Summary
A BMJ editorial argues that UK safeguards for non-surgical cosmetic procedures remain inadequate, particularly around practitioner training, consent, aftercare and complication management. It points to the scale of these procedures and reports of serious harm presented to Parliament.
A BMJ editorial argues that UK safeguards for non-surgical cosmetic procedures remain inadequate, with unresolved concerns about who may perform them, their training and the care available when complications occur. The authors, specialists in law, medical ethics and health policy, say the regulatory gaps identified more than a decade ago have not been adequately addressed.
A large field with varied practitioners
The editorial focuses particularly on botulinum toxin injections and dermal fillers. It cites an estimate of around 900,000 botulinum toxin injections performed annually in the UK. Research it refers to identified almost 20,000 practitioners working across more than 5,500 UK clinics in 2025; about a quarter were non-medical aestheticians.
The authors also raise concern about increasingly invasive procedures, including high-volume dermal filler treatments, being offered outside conventional healthcare settings. Their argument is that regulation needs to address not only which procedures are permitted, but also who can perform them, what training is required and what standards apply to premises, consent, aftercare and treatment of complications.
Concerns about harm and accountability
The editorial recalls the 2013 Keogh review, which identified serious gaps in the regulation of cosmetic interventions. It says concerns remain about accountability, liability and compensation for people who experience complications after procedures offered in high-street settings.
The authors also refer to evidence submitted in 2025 to the UK Parliament’s Women and Equalities Committee by consumers, clinicians and organisations. Those submissions documented cases of serious harm, including deaths, after liquid Brazilian butt lifts and other aesthetic procedures.
This is a policy editorial, rather than a new clinical study. Its central concern is that the rules governing practitioner qualifications and patient safeguards have not kept pace with the range and availability of cosmetic procedures. The examples it cites underline why training, informed consent and arrangements for managing complications are part of patient safety, not merely administrative details.