Lisa Markwell: Ads for cosmetic surgery that exploit women at their most vulnerable

Notebook: Like therapists, surgeons should not be allowed to recommend themselves for further (paying) treatment

To my mind, there's always been something a little unsettling about advertisements for cosmetic surgery clinics. Magazines that are all about female empowerment from pages 1 to 250 turn, from pages 250 to 275, to shrieking encouragements of dissatisfaction.

The intimation is that your flat chest or big nose is all that's stopping you from a life of glamour beyond your wildest dreams – to be lived, invariably, in a white bikini. Have that post-pregnancy tummy flap disappear; create Angelina-like pert breasts where once were milky tube socks. Want Megan Fox's nose, or J-Lo's butt? Why not pop in to an expensively carpeted West End clinic and emerge transformed? (Nobody mentions the bloodied bandages, bruises and pain.)

Now there are calls for a ban on such advertising, as well as tighter controls on products and practitioners. Well, excuse me, but what took you so long?

As Fazal Fatah, president of the British Association of Aesthetic Plastic Surgeons, said on Sunday: "In no other area of surgery would one encounter... two-for-one offers" – and he's not referring to breast augmentation. This gives the lie to the idea that having plastic surgery fixes the one feature that is causing a woman or man unhappiness. Indeed, some years ago while researching cosmetic surgery, I was told that upward of 70 per cent of patients return to have another procedure. That figure is highly unlikely to have gone down.

Hard-sell advertising, finance packages and unregulated clinics make good customers of the insecure and foolhardy. Even a veteran of eight procedures under general anaesthetic (all very much non-cosmetic) like me could waver. When a breast-cancer surgeon suggested I go for reconstruction "... and go up a cup size", it took strength to reject the breathtaking presumption.

This is soliciting for business when a woman is at her most vulnerable. A friend had a similar experience more recently and, after much soul-searching, decided against it. Then the PIP implant scandal broke, and we both thanked our reasoning (be it financial, moral or medical). Like therapists, surgeons should not be allowed to recommend themselves for further (paying) treatment; but this is just a drop in the ocean of unscrupulous marketing and manipulation.

The fact that the association which serves to promote aesthetic plastic surgery is calling for regulation proves the extent of discomfort about current practices. In this instance, vanity is a lesser evil than greed. We can only be glad not to live in America, where prescription drugs are advertised in magazines from Vogue to The New Yorker.

Despite everything we see on TV and in magazines about straightforward little procedures that – they say – enhance our lives as well as our busts/brows/bums, these are not modern "mummy makeovers" any more than Prozac is "mummy's little helper".

Eddie's lips are just too much of a distraction

Still on appearances, the cult of celebrity has probably done as much as – if not more than – advertising to encourage "civilians" to change their bodies. But to emulate the current line-up of leading men is beyond the surgeon's knife, I'd hazard.

I found the flawless beauty of Douglas Booth most distracting during the recent Great Expectations. On Sunday, I did my best to get carried away by the illicit romance and wartime anguish in the BBC's adaptation of Birdsong, but couldn't get past leading man Eddie Redmayne's lips.

Redmayne is a fine actor, but (not helped by a sparse script) he did so much gazing into the middle distance, pillow-lipped, all I could think was: imagine if he had to kiss singer-of-the-moment Lana del Rey? Each has a mouth the size of a king-sized feather bed. They'd have to stand on opposite sides of no-mans-land to make contact.

l.markwell@independent.co.uk