Untrained and out of control: health chiefs target rogue plastic surgeons

We do more nips and tucks than anywhere else in Europe but, until now, little has been done to rein in unscrupulous and untrained surgeons

Ministers are planning to overhaul Britain's booming cosmetic surgery industry after a review found shocking evidence that vulnerable patients are being exploited by untrained and unscrupulous medics.

Ministers are planning to overhaul Britain's booming cosmetic surgery industry after a review found shocking evidence that vulnerable patients are being exploited by untrained and unscrupulous medics.

Potentially dangerous procedures are being carried out by surgeons with no specific training on patients misled by exaggerated or false claims, a report for the Chief Medical Officer has found.

A string of high-profile blunders that have left women permanently disfigured has helped to alert the public to the dangers of the largely unregulated private plastic surgery industry. Botched tummy tucks, leaking breast implants and bodged botox injections are among a rising number of horror stories emerging from the trade, now the largest in any European country. An estimated £7m in compensation has been paid out in Britain in the past 13 years as a result of botched or inappropriate surgery.

Ministers are determined to toughen rules so that the 75,000 patients paying for private plastic surgery every year receive the same protection as NHS patients.

The official review, commissioned a year ago by Sir Liam Donaldson, the CMO, is understood to recommend new rules to limit the number of surgeons who can carry out the operations. Currently any basically qualified surgeon can set up shop and carry out often tricky procedures.

The review, headed by the patients' tsar, Harry Cayton, is also expected to call for:

* Patients to be counselled on proposed procedures by those with no financial interest in the outcome.

* A new licensing system for clinics to bring them up to the same standard as private fertility clinics.

* Improved public education on the risks of procedures and a register of surgeons.

New reality TV shows that offer participants the chance to undergo major operations to look like celebrities have helped to convince ministers that they need to act.

Adam Searle, president of the British Association of Aesthetic and Plastic Surgeons, said surgical procedures had been reduced to the "level of the home or garden makeover". "There is a situation where anybody can have a go if they choose," he said. "It would not be acceptable if it were a cardiac surgeon. We are witnessing a degradation in surgical procedures where it is down the level of the home or garden makeover."

Adrian Richards, a consultant plastic surgeon at Stoke Mandeville, warned that the growth in the industry has led to a decline in ethical standards. There was even evidence that booming demand meant that foreign surgeons were flying to Britain to carry out operations with no subsequent follow-up, he said. "I turn down 20 per cent of people asking for operations. It is either not realisticor I don't think I am the right person to help them, but when it is a business, they don't like turning people away."

Britain's 1,000 private clinics are supposed to be monitored by the Healthcare Commission. But the CMO took action after seeing evidence that some clinics were using untrained staff and issuing misleading claims.

A spokesman for the Department of Health said: "A group of experts has been looking at the options for additional regulation of plastic and cosmetic surgery and will report shortly."

The addict

'People said I had a lumpy figure'

Cindy Jackson, 49, who lives in London, underwent nine operations over 16 years from 1980 in what she calls "extreme makeover". She had more than 16 procedures, from nose jobs and cheek implants to liposuction and fat transfer.

"I had an overall plan to have the looks I wanted," she said. "I simply wanted to look better. I knew there was room for improvement because I had been told all my life that I had a big nose and a lumpy figure. I also noticed that people who look better are treated differently, and I wanted to be treated like they were."

Ms Jackson funded her surgery at first with a small legacy from her father, although she is now a successful writer and plastic surgery expert who advises film stars (www.cindy jackson.com). It wasn't all plain sailing. She had to have her first nose job done again and her breast surgery was also done twice.

She adds: "Plastic surgery is practically mainstream now. But the attitude towards it is still very 1960s, which is to judge people by it. Things like botox and facial peels are just a natural progression of the beauty salon. Like any profession, there is a thin wedge of people at the top who are doing exactly the right job and are virtuosos, and there's a thin wedge at the bottom who should be doing something else. In the middle there are people who are just good. I used to be a photographer and have an artistic eye. People who do the surgery don't always have the eye, and perhaps they should, because really it's about aesthetics."

The victim

'My implants burst. I'm in constant pain'

Six years ago Dawn Beaven, now 42, was a successful model, stunt actress and film body double. She was in Spice World, the Spice Girls' movie, and stood in for Elisabeth Shue in The Saint. Then the London-based actress found a lump in her breast. But it wasn't cancer as she first feared. The silicon she had had implanted in her breast 12 years earlier was leaking.

She said: "I was 24 when I had them put in. I had them because I was flat chested and always had a complex about them. I moved up three sizes from a 34A to 36B. Twelve years later the implants burst. Now I've been diagnosed with ME, Crohn's disease, lupus and arthritis, which I blame on the leaks.

"I had the implants removed and replaced three times in a year before I finally said just take them out. It was a horrendous year and I was in so much pain.

"Silicon is like a time bomb in your body. I'm still battling with everything now. I'm in constant pain. I think they should take silicon off the market. It's not just breasts: there are people with lesions on the legs from knee implants. My advice to people wanting a breast enhancement is don't do it."

A medical need

'Botox let me hold my head high'

For nine years Val Sharpe was affected by dystonia of the neck - involuntary muscle spasms. What began as a burning sensation went undiagnosed and by the age of 40 she was debilitated by the condition. Her right shoulder was hunched and her right ear rested on it.

Ms Sharpe, 51, from Northumberland, said: "I couldn't walk to work, couldn't cook, couldn't wash. I couldn't do anything that involved standing up. I couldn't read or sew or eat. It was OK when I was lying flat, but as soon as I stood it would cause spasm."

The disorder was also very painful, with Ms Sharpe's neck and spine muscles pulled into unnatural positions. "I was becoming very depressed," she added. "I was 40 and I thought, this is it, my life is over. Eventually in 1993 I was referred to a neurologist who diagnosed me immediately. I was offered botox there and then. I was given six or seven injections in the base of my head, neck and shoulders. The botox paralyses the muscle and stops the spasm. I have to have the treatment repeated every 10 weeks.

"If you saw me now you'd think there was nothing wrong. I can now lead a normal life."

The satisfied customer

'I was confident, but not when it came to the bedroom'

Stephanie Hewitt grew up being teased about her flat chest. With a "shapely figure" the hairdresser, 27, from Lincolnshire always felt out of proportion, even though she had "no trouble in attracting men". Indeed, it was only after she met her husband Mike that she felt she had the support she needed to have a breast enlargement operation. The couple used £3,695 left over from their wedding fund for Ms Hewitt's operation, which raised her from a B cup to a C cup, in July last year.

She said: "I did it because I wasn't comfortable with my body. I've got a shapely figure but had nothing up top. I wanted to do it for me. All my friends and my sister have nice bodies and I wanted to be the same. I used to wear push-up and padded bras. But it is so depressing when you take them off and there is nothing there.

"I'm very happy with them. It feels a lot better and it looks better for me - it puts me in proportion. It was all about looking normal. I was always confident on the exterior, but not when it came to the bedroom and being undressed - it did eat me up inside."