Cheap cosmetic procedures are tempting - but the real cost comes later
The aesthetic sector has expanded rapidly and mandatory licensing is the only credible solution, writes Dr Sach Mohan
Having practised in medical aesthetics for over twenty years, I’ve watched the government repeatedly fail to keep pace with the surge of people pivoting to practice in the sector, who have little to no understanding of medical risk, drawn by the promise of easy money.
Listen to this article
Cosmetic procedures, including injectables, carry significant risks if performed incorrectly or without taking a full medical history, yet are marketed as simple beauty treatments. The public lacks the knowledge to question them because the line between beauty and medicine has blurred. I regularly see distressed patients seeking correction after botched procedures by so-called “advanced aesthetic practitioners”.
The issues range from misshapen lips and misplaced product to immune reactions causing lumps, pigment changes from poorly used energy devices, or where dermal filler injection has obstructed the blood supply and caused skin damage.
These practitioners often lack a foundation in clinical training and regularly operate without medical supervision. They may not recognise complications or know how to manage them. Patients frequently end up turning to the NHS, which is already overstretched and not always equipped with the necessary medicines needed to manage these complications.
Poor regulation is central to the problem. The 2013 Keogh Review exposed weaknesses in the oversight and regulation of cosmetic interventions, yet since then, unregulated training academies have multiplied.
These short courses for “newbies” with no grounding in medical standards produce certificates that falsely reassure students they are qualified and competent to inject faces.
The sector is saturated with low-skilled practitioners; many have their training debt to pay back and struggle to earn a living. Under financial pressure, they chase customer volume through social media, easier to do in a celebrity-driven, image-focused culture, that is now drawing in an even younger audience who perhaps lacks the cynicism to challenge why something is so cheap when they are promised the easy route to looking like their idols or other influencers.
The public is inherently price sensitive, particularly for higher-risk procedures that cost more when performed by plastic surgeons. Prices have been driven down, and quality and patient safety inevitably follow. Practitioners may operate from poorly equipped premises, back rooms, or travel to the person’s home, all of which lack appropriate hygiene standards.
Low-quality, generic, unlicensed, sometimes counterfeit injectables, sourced online, are used because they are cheaper than using established brands or approved supply chains, which they may not have access to as a non-healthcare practitioner.
Regulation is back under discussion. The UK government defines regulations that affect England; the devolved nations often follow, but equally, they can lead, and this is where Scotland has forged ahead. Following amendments to the Health and Care Act in 2022, the previous Conservative government explored a licensing model and a traffic light system categorising treatment risk.
Political change in Downing Street has slowed progress, as Labour reviews prior proposals under its opposition. With the NHS under pressure, cosmetic regulation may not be its top priority. However, growing concern from medical professionals and the public is prompting renewed movement, and another consultation on standards and training is expected this year. It should define the qualifications, competencies and supervision required for distinct categories of treatment, many of which could be restricted to medically qualified professionals.
The aesthetic sector has expanded rapidly, and mandatory licensing is the only credible solution now to capture the broad span of practitioners.
As a medical doctor, I am accountable to the General Medical Council (GMC) and must evidence ongoing learning annually as nurses and dentists do. The Care Quality Commission (CQC) regulates our premises at Revere Clinics, yet many aesthetic treatments fall outside its scope, and where solely non-healthcare practitioners are involved.
Any new framework must not simply license those already regulated. It must set rigorous qualification standards, supervision requirements, and ensure effective enforcement through properly resourced local authorities and environmental health teams. Without meaningful policing and sanctions, public protection will remain inadequate. We have much still to debate.
____________________
Dr Sach Mohan is a celebrity cosmetic doctor and founder of Revere Clinics, one of Europe's foremost cosmetic dermatology clinics based in Harley Street.
LBC Opinion provides a platform for diverse opinions on current affairs and matters of public interest.
The views expressed are those of the authors and do not necessarily reflect the official LBC position.
To contact us email opinion@lbc.co.uk