Moreover, our research reveals that most patients identify and choose foreign providers via the internet. This underlines the necessity to extend consideration for regulation or banning of advertising of cosmetic surgery to the internet and specifically consider medical tourists. If such actions lie beyond the reach of national regulators there is greater urgency for accessible information and guidance for those considering traveling abroad for cosmetic surgery. We found that patients who travelled for cosmetic treatment are unlikely to consult their GP out of embarrassment or fear of being judged. Hence, communication on how to ensure that such guidance reaches potential medical tourists requires additional thought.

A ban on advertising by UK providers will address some of the concerns raised by the recent PIP scandal, as may regulation of advertising if measures are in place to enforce this. However, the increasing number of patients travelling abroad for cosmetic procedures means that a comprehensive review of cosmetic surgery needs to consider this or risk that its recommendations are little more than a short term ‘band aid‘ as more and more UK residents travel abroad for treatment.

The authors have recently completed a two year research project on UK medical tourism funded by the NIHR. This included quantitative analysis and qualitative interviews, including with UK residents who had travelled abroad to access cosmetic surgery.

[1] Smith R, Lunt N, Hanefeld J. The implications of PIP are more than just cosmetic. The Lancet. 2012; Volume 379, Issue 9822.

[2] Which? We expose medical tourism pitfalls: Do your homework before you go, urges Which? Which? [Internet]. 2008 1/11/2011. Available from:

[3] Nassab R, Hamnett N, Nelson K, Kaur S, Greensill B, Dhital S, et al. Cosmetic tourism: public opinion and analysis of information and content available on the Internet. Aesthetic Surgery Journal. 2010;30(3):465-9.

Competing interests: No competing interests

20 November 2012
Johanna Hanefeld
Lecturer in Health Systems Economics
Neil Lunt, Daniel Horsfall, Richard Smith
London School of Hygiene and Tropical Medicine
15-17 Tavistock Place. London WC1H 9SH