The study reports that many patients do not receive proper consent forms, information on complications, or aftercare instructions.
A survey of cosmetic injection recipients in the United Kingdom has revealed significant inconsistencies in the quality of care, consent procedures, and patient advice, according to a study published in Aesthetic Surgery Journal Open Forum.
Led by researchers from Anglia Ruskin University in collaboration with KLNIK, the study surveyed 919 adults who had undergone botulinum toxin treatments. It comes as the UK Government considers new restrictions on cosmetic procedures in a market where non-healthcare professionals can legally administer injections with minimal oversight. The study found that 89% of respondents were in favor of stricter regulations.
The findings show that despite requirements for botulinum toxin to be dispensed by a qualified prescriber, only 42% of participants reported a prescriber was present during their consultation. Additionally, 9% said they were not given a written consent form, and 18% were not informed of possible complications before their procedure. The survey also found that only 26% of patients received any post-treatment support, and just 28% recalled getting advice on how to manage potential side effects.
While 90% of individuals expressed satisfaction with their treatment, the report highlights a major gap in patient awareness of regulatory and reporting channels. Only 5% of participants filed a formal complaint following treatment. At the same time, just 35% were familiar with current regulations, and 74% were unaware of the UK’s Yellow Card reporting system, which is run by the Medicine and Healthcare products Regulatory Agency (MHRA) to collect data on safety concerns.
“The use of botulinum toxin for cosmetic purposes in the UK is a healthcare paradox; it’s a medically regulated drug, but it’s widely used in an unregulated aesthetic marketplace,” says Lee Smith, PhD, co-lead author and professor of public health at Anglia Ruskin University, in a release. “Our survey found that the public don’t know how to report issues they experience, highlighted by the lack of awareness of the Yellow Card scheme. At the same time, non-healthcare professionals, who represent a large proportion of those carrying out injections, lack formal reporting obligations as they are not members of professional bodies, indicating there could be a significant under-reporting of complications.”
The study points to the need for improved standards beyond technical proficiency as regulators consider new licensing frameworks.
“Our survey, the largest of its kind in the UK, shows that when administered correctly, botulinum toxin is generally well-tolerated and can be effective. However, our survey reveals serious gaps in informed consent and aftercare. Nearly one in 10 people didn’t sign a consent form, and almost one in five weren’t told how to manage complications,” says Dr Roshan Ravindran, co-lead author and an aesthetic doctor at KLNIK, in a release. “As the government moves towards statutory licensing, it’s vital the scheme includes minimum educational standards, ethical codes, and robust enforcement mechanisms. Practitioners must be trained in communication, patient-centred care, and the ability to screen patients, so those with conditions such as body dysmorphic disorder are instead provided with help rather than treatment.”
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