Cosmetic Interventions - Survey of Scottish Population

Key findings

Public awareness and perceptions

Public confidence in private healthcare industries

Nearly one quarter of Scottish adults report that they have at least a fair amount of confidence in the treatment provided by both the surgical (22%) and non-surgical (23%) cosmetic procedures healthcare industries.

Public confidence in cosmetic dentistry and physiotherapy is, however, significantly higher. Almost half (48%) of Scottish adults report that they have at least a fair amount of confidence in treatment provided by the cosmetic dentistry industry, and nearly three quarters (72%) in physiotherapy.

Chart 1: Confidence in treatment provided by private healthcare industries

Question: How much confidence, if any, do you have in the treatment provided by each of the following private sector healthcare industries or practices?

Base: all nat rep (1,980)

As illustrated in chart 2, young people aged 18-29 are significantly more likely than older adults aged 50-69 and 70+ to have confidence in the treatment provided by both the surgical and non-surgical cosmetic procedures industries.

Chart 2: Confidence in treatment provided by the surgical and non-surgical cosmetic procedures industries - overall confidence by age

Question: How much confidence, if any, do you have in the treatment provided by each of the following private sector healthcare industries or practices?

Base: all nat rep (1,980)

Scottish adults who have had a cosmetic procedure are significantly more likely than those who have not to have confidence in the treatment provided by the cosmetic procedures industries (53% compared with 22% for cosmetic surgery; 47% compared with 23% for non-surgical cosmetic procedures).

Further, adults who have not had a procedure but state they have considered doing so are significantly more likely than those who have not considered having a procedure to have confidence in surgical and non-surgical cosmetic treatments (40% compared with 18% for cosmetic surgery; 35% compared with 20% for non-surgical cosmetic procedures).

Regulation in private healthcare industries

When provided with a list of private healthcare industries, the Scottish public are most likely to think that physiotherapy is regulated, with half (50%) stating this belief. Cosmetic surgery and cosmetic dentistry are also believed to be regulated by relatively significant proportions (43% and 39% respectively), but the non-surgical cosmetic procedures industry by a much smaller proportion (12%).

Chart 3: Private healthcare industries believed to be regulated

Question: Which of the following private sector healthcare industries or practices, if any, do you think are regulated? Please tick all that apply. By regulation, we are referring to legal rules that govern their behaviour, actions and conduct, and where action may be taken if these rules aren't met.?

Base: all nat rep (1,980)

Consistent with young adults' propensity to have confidence in each industry, they are most likely to believe that the cosmetic surgery and non-surgical procedures industries are regulated.

As shown in chart 4, more than half (57%) of young adults think that cosmetic surgery is regulated, and one quarter (24%) that the non-surgical procedures industry is regulated.

Chart 4: Proportion who believe cosmetic surgery and non-surgical cosmetic procedures are regulated - by age

Question: How much confidence, if any, do you have in the treatment provided by each of the following private sector healthcare industries or practices?

Base: all nat rep (1,980)

Scottish adults who have no formal educational qualifications are significantly more likely than those with higher levels of education to believe that none of the industries listed are regulated (19% compared with 13% overall).

Familiarity with cosmetic procedures

When considering specific procedures, more than half of the Scottish public indicate that they are at least somewhat familiar with cosmetic dental treatments (53%) and breast enlargement/reductions (51%).

Significant proportions are also familiar with nose jobs (47%), surgical liposuction/sculpture (46%), and surgical face/neck lifts (39%).

It is relatively less common for Scottish adults to be aware of chemical peels (23%), injectable cosmetic treatments (22%), laser skin procedures (21%) and non-surgical fat reductions (21%).

Chart 5: Levels of familiarity with cosmetic procedures

Question: How familiar are you, if at all, with each of the following cosmetic procedures?

Base: all nat rep (1,980)

Younger adults are more likely than older adults to report that they are familiar with some cosmetic procedures, but their increased likelihood to have confidence in the industries and believe they are regulated does not necessarily translate into making them more familiar with specific procedures.

