Botulinum toxin and Fillers – can you trust the person injecting you?

Recommendations by Sir Bruce Keogh (NHS medical director) last year were intended to bring about better regulation of cosmetic procedures to protect consumers. The report came hot on the heels of the PIP implant scandal as a measure to avert similar disaster.

Keogh stated in the report that “a person having a non surgical cosmetic intervention has no more protection and redress than someone buying a ballpoint pen or a toothbrush.”

Key recommendations from the Keogh report include:

  • Making dermal fillers prescription only.
  • Ensuring all practitioners are qualified for the procedures they offer and are on a professional register.
  • An ombudsman to oversee all private healthcare including cosmetic procedures to help those who have been treated poorly.
  • All breast implants to go on a beast implant registry.
  • As medical professionals we awaited the Governments’ response to the report with hope and bated breath.

Unfortunately the Government has failed to deliver, at least on the count of fillers. Dermal fillers have not been reclassified as a medicine, ostensibly because of EU legislation (!). There will be a requirement for some form of yet to be defined training and oversight by doctors or ‘other appropriate health professional’. Like many of my colleagues, I am concerned that anyone will still be able to offer fillers as there will be no central register for qualification and there would be huge variability in what can count as training.

My personal view on injectables is very simple: they should only be administered by professionals who inject in their core professions. While the Government may be constrained by various regulations and agendas, as individual professionals, we are at liberty to only practice what we believe to be right. Hence, I will not be available to ‘oversee’ non-medical professionals who want to inject fillers or toxins and, in my old fashioned clinic, injections will continue to be given by doctors and nurses only.



Mrs CC Kat is a leading Midlands Consultant Plastic Surgeon specializing in cosmetic and reconstructive surgery. She is a full member of both British Association of Aesthetic Plastic Surgeons (BAAPS) and British Association of Aesthetic , Plastic and Reconstructive Surgeons (BAPRAS) as well as several international aesthetic surgery associations. She worked as a Consultant Plastic Surgeon at the Heart of England NHS Foundation Trust but now runs her private practice, CC Kat Aesthetics – Birmingham Laser, Skin and Cosmetic Surgery Clinic, full time. For more information, visit or call 0121 456 7930

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