Two in Three Cosmetic Surgery Injections in the UK Not Administered by Doctors

Two in three neuromodulators or fillers in the UK are not administered by doctors, new research shows.

For the study, researchers from UCL in London evaluated 3,000 websites to identify 1,224 independent clinics and 3,667 practitioners who performed cosmetic injections.

Of the professions represented, 32% were doctors, 13% were nurses, 24% were dentists, and 8% were dental nurses. Of the 1,163 doctors identified, 41% were on the specialist register and 19% were on the general practitioners register. Among the 27 specialties represented on the specialist register, plastic surgery was the largest group (37%) followed by dermatology (18%).

“Without knowledge of the professional backgrounds of practitioners, we cannot adequately regulate the industry,” says Dr David Zargaran, MBBS, a plastic surgeon at UCL, in a news release. “Our research highlights that the majority of practitioners are not doctors and include other healthcare professionals, as well as non-healthcare professionals such as beauticians.”

This finding opens a broader question relating to competence and consent. “One of the key challenges facing the government’s licensing scheme is to ensure that practitioners granted a license possess the skills and experience required to safely administer their treatment to minimize risks to patients,” he says.

“It is important for patients to be able to feel comfortable and confident that the person administering their treatment is competent in the procedure as a fundamental foundation of informed consent. This research provides a unique insight into the sector to help inform regulators and patients, and work towards a safer and more transparent cosmetic injectables industry in the UK.”

In the UK, the Government intends to introduce such legislation and update their policy around injectables, with a public consultation on the industry due to begin in August 2023. Recommendations are expected to inform amendments to the Medical Act in 2024.

 “Our findings should be a wake-up call for legislators to implement effective regulation and professional standards to safeguard patients from complications,” adds study co-author professor Julie Davies of the UCL School Global Business School for Health. “Although the risks associated with injections are often mild and temporary, the physical complications can be permanent and debilitating. There are also serious psychological, emotional, and financial consequences for patients when procedures go wrong.”

The study is published in the Journal of Plastic, Reconstructive & Aesthetic Surgery.

There are similar concerns in the US regarding who is performing injections, says Hema Sundaram, MD. She is the founder and Director of Sundaram Dermatology, Cosmetic and Laser Surgery Center. with offices in Rockville, Md, and Fairfax, Va. and an Honorary Senior Lecturer in Musculoskeletal and Dermatological Sciences in the School of Biological Sciences at the University of Manchester in the U.K. She is also Chair of the American Society for Dermatologic Surgery (ASDS) International Traveling Mentorship and Fellowship Recognition Programs Work Group and a member of the American Academy of Dermatology (AAD) Sulzberger Dermatologic Institute and Education Grants Committee.

“This is such a big issue, and it will have to be regulated at a state level in the US,” she tells AestheticsWire, “In the UK, regulations will be countrywide.”

The US and UK can learn from each other’s experiences in this regard, she says.

“There needs to be a mandate for patients to receive full disclosure as to the credentials of who is treating them to make an informed decision in both countries.”