BCAM 2024 Annual Clinical Review

Background

British College of Aesthetic Medicine (BCAM) have, for over a decade, gathered data from member Doctors and Dentists in the Aesthetic Medical Specialty. This data, directly reported from members’ clinical practices, provides the Board of Trustees with invaluable data from a rapidly developing specialist area of medicine, and ensures we are able to develop internal processes and influence national policy direction, through provision of evidence-based data and clinical expertise and advice to partner organisations and Government.

To the best of our knowledge, this is the only survey of its kind in this field, and is the most reliable and up-to-date source of clinical data across the speciality. By tracking this data year-on-year we are able to provide data and trend analysis to inform national and international decision making.

Specialty Trends

Aesthetic Medicine is a speciality in its own right, and is rapidly developing. The following is a summary of patient demographics and treatments performed.

58% of all patients treated were aged between 35 and 60, with only 7% being younger patients (18-24). 16% of all patients treated identified as male. These proportions are largely consistent with previous years.

Respondents to the survey reported offering the following treatments:

These results remain largely consistent with previous years, with the increase in clinicians offering non-HA dermal fillers being the only notable change in practice.

28% of respondents reported that at least 20% of their time is dedicated to consultations only, indicating that patients are effectively and appropriately counselled before embarking on aesthetic treatments, ensuring a safe, ethical, holistic, and patient-centred approach to treatment by our clinicians.

Respondents reported the following number of treatments administered in the reporting year:

 

Patient Safety and Clinical Complications

All aesthetic procedures carry risks of adverse events or post-procedure complications. BCAM members always discuss these risks, including their likelihood and potential impact, during consultations, to ensure patients are able to give informed consent to treatment. Our members, as highly experienced and qualified Doctors and Dentists, have extremely low complication rates, and the clinical skills and experience to deal with them appropriately.

BCAM members reported 1913 complications across all procedures in the 12 months reported, with the significant majority being minor complications including bruising, or patient dissatisfaction with overall aesthetic results. Severe complications with BCAM members are extremely rare, for example the risk of soft tissue infection is as low as 0.003% in injectable treatments.

By contrast, BCAM members provided treatment to correct 3547 complications resulting from aesthetic procedures carried out by other practitioners. A significant proportion of these (60%) were reported to have been carried out by beauticians, and complications included soft tissue infections, necrosis and scarring. Many of these complications required specialist, long term (and often costly) treatment to correct, and high volumes of patients are referred to the NHS for ongoing care as a result.

A number of BCAM members reported atypical complications resulting from botulinum toxin treatments performed by beauticians, including localised erythema, followed by blistering and eventually scarring. It is the expert clinical opinion of these members that such atypical reactions suggest the use of counterfeit products.

Due to a lack of regulation, and no mechanism for recording complication rates in patients who present directly to secondary care, it is impossible to accurately measure the scale of this risk to patient and public safety. It is conservatively estimated that the number of patients suffering harm due to poorly performed aesthetic treatments, by inadequately trained and experienced practitioners, is in the tens-of-thousands each year, placing significant burden on the NHS.

Additionally, 30% of our members report requests for treatment from children under 18 years of age. BCAM members received 62 requests to correct botched injectable treatments with botulinum toxin or dermal fillers, a treatment which has been a criminal offence to administer to a child under 18 years of age in England since 1^st October 2021.

Due to a lack of regulation, it is impossible to accurately measure the number of children being illegally treated with injectable, prescription-only, aesthetic medicine each year.

BCAM continues to work with partners from across the speciality, to reinforce its assertion that there is a clear and urgent need for regulation in the Aesthetic Medical speciality across the UK, and in line with European standards, for the protection of patients (particularly young and potentially vulnerable patients) and in the public interest. 

Dr Catherine Fairris, President of BCAM said

“BCAM are proud that our members have low complication rates and prioritise patient safety and evidence-based medicine. Our data shows a continued rising trend in complications caused by unqualified lay injectors, and we urge the Government to take action and bring forward robust legislation that will put patient safety at its core. We are hopeful that the new labour government will take this matter seriously, we will of course be sharing our data with them.”

Dr Aggie Zatonska, BCAM Trustee and author of the Annual Clinical Survey report said

“Lack of appropriate regulation that facilitates patient safety is frequently raised by BCAM members as an area that needs to be addressed urgently.

Notably, our members have reported unusual complications suggesting use of counterfeit products. This data will help BCAM to campaign for better regulations and improvement of patient safety.”

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