Aesthetic Regulation ‘Crackdown’– But What Does It Really Mean?

Updated: 19th August 2025 – One week after the announcement about licensing, the Department of Health and Social Care has launched a TikTok and Instagram campaign to warn of the dangers of cosmetic surgery tourism! I’ve added some thoughts about this at the end of this article. Seems like the DHSC has really got the bit between its teeth on aesthetic issues, which is… astonishing.

So, could it finally be happening? After years of campaigning, consultations, and cautionary headlines – and a continuous stream of horror stories ranging from botched faces, via the death of a mother-of-five after a ‘Brazilian Butt Lift’ last year, to the recent cases of botulism from fake botulinum toxin – the government has confirmed it’s going ahead with a mandatory licensing scheme for non-surgical cosmetic procedures in England.

If you’ve seen the headlines shouting about a “crackdown” on rogue injectors – and reports about poor quality cosmetic surgery abroad – you might be wondering: what does this actually mean – and is it really going to change anything? Here’s what you need to know…

What does the new legislation announcement actually mean?

It means that the government is at last moving forward with regulation of aesthetic procedures – specifically, Botox, fillers, microneedling, chemical peels, threads, and lasers, among others. A licensing scheme will be introduced to control who can offer what treatments and under what conditions.

What’s going to happen?

Practitioners who meet the criteria on education, training and ability (precise details yet to be decided) will be given a licence to carry out particular treatments. Actually they’ll need two licences:

1. A practitioner licence – to prove they’re suitably trained and insured.
2. A premises licence – to ensure treatments are carried out in settings that meet hygiene and safety standards.

Treatments will be classified into risk-based tiers, and higher-risk procedures (like injectables) will only be allowed for those with appropriate medical qualifications. Here at TTG, we always recommend choosing practitioners who have not just relevant qualifications for a procedure, but lots of experience at actually doing that procedure. We’ve yet to meet someone who gets worse through experience.

Here at TTG, we always recommend choosing practitioners who have not just relevant qualifications for a procedure, but lots of experience at actually doing that procedure. We’ve yet to meet someone who gets worse through experience.

Are these tiers the ‘traffic light’ system of grading cosmetic procedures?

Yes – that’s the plan. The government is proposing a risk-based ‘traffic light’ model to help determine which procedures can be performed by whom. This has yet to be firmed up but in essence:

• Red: High-risk procedures (like deep dermal fillers as used in Brazilian Butt Lifts,  threads, ablative lasers) – only to be carried out by medically qualified practitioners.
• Amber: Medium-risk treatments (e.g. dermal fillers, toxin injections), to be carried out by medically qualified practitioners or by therapists acting under supervision from medical professionals.
• Green: Low-risk procedures (like superficial facials, light treatments, lightweight peels) – possibly exempt or requiring minimal oversight.

Rating treatments according to their complexity and perceived danger levels makes a lot of sense in theory but there has already been immense argument around it. So we’ll have to wait to see how it’s defined in practice.

When will the new licensing scheme come into effect? 

Not for a while yet, but the wheels are finally in motion. Everything has moved at a glacial pace so far but key stakeholders including the JCCP and the British Beauty Council who have been inching everything along with the Department of Health and Social Care (DHSC) will keep pressing for movement.

When will it all become law?

The Health and Care Act 2022 gave the Secretary of State for Health and Social Care the right to introduce a licensing scheme for non-surgical procedures, and once the licensing scheme is firmed up and agreed, it will be brought into law by ‘secondary legislation’.

So this isn’t actually the ‘crackdown’ the headlines suggested?

No. It’s not an overnight ban or an instant clean-up of the industry. This is the start of a slow, careful regulatory process, which should eventually raise standards and protect patients – but the rogue operators haven’t been shut down yet.

How will the new rules be enforced?

Through local authorities, using existing teams (like Environmental Health and Trading Standards). They’ll issue the licences, inspect clinics, and follow up on complaints. It’s not clear how robust enforcement will be – that will depend on funding and prioritisation.

Will this really get rid of rogue operators?

Let’s hope so. If properly enforced, the licensing scheme will make it illegal for unlicensed practitioners to operate. But we’ve seen how adept the industry is at working in loopholes…

If properly enforced, the licensing scheme will make it illegal for unlicensed practitioners to operate. But we’ve seen how adept the industry is at working in loopholes…

Haven’t we been here before?

Absolutely. I’ve reported on proposed regulation since the early 2000s. The Keogh Review in 2013 called for action, declaring dermal fillers ‘a disaster waiting to happen’. The JCCP was created in 2018. The Botox and Fillers (Children) Act came in 2021.

And yet as we all know the industry remains riddled with countless thousands of injectors with little training and no qualifications – and horror stories. (‘Countless thousands’ isn’t just hyperbole, btw. They’re countless because there is no way of counting them. I saw someone estimating the total at 200,000 the other day. Is that on the mark or wildly out of order? I just don’t know.)

Why has it taken so long for the UK to take aesthetic regulation seriously?

Because non-surgical procedures fell between the cracks. They’re not regulated like medicine, nor like beauty therapy. And there’s been no political will – until now – to tackle what has become a £3 billion, fast-growing industry with serious public safety implications.

Why the 18-month delay after the consultation?

The public consultation on regulation of cosmetic procedures closed in October 2023. This was then reviewed. Since then – silence. Why? The government changed, there’s a lot else to do, it hasn’t been a priorty, regulation is going to be a complex and detailed headache… But the growing number of complaints, complications and even hospitalisations looks like it has made it an issue the government can no longer ignore.

So, this legislation is not a silver bullet – but it’s a vital step toward making the aesthetic industry safer. And not before time…

What about cosmetic surgery tourism?

And now there’s another Government campaign doing the rounds, specifically designed to warn against getting poor quality cosmetic surgery when abroad. The government is using social media medical influencers including MidwifeMarley and Doctally to warn people about the potential dangers of heading off to Turkey/ Slovakia/ Mexico/Thailand for a tummy tuck or similar. To be sure, it’s a far cry from the usual government-advice TV campaigns that we’re more used to, but given that social media is where most people do their research about aesthetics and procedures abroad (yes, ok, this is not what we at TTG would call ‘research’ but…) it is very much needed.

I totally get the attraction of heading abroad for surgery: it is massively cheaper. And of course there are good surgeons in every country (though will they be the ones who are advertising on TikTok?) BUT. There are a lot of buts and also horror stories, of people having operations quite different from the ones for which they had booked in and paid; of cack-handed work leaving faces and bodies lopsided, of dreadful scarring, of infections, wound breakdown, sepsis, blood clots, tissue necrosis. There are deaths, too; at least 28 Brits have died after medical-tourism trips to Turkey since 2019. I can’t understand why there hasn’t been more of an outcry over these figures.

Many patients returning home with problems need corrective surgery, which costs the NHS up to £15,000 per patient.

So, once again, this push for greater awareness about the risks is perhaps long over due.

Still tempted? Answer these questions 

Would you still do this if it weren’t so cheap? Have you researched the risks properly? Is the clinic reputable? Will you meet your surgeon before the day of the operation? Who will help if something goes wrong?

Further advice 

For wise advice on cosmetic tourism, head to the following links:

The British Association of Aesthetic Plastic Surgery (BAAPS) – Cosmetic Surgery Abroad, What You Need To Know

The NHS – Cosmetic Surgery Abroad