Leading article: Face the facts on plastic surgery

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It comes to something when the President of the association that brings together plastic surgeons in Britain suggests that all is not right with this area of medical practice and floats the need for tighter regulation.

The message, of course, is not quite as simple as it might look. Nigel Mercer, who heads the British Association of Aesthetic Plastic Surgeons (Baaps), represents a particular interest group – that of qualified plastic surgeons – who face growing competition from those who set up cosmetic practices without qualifications in that speciality. The aspersions he casts on advertising of holidays combined with surgery, or "two-for-one" deals, should be seen in this light.

That Mr Mercer and the Baaps have interests to defend, however, does not mean that his strictures are without foundation. It will probably surprise many people to know that plastic surgery in Britain is not regulated, and that pretty much anyone with a medical qualification can set up as a practitioner. This is not true in France, where only registered specialists may undertake plastic surgery. It is not unreasonable to ask why it is not similarly regulated here.

Advertising – banned completely in France – is another area of contention. Mr Mercer hazards that there should perhaps be a Europe-wide ban on advertising all cosmetic surgical procedures. Again, this would help qualified specialists, whose patients will generally be referred by hospitals and GPs, rather than people who approach them directly. But here, too, the point goes beyond the interests of a professional group.

Adverts for cosmetic surgery are one of the ways in which individuals, especially young women, can be made to feel inadequate. They add to the weighty social pressure many already feel to "improve" their appearance and they perpetuate stereotypes of what is desirable. Worse, however, they suggest that the supposed defects can be remedied at a certain financial cost. A Europe-wide ban on advertising may be too ambitious initially, but the case for a British ban, and strict regulation, is very hard to contest.

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