Experts ask government to tighten the regulations / 'Gold-rush' endangers clients, a chief plastic surgeon warns

It is a modern gold-rush founded on human vanity and the search for eternal youth. But today's prospectors are surgeons, not miners, and the lives they risk are not their own but those of their mostly female clients, lured with impossible promises of anatomical perfection.

In an astonishing attack on the booming cosmetic surgery industry, Nigel Mercer, president of the British Association of Aesthetic Plastic Surgeons (Baaps), and himself a practising cosmetic surgeon in Bristol, says it is time to call a halt to the unregulated trade.

Increasing numbers of medical and non-medical practitioners have entered the market over the past decade, drawn by the huge profits. But the casualties of the boom, seduced by the prospect of bigger breasts, tighter stomachs or more lustrous skin, are the patients doomed to disappointment.

"We have reached a stage where public expectation, driven by media hype and, dare one say, professional greed, has brought us to a 'perfect storm' in the cosmetic surgical market," Mr Mercer said.

An estimated 100,000 cosmetic surgical procedures are performed in Britain each year, many by doctors who have had no specialist training in cosmetic surgery. In addition, hundreds of thousands of non-surgical procedures are done, including Botox for wrinkles and laser peels to rejuvenate skin, many by non-medical staff.

The 200-member Baaps represents the top surgeons in the business who performed 34,187 surgical procedures in 2008, twice the number in 2004. More than 90 per cent of them were on women. The most popular procedure was breast augmentation, demand for which rose 30 per cent last year.

But Mr Mercer, who combines private practice as a cosmetic surgeon specialising in facelifts with his work as an NHS consultant in reconstructive surgery for cancer patients, said the market for cosmetic surgery, of which Baaps surgeons account for less than one third, was an "unregulated mess".

He added: "There has been a massive increase in marketing, including discount vouchers, two-for-one offers and holidays with surgery. In no other area of medicine is there such an unregulated mess. What is worse is that national governments would not allow it to happen in other areas of medicine. Imagine a two-for-one advert for general surgery. That way lies madness."

Mr Mercer, in the journal Clinical Risk, which publishes articles on cosmetic surgery today, he warns that "the doctor's first duty to protect the patient" has been forgotten in the headlong rush to cash in. "The motive for performing any procedure must never be financial gain ... if we cannot self-regulate then regulation will eventually be imposed."

Citing experience in France, where all advertising of cosmetic procedures is banned, he says: "Perhaps, like tobacco, there should be a Europe-wide ban on advertising all cosmetic surgical procedures, including on the internet search engines."

Among those who can testify to the dangers is Jill Saward, the former lead singer of 1980s group Shakatak, who last year agreed to a facelift in the hope of reviving her career after her divorce. But she suffered complications aggravated by her high blood pressure and bitterly regretted the decision. Three months after the operation she still did not have full feeling and was warned full recovery could take a year.

"Surgery is not a quick-fix solution," she said. "The simple truth is that I could have died. I was an idiot, I should have thought much more carefully about the operation and its dangers. It was pure vanity."

Foad Nahai, president of the International Society of Aesthetic Plastic Surgeons, backed Mr Mercer's warning, and called for tougher regulations to prevent doctors practising without specialist training. A code of practice backed by self-regulation of cosmetic clinics was announced by the Government in 2007. Clinics are also subject to inspection by the Care Quality Commission. But Baaps says the measures do not go far enough.

Top procedures: 2008

*Breast augmentation: 8,449 – up 30 per cent from 2007

*Blepharoplasty (eyelid surgery): 5,130 – down 10 per cent

*Face/neck lift: 4,547 – up 1.7 per cent

*Breast reduction: 3,845 – up 13 per cent

*Abdominoplasty: 3,638 – up 30 per cent

*Liposuction: 3,249 – down 29 per cent

*Rhinoplasty: 3,065 – up 1.5 per cent

*Otoplasty (ear correction): 1,260 – up 23 per cent

*Brow lifts: 1,004 – up 4 per cent

Ancient skills

Plastic surgery dates back at least 3,500 years to the Ancient Egyptians who restored damaged or malformed noses. By the sixth century BC the ancient Indian physician Sushruta, sometimes dubbed the father of surgery, was acknowledged as an expert.

In the 18th century British surgeons travelled to India to study nose reconstruction techniques and in the early nineteenth century Joseph Carpue carried out the first such major surgery in Europe, repairing an army officer’s nose using skin from the forehead.

Huge advances in plastic surgery were made during World War Two when Archibald McIndoe, a New Zealander working in Britain, pioneered treatment for RAF airmen who had suffered severe burns, often on the face and usually before being able to bail out of burning aircraft