The American website myfreeimplants.com allows women to post photos of themselves to solicit donations for cosmetic surgery. Donors are invited to “invest in breasts” by contributing money to women seeking breast implants. Women post photos and messages about their plastic surgery goals and network with online benefactors, and in return, donors pay women to help them “achieve the body of their dreams”. Gobsmacked? So was I. 

Unsurprisingly the website has attracted widespread criticism, not least by The British Association of Aesthetic Plastic Surgeons (BAAPS), which denounced the crowdsourcing site as “degrading”, “outrageous” and “inappropriate.” So far, however, the site has raised $8million, and a quick glance at the site’s feedback section gives an indication of its popularity.

The ethical debate about cosmetic surgery in general, and crowdsourcing breast implants in particular is complex and evolving, and I cannot do justice to it here. The truth is that, whatever you think about cosmetic surgery, more and more people are turning to cosmetic surgeons to help them to enhance their bodies. According to BAAPS, in 2013, there were 50,122 surgical procedures performed in the UK, including a 51% increase in liposuction procedures. The UK cosmetic surgery industry has an estimated value of £3.6bn.

The cosmetic surgery industry has always had a murky reputation, and sites such as myfreeimplants.com do nothing to help with that. Arguably, one of the most alarming aspects of the site is the way in which it refers its users directly to plastic surgeons willing to carry out the breast augmentations. The site boasts to surgeons that it “pays the clinic directly for 100% surgery costs. There are no fees, no forms, no delays.” A perfect arrangement for the surgeons, but what protection does this offer to potentially vulnerable women? How do they know whether the surgeon they are referred to is properly trained and sufficiently experienced?

Risks associated with cosmetic surgery

Regulation of the cosmetic surgery industry has historically been piecemeal and unsatisfactory, due partly to the fact that cosmetic surgery is not a defined specialty, and so much of it is carried out privately. In the UK, any doctor can call himself or herself a cosmetic or plastic surgeon without any specialist training, and there is no requirement that a cosmetic practitioner actually have any surgical training. Astonishingly, non-surgical procedures such as Botox, laser treatment, chemical peels and dermal fillers are completely unregulated, and can be carried out by anyone, yet the risks associated with these treatments include burning, scarring, infection and even blindness.

The risks associated with surgical procedures are just as serious. They include the following:

  • Haematoma – this is where a pocket of blood develops under the skin resembling a large, painful bruise. It can occur in breast augmentation, facelift and blepharoplasty surgery.
  • Nerve damage – many different types of cosmetic surgery carry a risk of nerve damage. Following breast augmentation, most women experience a change in sensitivity and a small percentage permanently lose nipple sensation.
  • Infection – this is one of the most common complications of cosmetic surgery. In some cases, it can be severe and internal, requiring IV antibiotics.
  • Thrombosis and Thrombophlebitis – any major operation done under general anaesthetic carries a risk of thrombosis (development of blood clot in a blood vessel). In addition, thrombophlebitis, inflammation of the veins, can occur, for example, following liposuction. This can cause pain, swelling and redness.
  • Reaction to implants – in some cases, the body can react to an implant by forming a thick and contracted capsule around it. This can cause pain or an unnaturally hard feeling around the implant. This occurs in 5-6% of women who have breast implants.
  • Scarring – hypertrophic scarring can occur, which is an abnormally red and thick raised scar. It may require treatment with additional operations.
  • Seroma – this is where serum from the blood pools beneath the surface of the skin, resulting in pain and swelling. It resembles a large blister. It can occur in all surgeries and can require drainage or aspiration. Seromas can sometimes become infected.
  • Blood loss – this can happen while on the operating table but also afterwards. In serious cases, a blood transfusion might be necessary. Occasionally, in rhinoplasty surgery, patients can develop heavy nose bleeding after the surgery which can require hospital treatment.
  • Anaesthesia complications – these can include lung infection, stroke, heart attack or even death
  • Aesthetic problems – surgery can go wrong and patients can end up with unnatural contouring, dimpling or asymmetry, potentially leaving them in a worse position than previously.

How can you reduce the risk?

The best way to mitigate against the above risks before undergoing surgery, is to properly inform yourself about the procedure you are planning to undergo, and to research the surgeon or doctor you are thinking of using. BAAPS provides a set of consumer safety guidelines which include talking to your GP, knowing your surgeon, making sure you feel comfortable, and not being taken in by offers of “free” procedures or special offers.