Intended for healthcare professionals


Cosmetic industry regulation is only skin deep

BMJ 2017; 357 doi: (Published 26 June 2017) Cite this as: BMJ 2017;357:j3047
  1. Sophie Arie, freelance journalist, London, UK
  1. sophiearie{at}

Legislation is urgently needed to protect the increasing number of people having cosmetic procedures to improve their appearance, Sophie Arie reports

Who would allow a stranger to redesign their vagina without knowing if the person was qualified to do so? Or inject the contents of a syringe into their eyelid without knowing what the risks might be?

Under growing pressure to perfect their bodies, and with an increasing range of non-reconstructive cosmetic procedures heavily promoted and easily available, more and more people, it seems, are doing exactly that.

“It is unethical that there is nothing to stop completely unqualified people from providing risky procedures like dermal fillers,” said the Nuffield Council on Bioethics as it launched its report Cosmetic Procedures: Ethical Issues on 22 June.1

The report laments the “regrettable absence of statutory controls over the standards and qualifications required for cosmetic practitioners.” And, the council said, “Children should not be able to walk off the street and have an invasive cosmetic procedure.”

It calls on the government to legislate urgently to protect the public from the risks of a booming but weakly regulated industry, estimated to have grown in value from £750m ($953m; €854m) in 2005 to £3.16bn in 2015.1 It laments that some of the most important recommendations made in a 2013 report by Bruce Keogh2 setting out how to make the industry safer have still not been implemented. Controls on the safety of some of the products used in procedures remain “completely inadequate,” the report says.

“There are a lot of new procedures on the market and the risks are not being reported,” says Mark Henley, a plastic and reconstructive surgeon at Nottingham University Hospitals and a member of the working party …

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