Most of us will remember the devastating effects “Men Behaving Badly” star Leslie Ash suffered, following her lip-plumping non-surgical procedure. So, it’s fair to say that the recent reports of fillers going wrong are not too surprising.

A booming business

The whole cosmetic surgery industry was worth £2.3bn in the UK in 2010, but the big money is in non-surgical procedures, accounting for nine out of 10 procedures and 75% of the market value.

However, the industry’s widely publicised inadequate regulation is a huge cause for concern and leaves patients vulnerable when things go wrong, and at significant risk of falling into the hands of cowboy firms or individuals whose only aim is to make a quick profit.

The biggest growth area is in non-surgical procedures such as fillers, Botox and laser hair removal – this area the report describes as “almost entirely unregulated”.

Dermal fillers are used to plump out wrinkles or change the contours of the face. They are not classified as medicines so they can be administered by people with little or no medical training and after only a few hours basic instruction.

“Crisis” waiting to happen

Following a UK review of cosmetic procedures by the Department of Health in England, injections to plump up the skin have been dubbed a “crisis waiting to happen” and should be available only on prescription.

The review warned that easily obtainable dermal fillers, which are covered only by the same level of regulation as toothbrushes, could cause lasting harm to patients and added that cosmetic surgery had been “trivialised.” It also criticised “distasteful” companies for prioritising profit ahead of care.

As a result of its findings, the review recommends a series of measures to better protect patients…


  • Legislation to classify fillers as prescription only
  • Formal qualifications for anyone who injects fillers or Botox
  • Register of everyone who performs surgical or non-surgical cosmetic interventions
  • Ban on special financial offers for surgery
  • Formal certificate of competence for cosmetic surgeons
  • A breast implant register to monitor patients
  • Patients’ procedures must be approved by a surgeon not a salesperson
  • Compulsory insurance in case things go wrong
  • A pooled fund to help patients when companies go bust – similar to the travel industry

The advisory panel said the procedures, which could potentially go horribly wrong, were being treated as casually as popping into the hairdressers for highlights on your lunch hour or attending or hosting a “beauty” parties.

Sir Bruce Keogh, the NHS medical director for England who led the review, said: “The most striking thing is that anybody, anywhere, anytime can give a filler to anybody else, and that is bizarre.”

Fillers are deemed to have no medical purpose so are regulated in the same way as toothbrushes and ball-point pens. There are 190 different fillers available in Europe compared with just 14 in the US.

Sir Bruce Keogh says: “I don’t think we can wait, keeping our citizens at risk.”

Sir Bruce also said cosmetic surgery deals, such as buy-one-get-one-free offers and handing out free breast surgery as prizes in raffles, were a “particularly distasteful” way of incentivising people to go under the knife.

There were also questions of safety. The review said there were no checks on surgeons’ qualifications in some parts of the private sector, an issue made worse by more than half of cosmetic surgery being performed by “fly in, fly out” doctors – surgeons based abroad who fly into the UK to perform operations and then fly back out again.

Health Minister for England, Dan Poulter said he agreed “entirely” with the principles of the recommendations and there would be a full response in the summer.

“It is clear that it is time for the government to step in to ensure the public are properly protected.”

Reported Complaints:

  • blindness in eyes after being injected with a dermal filler
  • discolouration of the skin
  • necrosis, where lack of blood flow to the treated area causes skin to die
  • Bacterial infections if hygiene is poor
  • filler migrating or becoming lumpy
  • burning or scarring of the skin during laser hair removal


The British Association of Aesthetic Plastic Surgeons said it was “thoroughly relieved” with the findings and that there was an “urgent need” for dermal fillers to be classed as prescription medicines.

The government’s plans are expected in the summer. However, some of the proposals would require legislation and would take a considerable amount time to come into effect.

Sources of information: Daily Mail, BBC News, Telegraph, BAAPS

Abacus Solicitors Can Help You…

If you have suffered ill-effects following a cosmetic procedure, at Abacus we understand that this can be distressing, painful and traumatic.

With sensitive, sympathetic advice, our specialist team of solicitors will assess your needs and treat your case with dignity and compassion.

To talk through your experience with one of dedicated cosmetic specialists, call 0161 833 0044 or email