Expert: Why proposed changes to cosmetic surgery industry are so vital

The Government is preparing to introduce new measures including a proposed licensing scheme for non-surgical aesthetic procedures such as Botox and dermal fillers.

The changes are currently under formal consultation, following a rise in public complaints and safety concerns.

Commenting Dr Manish Sinha, one of the UK’s leading cosmetic surgeons, said: “This is a pivotal moment. We now have the chance to create a system that puts safety, transparency, and quality at its core. It won’t fix everything overnight, but it’s a vital first step.

"The changes we’re expecting could be transformative. If implemented correctly, they have the potential to make treatments safer and restore confidence for both patients and practitioners.This legislation is not just timely; it is necessary. The key will be ensuring that qualifications, hygiene standards, insurance requirements, and public awareness are all addressed in one unified system.”

Here, Dr Sinha elaborates on the need for stricter reforms and how they can be implemented effectively:

Why Reform Can't Wait

“The need for reform is evident by the growing mismatch between industry growth and regulatory standards. Public concern has mounted in light of rising complaints, high-profile injuries, and the lack of qualification requirements for many providers offering injectables.

In 2023, UCL researchers reviewed over 500 Instagram accounts advertising aesthetic treatments. They found that only 32% of practitioners had a recognised medical qualification, and 73% were performing procedures without any clinical oversight. Out of these, lip fillers were the most frequently promoted treatment (63%), followed by dermal fillers (37%) and botulinum toxin injections (28%). Recently one young woman died after undergoing a Brazilian Butt Lift abroad. Procedures like these remain among the most dangerous cosmetic surgeries and are not recommended outside hospital settings, as BAAPS has repeatedly warned.”

A Framework for the Future

“The proposed licensing scheme, introduced through the Health and Care Act 2022, is intended to establish consistent standards across England. As doctors, we’re expected to complete annual appraisals and revalidation cycles every five years.”

“If someone is delivering injections that can affect nerve function or blood flow, similar expectations must apply.

Bodies such as the Joint Council for Cosmetic Practitioners (JCCP) currently offer voluntary registers and recommended training levels. However, without legal backing, these standards remain optional. A statutory register would ensure that practitioners cannot bypass qualifications and safety checks.

Unregulated Practice, Public Cost

“Rising complication rates are affecting public services too. In 2022, Save Face reported 2,824 complaints related to non-surgical aesthetic treatments. Approximately 69% of these complaints were linked to dermal fillers, and around 24% involved botulinum toxin injections. Many of these procedures were performed without proper consultation, consent, or aftercare.

“When things go wrong, it’s the NHS that bears the cost. Patients turn up with infections, vascular occlusions, or psychological distress, and public healthcare is left to intervene.”

Professionalising the Sector

“A licensing scheme has the potential not just to protect patients, but to raise the bar for the entire industry. Many qualified professionals invest in insurance, training, and equipment. But they’re competing with unlicensed providers operating from non-clinical environments. That is neither sustainable nor safe.”