In this guide we look at the sorts of information that patients should consider before having cosmetic procedures. We use data on the UK’s most popular surgery and speak to experts to get their insights.
What is cosmetic surgery and is it available on the NHS?
Cosmetic surgery is a type of plastic surgery which patients use to try and improve their visual appearance (augmentation). This type of surgery is not normally paid for by the NHS so patients are primarily operated on in the private healthcare.
The patient normally pays for the procedure themself (see our Self-pay guide). If there is an associated medical reason for treatment then a private medical insurer may pay.
People have cosmetic surgery for many reasons and it can be a big decision to go ahead with this form of procedure. These types of surgery are mostly related to physical appearance. This can include circumstances originating even before birth, but there can also be psychological reasons, for example body confidence and self-esteem, meaning people want a procedure such as body contouring or a tummy tuck.
At present 9 out of 10 patients are female, though increasing numbers of men are having cosmetic facial surgery.
What are the most popular procedures?
The table below shows the number of cosmetic procedures in the UK as reported to PHIN by private hospitals and facilities. This covers a recent 12-month period compared with 12 months leading up to Covid to show the change in the market. Breast-related cosmetic surgery has the highest volumes, followed by eye lifts and liposuction. Overall, there has been:
- A small increase in the number of people having breast enlargements – which are primarily done to change the person’s appearance.
- A much greater increase in the number of those having breast reductions – which may be done for more practical purposes, including to reduce back pain.
- A large increase in people having eyelid surgery (blepharoplasty), face lifts and brow lifts.
Count of Private Episodes (All United Kingdom). Figures are rounded to nearest 5. Totals and change % based off of rounded figures, total change % based off of rounded totals.
What are the risks of cosmetic surgery?
In the UK safety is good due to strong regulations, and the training, outcome measurement, oversight and audits that take place. This can mean higher prices than in other countries, but there is also greater protection for consumers.
There have been many reports in recent years of people receiving poor treatment or, tragically, not even returning from treatment abroad, where clinical standards may be more lax. With cheap surgery, patients may not get the results they hope or pay for, so you should always check your proposed healthcare provider’s patient feedback and safety records, and allow sufficient recovery time before attempting to travel back to the UK after surgery, if you choose to go abroad.
In the UK, cosmetic surgical procedure should always take place in a Care Quality Commission (CQC) registered facility, such as a hospital or clinic for inpatient and day surgery treatment. Non-surgical treatments such as filler injections, botox and chemical peels can be done in a dedicated centre which might even be on the high street.
The Government is currently proposing a scheme requiring licensing for non-surgical cosmetic procedures and the premises which operate them, but the process is expected to take until at least 2025 before becoming law.
In case something does go wrong, each facility should have a complaints process. Private facilities are encouraged to have those processes validated by ISCAS – Independent Sector Complaints Adjudication Service (cedr.com).
While there are very many highly professional plastic and cosmetic surgeons in the UK, it’s also true that there are more complaints about plastic surgery than for any other specialty. Unfortunately, rogue surgeons do operate under the radar, without registration with relevant bodies – so patients need to be made aware of how important their own research is.
What can I expect from my cosmetic surgery?
Some complaints about the results of cosmetic surgery may be due to the different mindsets patients seeking treatment have, or to unrealistic expectations.
Patients considering having cosmetic surgery procedures should ensure they do their research and have detailed conversations with their surgeons.
Cosmetic surgeons can have a significant impact in terms of changing facial or bodily appearance, but there are limits to what can be achieved.
The President of the British Association of Aesthetic and Plastic Surgeons, Marc Pacifico, told PHIN that patients should find out about their consultants’ qualifications and assure themselves about their competence before having treatment.
Patients should always ask their healthcare professional about all aspects of their proposed surgery: a good consultant will be comfortable to explain everything in the initial consultation, and won’t put any pressure on the patient. Topics for the consultant to cover with the patient may include their reasons for having treatment, and the consultant should give realistic expectations about treatment outcomes.
Perfection doesn’t exist and surgeons can’t perform magic, but professionally-qualified consultants can and do achieve excellent outcomes. However no surgeon can guarantee the result they can achieve for a patient. Ideally a patient should have two consultations before surgery, in order to ensure they have had time to reflect and feel confident about their treatment plan.
What are the potential complications of cosmetic surgery?
Patients should also be told about the risk of complications that can occur during and after surgery. Surgeons have legal responsibility to talk through potential risks, and the patient should then sign a form to acknowledge this. Patients should be wary of any consultant who is evasive or dismissive of these risks.
Uniquely in surgery , cosmetic surgery is significantly promoted via the internet and by social influencers.
However, in order to have reassurance about getting good outcomes, there are various things patients should do when researching cosmetic treatments.
Where do I find out more about cosmetic surgery?
As well as speaking with any friends, family or peers who’ve had cosmetic surgery, patients are encouraged to look up the websites of organisations and professional bodies who can provide expert guidance in their field, for example where relevant:
- The British Association of Aesthetic Plastic Surgeons The British Association of Aesthetic Plastic Surgeons (baaps.org.uk)
- British Association of Plastic and Reconstructive Surgeons Home | BAPRAS
- ENT UK (Ear, Nose and Throat and related specialties)
- The Association of Breast Surgery Association of Breast Surgery
- British Oculoplastic Surgery Society
It can be dangerous to take advice from online influencers who aren’t medically qualified, or those who may be incentivised online to promote treatments and who may not even know the pros and cons of surgery, let alone what is right for each individual patient.
- All consultant surgeons performing cosmetic surgery should be on the GMC specialist register in line with the 2004 Care Standards Act.
- The Royal College of Surgeons website provides assurance about surgeons who carry out a sufficient number of procedures that they fulfil standards of training and clinical skills: Certified Cosmetic Surgeons.
- BAAPS also has a consultant finder by procedure and region which can also provide reassurance that the surgeon’s work aligns with necessary professional and ethical codes of conduct. Find a Surgeon | The British Association of Aesthetic Plastic Surgeons.
It is also important to ensure you receive the correct aftercare and follow your consultant’s instructions to ensure the results you expect.
