There’s something grotesque in the business of selling beauty. Bruce Keogh’s review into the regulation of the cosmetic treatment industry – covering implants, surgery, fillers, injections, and every other way of primping, plumping, shrinking and smoothing your face and body – reveals a world of hard sell for hard bodies. Loss-leading free consultations draw customers into clinics (and despite the fact that the industry offers invasive medical procedures, the review shows that it treats those in its care as customers, not patients), and multibuy offers put the decision to get silicon bags inserted in your chest or fat siphoned out of your thighs on a par with chucking an extra packet of chicken joints into your trolley during a Bogof offer.
And if your treatment doesn’t work out quite the way it was sold? That, as they say, is tough titty: there’s no clear legal responsibility for cosmetic practitioners to provide aftercare. During the PIP implant scandal, the Transform Cosmetic Surgery Group and the Hospital Group initially refused to pay for the removal of implants containing non-surgical grade silicon. Under pressure from the Department of Health and huge adverse publicity, they reversed that decision – but women were still left to pay for their own replacements.
If your supermarket chicken pieces are bad, the shop doesn’t just take the bad pack back: it’s also obliged by the Sale of Goods Act to replace or repair it. Yet the rules for surgical implants are apparently more lax. I can’t even say the cosmetic surgery business treats women like meat, because actually it offers a lower standard of care to its patrons than your average butcher. And for decades, shamefully, this has been tolerated, with inadequate legislation allowing inadequate treatment to continue. Reading the report, the collective negligence of the industry sticks out like a bone in an eyeball (yes – one woman grew bone fragments in her eyes as a result of an experimental stem cell cosmetic procedure).
Slack regulation of advertising allows surgeries to use high-pressure tactics like time-limited offers while minimising the “cutting you open, putting something inside you” aspect of their procedures. There’s no specialist register of cosmetic surgeons – and amazingly, the title “surgeon” isn’t even protected, meaning that practitioners may use it while having no surgical expertise. Private providers currently aren’t required to perform a clinical audit, and data collection is so sloppy and vague, we don’t even have a figure for how many procedures are performed each year. Oh, and consent for your own personal slicing and dicing can be obtained with a single signature in a meeting with a sales rep.
The whole industry starts to look like a nightmarish, tentacled beast stretching secretively through clinics and salons, invading bodies and injecting its poisons, and the people who are undergoing these treatments are often those who should have a particular claim on protection. Another thing the cosmetic surgery industry doesn’t have is a standardised psychological assessment for those seeking treatment: those giving evidence to Keogh felt that enough was already done to pick up potential patients with body dysmorphia or personality disorder, but isn’t it somewhat remarkable that we accept the pursuit of radical, appearance-altering surgery as rational until proved otherwise?