UK experts: Cosmetic surgery needs tighter rules

by Maria Cheng
In this Friday, Jan. 6, 2012, file photo showing the closed gate of the entrance to Poly Implant Prothese, PIP factory in La Seyne-sur-Mer, southern France. An independent expert group released a report Wednesday April 24, 2013, which slammed Britain's cosmetic surgery industry for not protecting patients adequately and is calling for stricter controls in the aftermath of a breast implant scandal in Europe last year that left tens of thousands of women with cheap silicone implants which are allegedly prone to ruptures. The expert group, commissioned by the U.K. Department of Health, also called for the creation of a registry of implants and other medical devices. (AP Photo/Claude Paris, File)

A group of independent experts has slammed Britain's cosmetic surgery industry for not protecting patients adequately and is calling for stricter controls in the aftermath of a breast implant scandal in Europe last year that left tens of thousands of women with cheap silicone implants prone to ruptures. A top British health official, meanwhile, signaled support for their recommendations.

In a review of how cosmetic procedures are regulated, the group said all skin fillers should be available by prescription only and that all practitioners—from surgeons to aestheticians who inject Botox—must be properly qualified. The expert group, commissioned by the U.K. Department of Health, also called for the creation of a registry of implants and other medical devices and an ombudsman for private health care, among other suggestions.

The recommendations were released in a report on Wednesday.

The British government has previously rejected calls to oversee cosmetic procedures and the industry is largely self-regulated. There are few rules on who is allowed to perform a non-surgical cosmetic intervention.

"Anyone can give you a (skin) filler anytime, anywhere," said Bruce Keogh, medical director of the National Health Service, who led the review. "This is a bizarre situation."

During an embargoed press briefing on Monday, Keogh said the commercialization of the industry has led to some questionable claims about the efficacy of certain procedures.

In this Wednesday, Dec. 21, 2011, file photo Dr. Maurice Mimoun, a plastic surgeon at the St Louis hospital in Paris holds a silicone gel breast implant made by French company Poly Implant Prothese, or PIP, that he removed from a patient because of concerns that they are unsafe. An independent expert group released a report Wednesday April 24, 2013, which slammed Britain's cosmetic surgery industry for not protecting patients adequately and is calling for stricter controls in the aftermath of a breast implant scandal in Europe last year that left tens of thousands of women with cheap silicone implants prone to ruptures. The expert group, commissioned by the U.K. Department of Health, also called for the creation of a registry of implants and other medical devices. (AP Photo/Michel Euler, File)

"This is a pretty data-free zone," Keogh said.

In the report, Keogh and others wrote that a person having a non-surgical procedure such as a Botox injection "has no more protection and redress than someone buying a ballpoint pen."

They noted that the cosmetic interventions sector has grown by 300 percent in the last five years and that the use of procedures such as injecting substances to smooth out the skin make up 75 percent of the market. "It is our view that dermal fillers are a crisis waiting to happen," the report concluded. Side effects from skin fillers can include scarring, infection and even blindness.

Catherine Kydd, a Briton who received faulty breast implants, said stricter ethical policies should be in place for those who perform cosmetic surgeries and procedures.

"When you see a surgeon, you shouldn't be seeing a salesman," she said.

Regulations on cosmetic interventions in the U.K. are more lax than elsewhere. In Denmark, anyone carrying out cosmetic interventions must be registered with a national health board. When standards are breached, the board can suspend a clinic's operations, impose fines, strike professionals off the register and refer cases to the police. There is no such system in the U.K.

Keogh noted there are about 190 different types of skin fillers available in Europe versus only 14 approved by the U.S. Food and Drug Administration.

In a statement, Dr. Dan Poulter, a senior minister in the Department of Health, said it was time for the government to step in. "There is a significant risk of people falling into the hands of cowboy firms or individuals or individuals whose only aim is to make a quick profit," he said.

Poulter said the government would respond to the report in detail in the summer.

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