Why does a young mother have to die for the UK to regulate the 'wild west' aesthetics industry?
Today, my morning routine had all the mundane and familiar hallmarks that any busy parent would recognise. The sound of milk sloshing over Weetabix, the braiding of two sets of pigtails, the searching for school bags and the smiles through gritted teeth while repeating ‘put your shoes on’ for the thirtieth time. It’s a privilege, albeit one wrapped in micro-moments of bedlam, that I wouldn’t trade. And it’s one that Alice Webb will never experience again.
Following the news that the 33-year-old mother-of-five had been rushed to Gloucestershire Royal Hospital last Monday, hours after she reportedly had a liquid Brazilian Butt Lift (BBL) - a non-surgical treatment that sees dermal filler or biostimulators injected into the buttocks to change their size or shape – came the news I’d been dreading since the notification first flashed up on my phone. In the early hours of Tuesday morning, Alice died; she is thought to be the first first person in the UK to lose their life to the procedure.
In the seven days since the news broke, I’ve been watching the story closely. Alice’s cause of death hasn’t been made official and news stories linking her death to a BBL came via Save Face – a government approved national voluntary register of accredited practitioners who offer non-surgical cosmetic treatments - who released a statement after having been in touch with her family. The treatment is believed to have been performed at a clinic in Gloucester and two people have been arrested on suspicion of manslaughter.
But based on what we do know, Alice’ death was preventable; the consequence of a dysfunctional but booming aesthetics industry, amoral businesses and a government who failed to heed the warnings of the industry that the existing legal framework made a death like this highly likely. And as someone who has written about the beauty industry for over a decade, it pains me to say I’m not surprised that this has finally happened.
High risk
BBLs are particularly controversial because, according to the NHS, they have the highest death rate of any cosmetic procedures (previously cited as 1 in 3000). Complications can arise because the treatment involves injecting filler, which can travel to the heart or brain via tiny bloody vessels. Issues can include severe bacterial infections to tissue dying, wound ruptures and abscesses.
A liquid BBL differs to surgical BBL as the latter involves transferring fat from another part of the body, such as the abdomen or thighs, to the buttocks. It's usually performed under general anaesthetic and carries the same risk factors. Currently, there is no legal framework on who can carry out aesthetic treatments such as BBLs and injectables, meaning non-medically qualified persons are legally allowed to buy the equipment and perform the treatment on members of the public.
Last year, Wolverhampton City Council banned a company from carrying out the procedure after identifying risks associated with their processes, including blood clots, sepsis, and the potential for the death of body tissues. Five local authorities in Essex and Glasgow followed suit and have banned certain companies from carrying out BBLs. That these decisions are left to the whims of local city councils means that women’s lives have become a game of Russian roulette.
For years, campaigners at Save Face, as well as the Joint Council for Cosmetic Practitioners (JCCP) and The British College of Aesthetic Medicine (BCAM), have been calling for stricter guidelines on non-surgical treatments, such as BBL. ‘It feels as though we’ve been shouting into a void,’ says Dr Sophie Shotter – an aesthetic doctor who's been publicly calling for tighter restrictions for years and who took to Instagram to share her anger with her audience hours after reports of Alice being hospitalised emerged. ‘I first sat down with my MP back in 2019 after an horrific complication from an unqualified practitioner came to my attention - and still little progress has been made.’
Since December, Save Face has been calling on the government to ban high-risk liquid BBL procedures. They launched a public campaign after research they carried out revealed that 99 per cent of medical professionals do not perform BBL procedures as they deemed them too dangerous. Despite this, they’re being offered by laypeople, hairdressers and beauticians who have no healthcare experience and are unable to manage potential complications. Their findings led them to conclude that unless urgent action was taken, someone could lose their life.
The Sunak Conservative government didn't respond to the Save Face campaign directly. But action was already underway regarding a consultation paper published in September 2023; the paper acknowledged growing concern that some procedures carry risks and can lead to serious complications if not correctly done. The proposed move towards licensing cosmetic practitioners and the premises they work from is still in motion. If it comes into effect (the Starmer Labour government haven't yet confirmed their plans, but more on which below) the new licensing scheme will make it an offence for anybody to carry out non-surgical cosmetic treatments without a license - which only qualified medical professionals will able to obtain. Had this scheme been enacted a year ago, I can’t help wonder if five children would still be caught up in this heartbreaking nightmare.
Home truths
Until now, deaths from aesthetic treatments have only ever happened abroad. According to the Foreign Office, 28 Britons have died as a result of cosmetic surgery in Turkey alone since 2019. Last month, Kaydell Brown, 38, of Sheffield, died after having a 'mum MOT' in Turkey that included a Brazilian butt lift, tummy tuck and breast enlargement; 31-year-old Melissa Kerra, from Gorleston, Norfolk, died in 2019 from a BBL after injected fat entered a vein and blocked her pulmonary artery. Her family praised the coroner for committing to asking the government to warn people about cosmetic procedures abroad. Others include Abimbola Ajoke Bamgbose and Leah Cambridge, who both died after visiting Turkey to get BBLs.
But Alice’s story is stark reminder that the UK cannot afford to claim the moral high ground. In America - a country where you can buy and own military-style semiautomatic assault weapons - there are strict regulations on cosmetic procedures, allowing only licensed doctors and nurses to perform Botox, fillers, or BBLs, tells you all you need to know. Not only would comprehensive regulation make it illegal for anyone but qualified medical practitioners to perform these procedures, it would have the secondary effect of raising awareness of just how dangerous they really are. '[The public] believe that if a PA or chiropodist is allowed to carry out these treatments, the risks must be low,' adds Dr Shotter. 'They don't question it.'
Following Alice's death, a Department of Health and Social Care spokesperson told WH that while they couldn't comment on this specific case, patient safety is 'paramount'. 'We would urge anyone considering a cosmetic procedure to consider the possible health impacts and find a reputable, insured, and qualified practitioner. The government is exploring options around regulatory oversight of the non-surgical cosmetics sector and will provide an update in due course.'
Time to act
Of course, at the heart of this tragedy, is a bigger conversation about beauty standards. I have no doubt that some will victim-blame Alice, believing that women who opt for the treatments are at best vain, and at worse, irresponsible. And yet, every day, women have to navigate the double-edged sword that is oppressive and toxic beauty ideals; your bum must be pert to align with zeitgeist-y body type that’s dominated social media feeds since Kim Kardashian who appeared naked on the cover of Paper a decade ago. But faking it via a treatment? Well, that's obviously cheating.
The most attention-grabbing outcome of the UK's obsession with the perfect body type is the casualties. But the deeper implications of this growing fixation on BBL is both upsetting and incredibly bleak. Not only does it underscore the notion that many of us must fight to feel comfortable in our bodies, but that there's a deep misogyny at play, which means women are unable to make informed decisions within a safe and well-regulated industry. We owe it to ourselves, and to Alice, to keep fighting for regulation in the hope that it will prevent more women dying needlessly.
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