As shown in chart 6, women are significantly more likely than men to be familiar with all of the cosmetic procedures listed. This is the case among women with all levels of education.

Chart 6: Levels of familiarity with cosmetic procedures - overall familiarity by gender

Question: How familiar are you, if at all, with each of the following cosmetic procedures?

Base: all nat rep (1,980)

Opinions regarding cosmetic procedures and NHS support

When the Scottish public are asked whether or not they agree that it is acceptable for the NHS to cover the costs of caring for someone whose private cosmetic procedure has gone wrong, one third (33%) feel that it is while two thirds (67%) that it is not.

Chart 7: Opinion regarding whether or not it is acceptable for the NHS to cover care related to a private cosmetic procedure

Question: As you may already be aware, there are occasions where something can go wrong as a result of a private cosmetic procedure. In these instances, is it acceptable for the NHS to cover the costs of caring for the person in need and/or correct the issue. Which of the following statements best describes your opinion?

Base: all nat rep (1,980)

This opinion varies significantly by age: young adults aged 18-29 are significantly more likely than older adults to agree that it is acceptable for the NHS to cover these costs, with nearly half (48%) stating that they agree with the principle. Comparatively, only one quarter (25%) of those aged 50-69 feel it is acceptable for the NHS to do so.

Chart 8: Opinion regarding whether or not it is acceptable for the NHS to cover care related to a private cosmetic procedure - by age

Question: As you may already be aware, there are occasions where something can go wrong as a result of a private cosmetic procedure. In these instances, is it acceptable for the NHS to cover the costs of caring for the person in need and/or correct the issue. Which of the following statements best describes your opinion?

Base: all nat rep (1,980)

Scottish men and women do not express any differences in opinion from one another when considering the acceptability of the NHS covering healthcare costs related to private cosmetic procedures.

However, when comparing by education, women with a GCE A level/Higher Certificate/Scottish Higher Certificate (34%) are more likely to agree that it is acceptable than those with a Scottish Ordinary/Lower Certificate or less (24%). The same pattern is seen among men (37% compared with 22%).

Private cosmetic procedures among the Scottish public

Incidence of private cosmetic procedures

Four per cent of the Scottish adult population report that they have had a private cosmetic procedure^[1] in their lifetime.

Among those who have had a procedure, by a significant margin the most commonly reported private cosmetic procedures are dental treatments, with more than half (54%) saying they have had one of these.

The next most popular procedures are an injectable cosmetic treatment (17% of Scottish adults who have had a private procedure) and a laser skin procedure (16%).

Less common procedures are a chemical peel (9% of adults who have had a cosmetic procedure), a breast enlargement/reduction (7%), nose job (6%), surgical face/neck lift (4%), non-surgical fat reduction (2%) and surgical liposuction/sculpture (1%).

Ten per cent of those who have had a procedure indicate they have had another treatment or procedure not listed, and open-ended mentions for this category include treatments such as laser eye surgery and mole removal.

Chart 9: Private cosmetic procedures Scottish adults have had - among only those who have had a procedure

Question: Which of the following cosmetic procedures, if any, have you ever had and paid for privately? Please tick all that apply.

Base: all who have had a private cosmetic procedure (79)

Chart 10 shows the incidence of having undergone procedures among the full national population. While 4% of Scottish adults have undergone a cosmetic procedure in their lifetime, 2% have had a cosmetic dental treatment. Moving down the list, 0.6% of Scottish adults have had an injectable treatment, 0.6% a laser skin procedure, 0.3% a breast enlargement/reduction, 0.3% a chemical peel, 0.2% a nose job, 0.2% a surgical face/neck lift, and 0.1% surgical liposuction/sculpture or a non-surgical fat reduction. The remaining 96% of the Scottish population have never had a cosmetic procedure.

