Regulating invasive cosmetic procedures to reduce harm

In 2024, Alice Webb died after a non-surgical Brazilian butt lift, a cosmetic procedure that was done in the UK by a provider who was not medically qualified. 1Once considered a consumer concern, cosmetic interventions now raise substantive patient safety and health system issues.Although deaths remain rare, evidence suggests that associated harms are increasing.Surgical or invasive cosmetic procedures are generally understood as those that involve the insertion of instruments or equipment into the body, such as tummy tuck or breast augmentation, while non-surgical procedures are minimally invasive and include subcutaneous injections to alter appearance such as botox or dermal filler. 2 However, non-surgical procedures are becoming increasingly invasive, blurring the distinction.Reliable data on cosmetic procedures are hard to find, largely because of the mix of providers, environments, regulatory gaps, absence of structured reporting systems, and cosmetic tourism.Nevertheless, alarm over the numerous publicised cases has prompted regulators in some countries (including Germany and Australia) to impose standards of care and enhanced oversight for cosmetic interventions. 3 -6 The governments of Scotland and England look set to follow suit.However, current proposals within the UK are disjointed and insufficiently protective.