The number of regulated clinics in Scotland able to provide cosmetic treatments such as Botox and filler injections has soared by more than 150% amid a boom in demand for non-surgical procedures.

Figures obtained by The Herald show that the number of independent clinics registered with the watchdog, Healthcare Improvement Scotland (HIS), has gone from 200 in April 2017 to 503 in 2023/24.

HIS said that "most, but not all" of the 503 independent clinics are offering some kind of cosmetic procedure.

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The exact size of the sector in Scotland is difficult to quantify, however, as a large number of practitioners - such as beauty therapists - can offer treatments such as filler injections without having to register with HIS.

Campaigners warn that the unregulated market is endangering consumers.

Ashton Collins, director and founder of Save Face, which was set up in 2014 to raise awareness of problems engulfing the sector UK-wide, said: "Undoubtedly there is a rise, in both medical and non-medical people entering this sector.

"That growth [in the number of clinics registered with HIS] isn't necessarily surprising to us given the volume of enquiries that we deal with from members of the public, and complaints, which are in the most part about the non-regulated practitioners.

"Over the past 10 years we've helped about 15,000 members of the public and, on average, about 85% of those complaints are about non-healthcare professionals.

"It's that side of things that causes us the greatest deal of concern because a lot of these practitioners operate in the shadows.

"They operate like ghosts."

The Scottish Government is currently weighing up what to do about regulation of the cosmetic sector, with an update expected at the end of September.

It comes as the Herald launches its latest in-depth series today, exploring current trends in the surgical and non-surgical cosmetic sector, how it has evolved, and the challenges and changes facing the industry.

Data from the British Association of Aesthetic Plastic Surgeons (BAAPS) shows that the total number of surgical procedures such as facelifts, nose jobs, and breast enlargements being performed in the UK peaked at 51,140 in 2015.

By 2023, it had fallen to 25,972.

The Herald has heard that cosmetic plastic surgeons working in the larger private hospital chains have found their theatre allocations squeezed in recent years as providers have prioritised operations such as hip replacements from a growing number of self-funding patients.

A spokeswoman for BAAPS said this had been driven by the "increased profit margins that orthopaedic surgery brings to the private hospitals", with the trend accelerating after Covid as a result of NHS backlogs fuelling more patients to go private.

There are concerns that the situation is contributing to a surge in people going overseas.

A spokeswoman for BAAPS said: "If it becomes increasingly difficult to see someone here, and it's already incredibly expensive here by comparison, the lure of going abroad to have cosmetic surgery at a cheaper price is going to be attractive."

BAAPS estimates that the average cost to the NHS of treating complications following cosmetic surgery abroad is around £15,000 per patientBAAPS estimates that the average cost to the NHS of treating complications following cosmetic surgery abroad is around £15,000 per patient (Image: Getty)

Ken Hay, Scotland chair for the Independent Healthcare Provider Network (IHPN), said there were "ebbs and flows all the time" in private hospitals and providers were mainly responding to changes in demand from patients, rather than profit margins.

Demand for cosmetic procedures were more likely to fluctuate with the economy, he added: “When times are better and there’s more demand, demand for cosmetic surgery goes up."

Mr Hay said that while hip replacements were "at the higher end of profitability" on an individual basis, they tended to require longer theatre time and hospital stays for patients which impacts on capacity.

"Delivering say six hip replacements in a day is much more resource intensive than delivering 10 cosmetic procedures in the same period.

"It’s not quite as straightforward as looking at one individual procedure in isolation.”

Mr Hay stressed that - in his view - people were going abroad for cosmetic surgery because it is cheaper, rather than due to UK waiting lists.

“The only reason I’ve ever heard for people going abroad for surgery is cost,” said Mr Hay.