Chart 10: Private cosmetic procedures Scottish adults have had - among the national population

Base: all nat rep (1,980)

Among Scottish adults who have had a private cosmetic procedure in their lifetime, roughly one third (34%) indicate they have had at least one in the past twelve months. Consistent with findings on procedures that have ever been undertaken, the most commonly reported procedure from the past twelve months is a cosmetic dental treatment (15%).

Otherwise, in the past twelve months 11% have had a laser skin procedure, 3% an injectable cosmetic treatment, 2% a chemical peel and 1% a face/neck lift. Five per cent also report that they have had another procedure not listed.

However, the remaining two-in-three (66%) Scottish adults who have had a private cosmetic procedure report that they have not had any in the past twelve months.

When considering the overall population of Scottish adults, 1% overall have had a cosmetic procedure in the past 12 months.

Experience of private cosmetic procedures

Expectations and understanding

Two thirds (66%) of Scottish adults who have had a cosmetic procedure indicate that they feel they had a strong understanding of what the experience would involve in advance of their most recent procedure.

On a scale of 1 to 10, where 1 represents no understanding at all and 10 represents a very strong understanding, roughly one quarter (26%) report that they would rate their understanding of the experience in advance of the procedure as '10', and nearly another quarter (20%) as '9'. Two-thirds rated their understanding at 8 or higher.

A very small proportion of people indicate that they had little understanding of what the experience of the procedure would involve, with only 1% rating it 3 or lower.

The median rating on the scale of level of understanding is '8', therefore implying that overall Scottish adults who have had a private cosmetic procedure feel they had a strong understanding of what the experience would involve.

Chart 11: Rating of the level of understanding Scottish adults had about what the experience of the private cosmetic procedure would involve (scale of 1-10)

Question: In advance of your most recent procedure, how would you describe the level of understanding you had about what the experience of the procedure would involve? Please provide your response on a scale of 1 to 10, where 1 represents no understanding at all and 10 represents a very strong understanding.

Base: all who have had a private cosmetic procedure (79)

Satisfaction with results of procedure

Building on the levels of apparent satisfaction reported regarding understanding of private cosmetic procedures, results indicate that Scottish adults who have undergone a private cosmetic procedure are also satisfied with the outcome overall. More than three quarters (78%) agree that their most recent procedure achieved what they expected, with two-in-five (40%) strongly agreeing and 38% somewhat agreeing.

Meanwhile, 19% disagree that their most recent procedure achieved what they expected and the remaining 3% indicate that they neither agree nor disagree.

Chart 12: Agreement that most recent procedure achieved what was expected

Question: How strongly do you agree or disagree that your most recent procedure achieved what you expected?

Base: all who have had a private cosmetic procedure (79)

Health problems resulting from private cosmetic procedures

More than one quarter (27%) of Scottish adults who have undergone a private cosmetic procedure report that they have had at least one health problem as a result within the first month following. The most common health problem they report having experienced is slow healing (11%). Less than one in ten also say that within the first month they experienced bleeding (8%), infection (7%), numbness (6%), burns (4%) or another problem (4%).

Nearly three quarters (73%) of Scottish adults who have undergone a cosmetic procedure, however, report that they have never experienced any health problems within the first month following.

Chart 13: Health problems experienced within the first month after a cosmetic procedure

Question: As a result of any of your previous cosmetic procedures, did you ever have any of the following health problems within the first month after the procedure? Please tick all that apply.

Base: all who have had a private cosmetic procedure (79)

Public consideration for future cosmetic procedures

Consideration and likelihood

Sixteen per cent of Scottish adults who have not had a cosmetic procedure report that they have thought about doing so to some extent. Seven per cent overall report that they have seriously considered doing so while 8% say they have considered it less seriously. The remainder (84%) have never thought about having a cosmetic procedure.

Women (22%) are significantly more likely than men (9%) to state this, while young adults aged 18-29 (21%) are significantly more likely than older adults aged 50+ years to do so (12% for 50-69 years and 5% for 70+ years).

