Why asking 'how much' is the wrong question to ask when it comes to aesthetics.

Fiona Clark

Should price be your guide when it comes to aesthetic treatments? Harley Street Emporium Editor, Fiona Clark, explains why “how much” the last question you should ask.

We’re constantly bombarded with images on social media of celebrities and ‘influencers’ having an seemingly endless flow of treatments from Botox to butt lifts. Unfortunately this gives the impression that these are simple procedures that carry no risk – but this is simply not the case.

Here at Harley Street Emporium I get a lot of phone calls from people wanting all sorts of treatments, and often the first question they ask is “how much?”

At first I answered with the the price if I knew it (all of the doctors on Harley Street Emporium are independent clinics so sometimes I have to check) or I said I’d find out. Now, I’m not quite so polite – especially if it’s for a procedure that could scar, blind, pass on a blood borne infection or cause death. So, now I say: “I’m not sure if that’s the right question to ask.”

“Over dramatic” – I hear you say – “No one dies from cosmetic procedures!”

Well, actually they do.

Two UK women who travelled abroad for Brazilian Butt Lift operations died last year.

Recently we’ve seen professional bodies such as the British Association of Aesthetic Plastic Surgeons (BAAPS) advise UK doctors to stop doing Brazilian Butt Lifts done with a fat transfer because the risk of death is too high. It’s estimated that 1 in 3000 people die from this procedure as the fat finds it’s way into the blood stream, ending up in the heart, lung or brain, which can lead to death.

Complications are common too. Infection, pain, scarring, disfigurement – and it’s often the NHS that ends up picking up the pieces with an estimated cost of £13000 per patient, according to the BBC. On top of that, there’s the psychological damage this can cause.

But “ok – butt lifts are surgery so of course they carry a higher risk”, you say.

True, but many procedures that are classed as non-invasive also have risks.


Let’s take laser treatments, for example. There is a risk of burns and scarring if the individual who is doing them isn’t properly trained or, depending on the type of laser they are using, not working under medical supervision, or they simply haven’t checked the settings before they start.

While many companies require what’s known as a ‘level 4’ beauty qualification before they’ll train someone on a laser machine,  some companies provide weekend courses for people with no qualifications at all. The same applies for fat freezing devices.

So, yes, you may be able to find cheap treatments – but is the equipment they’ve bought calibrated regularly and of good quality? Is it approved for use in the UK with either a CE or FDA approval or did they buy it cheaply on amazon?

And, does the operator really understand what the laser does and how it works on different skin types?

Price is not a good guide.


“I’ve had a cheaper quote than that”

And what about PRP treatments? I’ve had a number of people say: “oh, I’ve had a cheaper quote than that.” And yes, they may have, but there are various reasons why someone could be offering a treatment at below the usual prices.

The first is the type of equipment that are using to spin the blood and extract the plasma. There is a significant variation in price on centrifuge machines and the quality of plasma you get from them as a result. Some do multiple spins to ensure you get the most growth factors and stem cells in your PRP. Others will only do one spin so the concentration is lower – and that means poorer quality PRP.


Secondly, are the machines they’ve bought safe from cross contamination of blood products – ie – is there a risk you could end up getting a blood borne disease like Hep C or HIV because there are traces of someone else’s blood mixed in with yours.  They should have disposable PRP kits for single use only and a latch-closed lid – preferable an inner lid as well.

And what about the dermapen they use to stamp the PRP into the skin – is it single use? If they are cost cutting and reusing them or are using a machine that doesn’t have a disposable needle head you are at risk of infection with a blood-borne virus.

Recently it was reported that two cases of HIV had been contracted in a New Mexico beauty spa in the USA. The New Mexico health authorities are testing more people who’d had the treatment there.

The spa has been shut down after an inspection by the New Mexico authorities “found unsafe practices that could have spread blood-borne infections, such as HIV, to clients,” CNN reports.

Which leads to the next question – equipment aside – is the practitioner medically trained and do they know how to safely handle blood products? If the answer is no – walk away.

But fillers safe, aren’t they?

Next, there are fillers. Yes, I know I go on about this, but fillers injected into blood vessels can cause skin death and even blindness. In 2015 a study was published saying there had been 98 reported cases of blindness. Since then there has been a case in the UK and one in Australia.

The study concluded that: “Although the risk of blindness from fillers is rare, it is critical for injecting physicians to have a firm knowledge of the vascular anatomy and to understand key prevention and management strategies.”

You can not learn that level of anatomy in a weekend course. I studied anatomy for three years at university, on cadavers not just pictures, and I wouldn’t inject someone’s face with filler.


The endless pictures of botched jobs on instagram shows that this isn’t as easy as it looks, and it should not be possible to do this without some form of medical training. In many countries around the world it is limited to doctors, nurses and dentists – and for very good reasons – it is a medical procedure.

To me, all of these examples (and there are more) show we are looking at this industry in the wrong way.

Cosmetic procedures can scar, cause disfigurement and psychological damage – and at worst can cost you your life.

They are medical procedures and – even though things can go wrong in medical hands – they are a much safer choice because they should be able to handle blood properly, understand the risk, recognise when things go wrong and be able to fix it.

That’s what you’re paying for.

So, before you decide on a procedure, ask the practitioners:

  • what are their qualifications
  • what training have they had in this procedure and how many have they done
  • are they insured
  • are they registered to practice with their respective professions regulatory body – GMC for doctors, GDC for dentists, or NMC for nurses
  • what is their aftercare policy if something goes wrong
  • are they members of professional bodies like the British Association of Cosmetic Nurses or British College of Aesthetic Medicine, BAAPs or BAPRAS for plastic surgeons, or BAD for dermatologists
  • what machines they are using and are the CE or FDA approved devices
  • if its filler or Botox, what brand is it and ask to see the box and make sure they don’t leave the room to fill the syringe. (Some people substitute cheaper products with the real thing or believe it or not – use leftovers from another patient. Again a risk blood borne infection!)

Most practitioners will appreciate that you’ve taken the time to do some homework and are interested in what is happening to your body, and if they take offence, perhaps they aren’t the right practitioner for you.

I don’t want to put you off procedures because it is a personal choice for each individual, but I do want you to think seriously about them because – if they go wrong – you could end up pay a big price for it.

So, how much is your face or body really worth?






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