Michael Saul, partner at Cosmetic Surgery Solicitors, warns that while social media normalises surgical procedures, the legal framework is only now beginning to catch up.
In December 2022, Google Searches for the term “Buccal fat removal’ had surged by more than 650% from November 2022. The catalyst of this increase was the rising popularity of buccal fat removals on social media, inspired by celebrities and influencers. The procedure had been trending for six months before the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) issued extreme caution. But unfortunately for many patients who underwent buccal fat removal at the time of the trend, the results of this procedure will last a lifetime.
This is the central tension now confronting cosmetic surgery in the UK. Social media has created a mechanism that compresses decision timelines for patients by amplifying body insecurities and normalising surgical procedures due to fleeting cultural moments. The consent processes that govern these procedures were not built to deal with these compressed timelines, and the legal framework for this is only now beginning to catch up.
The scale and mechanism of the problem
Traditionally, cosmetic surgery has been a well-thought-out and deliberated decision, made following months of research and consultations with multiple practitioners. Patients would arrive for their procedure knowing exactly what they wanted and why. However, with the rise of cosmetic procedure trends on social media, this process has been disrupted.
For instance, when media personality, entrepreneur and influencer Kylie Jenner publicly shared her use of Juvéderm lip injections, what followed was a reported 70% increase in enquiries within 24 hours at some UK clinics. The buccal fat removal trends followed a similar pattern of being niche, to mainstream media and then becoming medically cautioned, within a matter of months.
The problem doesn’t just lie with the increasing pace, it’s increasingly concerned with patient motivations. A patient arriving at a consultation with a celebrity reference photo presents a completely different clinical and legal issue than one who has reached a well-considered, independent decision.
The legal adequacy of current consent
Under Montgomery v Lanarkshire (2015), practitioners are required to disclose all material risks associated with a particular procedure. However, the current pre-operative assessment for cosmetic procedures often won’t include patient motivation as a consideration, instead focusing simply on the physical risks. Something that should be considered in the age of social media algorithms is trend regret, which refers to the feeling of embarrassment when a past cosmetic procedure has fallen out of style.
Sometimes, with hindsight, patients recognise that they were caught up in a moment rather than making a considered decision – but by the time that realisation comes, the procedure is irreversible. The law already requires practitioners to understand what matters to their patient. Right now, many consent processes simply aren’t asking.
Some clinics actively amplify trend demand by utilising specific celebrity inspiration and trends as a marketing tool. However, if patients book procedures from these advertisements, this creates a huge legal and ethical implication regarding patient decision-making.
Advertising Standards Authority (ASA) regulations do exist to prohibit misleading advertising in aesthetic medicine, but they fail to specifically address trend-amplifying advertisements. A clinic that has generated a trend-driven demand cannot claim that the consent process was independent of that marketing process, making it difficult to separate the consent environment from the marketing context.
What must change
The cosmetic surgery sector is facing increasing regulatory reform, with England’s tiered licensing framework and Scotland’s Non-Surgical Procedures Bill setting stringent new standards for practitioner qualifications and client safety.
But regulatory reform alone is not enough. Consideration should be given to the current consent process to include a thorough assessment of patient motivations. If social media trends or celebrity inspirations are found to be a significant driver, the appropriate psychological screening must be undertaken to establish that patients are aware of the risks and understand the realistic outcomes from surgery.
Furthermore, marketing standards such as those from the ASA and Joint Council for Cosmetic Practitioners (JCCP) need to develop strict guidance on trend-amplifying advertising. The era of extracting commercial value from viral trends, without legal or ethical accountability, needs to end. The practitioners and clinics that take this movement first will place themselves on the correct side of the law, and, even more importantly, will protect the physical and psychological well-being of their patients.