Among these adults who have ever thought about having a cosmetic procedure, almost half (46%) say they have considered it seriously, with 36% having considered it somewhat seriously and 10% very seriously.

Young adults are significantly more likely than older adults to report having considered a cosmetic procedure very seriously (4% for 18-29 years and 1% for 50-69 years).

Chart 14: Levels of seriousness in considering having a cosmetic procedure

Question: How seriously, if at all, did you consider having a cosmetic procedure?

Base: all nat rep who have not had a cosmetic procedure (1,901)

Among Scottish adults who have thought about having a cosmetic procedure but have not yet done so, roughly one quarter (23%) say they are very or somewhat likely to have one in the next three years. Otherwise, nearly three quarters (70%) are unlikely to have a cosmetic procedure in this time frame and 6% do not know.

As shown in chart 15, among the total population of Scottish adults who have not undergone a cosmetic procedure, 4% report that they are likely to have one in the next three years and 11% that they are not likely to do so. The remainder (84%) have never thought about having a cosmetic procedure.

Chart 15: Likelihood of having a cosmetic procedure in the next three years

Question: And how likely would you say you are, if at all, to have a cosmetic procedure in the next three years?

Base: all nat rep who have not had a cosmetic procedure (1,901)

Cosmetic procedures the Scottish public have considered

Among Scottish adults who have thought about having a cosmetic procedure but have not yet done so, the most commonly considered procedure is a cosmetic dental treatment, with almost half (48%) of this group have considered having one. This translates into 8% among the full population of Scottish adults who have never had a cosmetic procedure. This is consistent with reports of the procedures that Scottish adults have already undergone in their lifetime; by a significant margin cosmetic dental treatments are the most common.

Four per cent of adults who have not had a cosmetic procedure report that they have considered having surgical liposuction/sculpture or a breast enlargement/reduction. Slightly less commonly, they report having considered a nose job (3%), non-surgical fat reduction (2%), injectable treatment (2%), surgical face/neck lift (2%), chemical peel (2%) or laser skin procedure (1%).

Chart 16: Cosmetic procedures Scottish adults have considered

Question: Which of the following cosmetic procedures, if any, have you ever thought about having? Please tick all that apply.

Base: all nat rep who have not had a cosmetic procedure (1,901)

Women are significantly more likely than men to report that they have considered having a wide variety of procedures, including an injectable treatment (3.1% compared with 0.2%), a surgical face/neck lift (3.0% compared with 0.6%) and a breast enlargement/reduction (7.3% compared with 0.2%).

Further, young adults aged 18-29 are significantly more likely than older adults aged 50-69 to say they've considered having a breast enlargement/reduction (8.1% compared with 1.6%), while older adults are more likely to have considered a face/neck lift (2.9% compared with 0.3%).

Intentions for cosmetic procedures in the next 12 months

Amongst the full nationally representative sample of Scottish adults, 4% report that they are planning to have a cosmetic procedure in the next 12 months.

Women (5%) are significantly more likely than men (3%) to say they plan to have a procedure in the next 12 months, as are younger adults aged 18-29 (5%) more likely than older adults aged 50-69 (3%).

When the 4% are broken out by the specific procedures they are planning to have in the next 12 months, the proportions become very small. Most commonly, Scottish adults are planning to have a cosmetic dental treatment (1.7%). Others are planning to have a laser skin procedure (0.6%), an injectable treatment (0.5%), a breast enlargement/reduction (0.4%), or another treatment not listed (0.6%). Very small proportions are planning to have a chemical peel (0.3%), surgical liposuction/sculpture (0.3%), a surgical face/neck lift (0.2%), a nose job (0.1%), or a non-surgical fat reduction (0.1%).

Again, these findings are on par with the procedures reported to have been undertaken by those Scottish adults who have already had a cosmetic procedure in their lifetime; dental treatments are the most common cosmetic procedure, followed by injectable treatments and laser skin procedures.

