The doctors on London's Harley Street are more than a little unnerved by the increase in cosmetic surgery practitioners cashing in on their good name.
Harley Street, they said last week, has not turned into the UK's Botox and boob-job paradise. The Howard de Walden Estate, which owns much of the street, has strict rules on who can practise in its smart Georgian houses and says it restricts the numbers augmenting breasts and tightening skin.
"I couldn't even name any practitioner in Harley Street who does any of the services you just described," said Dr Nick Plowman, consultant and senior clinical oncologist at Bart's Hospital, and a Harley Street cancer specialist for the past 20 years. "We practise serious, world-class medicine here."
Yet the cosmeticians and plastic surgeons are popping up on and around these tidy central London streets. Cosmetic surgery is encircling Harley Street in an attempt to get as close as possible to the most famous medical street in the world. There is no question as to the attraction. Harley Street turns over about £1bn a year and treats more than one million patients. Those in the cosmetic business want to cash in on its cachet.
None, perhaps, wants that as much as Dr Jeya Prakash. The 55-year-old Indian-born plastic surgeon believes he has discovered the secret of eternal youth. He has spent the past 15 months injecting himself and his wife with HGH, a controversial growth hormone that the US anti-ageing lobby says could make you 20 years younger.
From January, he wants to inject British patients with it, too. The use of HGH is normally restricted to the treatment of dwarfism and, more worryingly, could cause cancer. But its potential is huge. He believes it will become Britain's new Botox. If it does, it will make Dr Prakash, the first doctor in the UK to offer the treatment, a multi-millionaire.
By 2007, we will be spending more on plastic surgery than on cups of tea. This year, more than 700,000 cosmetic procedures will be performed across the country - from a bleached white smile to a lunchtime breast augmentation, spider vein zapping and eye lasering. We are spending £539m on making ourselves younger and better looking. Analysts say if current trends continue, by 2009 that figure will have grown to over £1bn.
"It is astonishing," says Wendy Lewis, a New York cosmetic surgery consultant who has been holding "surgeries" in London since 1990 advising women on aesthetic procedures. "When I wrote my first UK book on cosmetic procedures in 2000, the publisher took a huge risk as no one was even talking about cosmetic surgery. Nowadays, you can't pick up a magazine in Britain without reading about it."
Today, one in four women and one in 10 men say they are considering going under the knife. "Women come to me with a five-year plan and a laundry list of things they want done," says Ms Lewis. "They are willing to spend far more money."
Researchers say increased demand for serious operations such as facelifts and nose jobs is due to reality TV programmes such as 10 Years Younger and Extreme Makeover. But doctors say the far bigger increase in the UK market in recent years has been in non-invasive procedures.
"People are still wary and there is less fear about having a non-invasive procedure than having a more serious operation like a facelift," says Dr Patrick Bowler, chairman of the British Association of Cosmetic Doctors and author of The Nervous Girl's Guide to Nip and Tuck. Last year, Dr Bowler, who runs eight clinics across the UK, treated 100,000 people with Botox.
"We initially started in central London, but we soon found that we had to expand to Greater London and into the Home Counties," says Bill Green, founder and managing director of Botonics, which sends doctors on motorbikes to give you Botox in the comfort of your own home.
It is an obsession, some say, that now has Britain close to aping the US in its quest for beauty and youth. "The younger British women I see are just as savvy as American women nowadays," says Ms Lewis. "They know what they want, and can have done, and know how to educate themselves in finding a good doctor."
But others are unsure. "I don't think our demand for cosmetic procedures will ever get as fervent as in America," says Douglas McGeorge, president of the British Association of Aesthetic Plastic Surgeons. "It's just not the British way."
Back in Harley Street, that is probably not what Dr Prakash wants to hear. In the US, off-licence sales of HGH for anti-ageing treatments have soared to £400m a year, despite not being approved for such use. "Everything is ready to roll," he said last week. "If I do this properly, it could become a multimillion-pound business within a few years."
LONDON'S TOP COSMETIC SURGEONS
Surgeon: Bryan Mayou
Surgery: Private clinic in Chelsea, tel 020 7824 8080.
What he does: A former consultant plastic surgeon at Guy's and St Thomas' Hospital where he was at the leading edge of abdominoplasty. Also famous for doing interior designer Nicky Haslam's facelift. He is a fan of converting houses.
Average UK cost: £5,200
Surgeon: Dr Jean-Louis Sebagh
Surgery: 25 Wimpole Street, London.
What he does: The "Botox King", Dr Jean-Louis Sebagh was at the forefront of the Botox revolution, popularising the use of Botox injections in the UK. Supermodel Naomi Campbell is currently suing Dr Sebagh after he claimed she is his patient.
Average UK cost: £199
Surgeon: Patrick Mallucci
Surgery: London Plastic Surgery Associates, 30 Devonshire Street.
What he does: Consultant plastic surgeon at London's Royal Free Hospital, he first shot to fame in 1993 treating a Bosnian war victim. He says: "Surgery is potentially dangerous. All good surgeons get complications."
Average UK cost: £3,700
Surgeon: Adrian Richards, AR & Associates
Surgery: 10 Harley St, London.
What he does: A plastic surgery specialist for the past 12 years, Richards is a leader in his field where saline or silicone gel implants are used to increase breast size for cosmetic reasons or after mastectomy, and was a lead investigator into Botox use.
Average UK cost: £5,750
Surgeon: Rita Rakus
Surgery: Dr Rita Rakus, 34 Hans Road, Knightsbridge, London.
What she does: Regarded as especially adept at plumping up thinning lips, the self-styled "London Lip Queen" Dr Rakus is said to create lips so soft they will pass the "ultimate kiss test". Dido is rumoured to be one of Rakus's celebrity clients.
Average UK cost: £275
Surgeon: Norman Waterhouse
Surgery: The Practice, 55 Harley Street, London.
What he does: A former president of the British Association of Aesthetic Plastic Surgeons, Mr Waterhouse is a tutor in aesthetic surgery at the Royal College of Surgeons and has undertaken training at Adelaide's Cranofacial unit in Australia.
Average UK cost: £7,750
Surgeon: Martin Kelly
Surgery: London Plastic Surgery Associates, 30 Devonshire Street, London.
What he does: The top london plastic surgeon spent three hours this summer restoring Tara Palmer-Tomkinson's cocaine-ravaged nose, taking cartilage from her ears and using it to reconstruct the nose base.
Average UK cost: £4,500
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