Commentary

The Women and Equalities Committee published its report on cosmetic procedures in February this year. It is the most thorough parliamentary examination the aesthetics industry has ever received, and if you work in this sector, it is worth reading closely.

Where the motivation is subjective, the risk disclosure has to include subjective outcomes. If a procedure is chosen for psychological reasons, psychological outcomes belong in the consent conversation. When a procedure fails to deliver them — when the patient is left with a technically acceptable result and the same distress they walked in with — that is a harm.

Ask most aesthetic practitioners whether psychological risk is part of their informed consent process and the answer will be yes. In theory, they are not wrong. The guidance is there. Practitioners can point to it. And yet patients are routinely consented for cosmetic procedures without receiving any structured information about psychological risk at all.

I spent two years trying to improve patient mental health safeguarding in aesthetic medicine. What I actually learned was how an industry protects itself from the very changes it claims to want.

The medical aesthetics industry has spent years talking about the need to identify unsuitable patients. On paper, that sounds sensible. If a big part of the risk sits in patient motivation, expectations, or appearance-related distress, then screening for those issues can seem like the obvious answer. However, that logic falls apart when it meets the real conditions of cosmetic care.