Chart 17: Cosmetic procedures Scottish adults are planning to have in the next 12 months

Question: Which of the following procedures, if any, are you planning to have in the next 12 months? Please tick all that apply.

Base: all nat rep (1,980)

Women are significantly more likely than men to be planning to have a dental treatment (2.3% compared with 1.0%) and a breast enlargement/reduction (0.8% compared with 0.0%).

Significant differences do not present themselves between younger and older adults in terms of specific procedures being considered in the next 12 months.

Resources and seeking advice

Sources to use for information about cosmetic procedures

When Scottish adults are asked on an open-ended basis which sources they would use if seeking information about cosmetic procedures, they most commonly suggest that they would speak to their GP or do an internet search. Some also mention specific websites, such as the NHS or Bupa websites.

When provided with a list of sources a consistent picture is seen, with roughly half saying they would turn to their GP practice (50%) or search on the internet (49%). A significant proportion also say they would use the NHS Scotland website (40%).

Closer to one quarter report that they would use the NHS Choices (29%) or Scottish Government Health and Social Care (23%) websites, contact a private practitioner/special in the cosmetic procedures industry (24%), or speak to friends and family (21%).

Chart 18: Information sources the Scottish public would use

Question: Which of the following sources, if any, would you use if seeking information about surgical or non-surgical cosmetic procedures? Please tick all that apply.

Base: all nat rep (1,980)

Women are significantly more likely than men to say they would use many of the sources listed. Among others, more women report that they would do a general internet search (52% compared with 46%), as well as use the NHS Scotland website (43% compared with 37%) and the NHS Choices website (31% compared with 26%). Further, they are more likely to seek information through a private practitioner or specialist in the industry (29% compared with 19%). Men, conversely, are significantly more likely to say they would not use any of these sources (13% compared with 8%).

Women with a higher education level are significantly more likely to report that they would take a variety of actions, including an internet search (56% of those with a GCE A level/Higher Certificate/Scottish Higher Certificate compared with 37% of those with a Scottish Ordinary/Lower Certificate or less), using the NHS Scotland (45% compared with 33%) or NHS Choices (33% compared with 25%) websites, and speaking to a private practitioner/specialist (31% compared with 21%).

Young adults aged 18-29 are also significantly more likely than older adults aged 50-69 to use information sources if seeking information about cosmetic procedures, including the NHS Scotland (46% compared with 38%) or NHS Choices (38% compared with 26%) websites, and a private practitioner/specialist (35% compared with 18%). Older adults are more likely to say they would not make use of any of these sources (12% compared with 6%).

Points of contact for raising a concern or complaint

Most commonly, Scottish adults report that their first point of contact if something were to go wrong with a cosmetic procedure would be the practitioner who conducted the work, with two-in-five (40%) indicating this.

Approximately one-in-five (22%) say their first point of contact would be their GP.

Less frequently used routes would be a solicitor (8%), the Independent Healthcare Advisory Services (4%), Citizens Advice Scotland (4%), a hospital (3%), or the NHS Scotland (2%), NHS Choices (1%) or Scottish Government Health and Social Care (1%) websites.

Chart 19: First point of contact the Scottish public would use for assistance or making a complaint if something went wrong with a cosmetic procedure

Question: Please imagine that you have recently had a cosmetic procedure and something went wrong. Who, if anyone, would you be most likely to contact first for information, assistance or to make a complaint? Please select just one option.

Base: all nat rep (1,980)

Women are significantly more likely than men to say they would contact the practitioner first (44% compared with 35%).

Conversely, young adults aged 18-29 are significantly more likely than older adults to report that they would turn to a hospital first (7% compared with 3% for 30-49 years and 2% for 50-69/70+ years). This is also the case among adults belonging to minority ethnic groups, with 7% stating this compared with 3% of white adults.