Why we urgently need a regulatory framework for cosmetic surgeries in the country

Framework is necessary to ensure patient safety and establish accountability

India has emerged as a major destination for cosmetic surgeries due to affordable costs and skilled professionals. This rapid growth of the industry necessitates a pressing need for a regulatory framework to safeguard patient safety, ensure ethical practices, and establish accountability. By implementing standardized qualifications, informed consent guidelines, and a mechanism to address grievances, the government can protect patients and enhance the reputation of the cosmetic surgery industry in India. As we celebrate World Plastic Surgery Day this month, let’s have a look at some data and research to understand what potential benefits can be derived from a defined regulatory framework.  

According to search volume data, hair transplants were India's most popular form of cosmetic surgery as of January 2021, with over 30 thousand results per month. Liposuction and Rhinoplasty came next, with over 20,000 and 19,000 results, respectively. According to the Plastic Surgery Statistics Report 2020, the most common cosmetic surgery is nose reshaping, upper eyelid surgery, facelift, liposuction, and breast enlargement.  

The era of 'bigger is better' plastic surgery, where bigger breasts and buttocks were the norm for A-listers, seems to end in 2023. We are seeing a more subtle, understated aesthetic in a growing number of celebrities as a result of the influence of influencers and social media.  

These days, it is all the rage to flaunt a curvy but incredibly toned and muscular physique and average-sized bust. People's interest in liposuction and skin tightening procedures to try to tone their bodies is on the rise, and we think that this trend will continue as people start to lose weight after the pandemic.

In 2021, the global cosmetic surgery market was estimated to be worth USD 53.79 billion. The market is expected to grow from USD 55.65 billion in 2022 to USD 71.93 billion by 2030, at a 3.7% CAGR during the forecast period as per the Contrive Datum Insights Pvt Ltd. data.

The magnitude of the Black market  

Most hair transplant surgeons estimate that between 0% and 25% (6% on average) of their cases involve fixing a botched hair transplant performed on the black market, according to the 2022 ISHRS (International Society of Hair Restoration) census. A majority of ISHRS members, 51%, believe that unlicensed hair transplant clinics exist in their community. 73% also said "NO" when asked if the black market had an impact on how they set prices. Only a minority of people answered "YES" (15.8%). The census also revealed another cause for concern: a decline in patient confidence in hair transplant surgery due to "offering lower prices and unqualified surgeries." The above statistics only account for hair transplants performed by ISHRS members; the true global number is much higher.  

The absence of regulation, lack of ethics, and the black market have plagued other cosmetic procedures as well. All of this emphasizes the critical need for a cosmetic surgery regulatory system in India.

Reasons for the requirement of regulation in cosmetic surgeries in India

1. Patient Safety: The safety of patients undergoing cosmetic surgery is the primary concern. Proper regulations ensure that these procedures are performed by qualified and competent professionals, lowering the risk of complications and negative outcomes. Setting guidelines for surgical facilities, equipment, and hygiene practices can improve patient safety significantly.

2. Practice Standardization: A regulatory framework aids the standardization of practices in the cosmetic surgery industry. It can specify the qualifications, training, and experience that practitioners must have to meet a certain level of competence and expertise. This helps to keep unqualified or inexperienced individuals from performing procedures that could endanger patients.

3.   Reduction of Unethical Practices: Regulations may address industry-wide unethical practices. This includes guarding against false advertising, misrepresenting credentials, and pressuring patients into undergoing unnecessary or inappropriate procedures. It is possible to identify unethical practitioners and hold them accountable by establishing clear rules and protecting vulnerable patients.

4. Consumer Awareness and Informed Consent: A legal framework can support informed consent by fostering consumer awareness. It may be necessary for practitioners to give patients thorough information about the drawbacks, advantages, alternatives, and possible results of cosmetic procedures. This gives patients the power to decide on their treatments with knowledge and guarantees that they know the implications and potential drawbacks.

5. Prevention of Medical Tourism Risks: India is a well-liked location for cosmetic surgery and other types of medical tourism. Regulations are put into place to protect the interests of both domestic and foreign patients seeking cosmetic surgery. Building a foundation of trust and confidence in the standard of care lowers the risks connected to unregulated practices and subpar facilities.

6. Postoperative Care and Follow-Up: The requirement for postoperative care and follow-up can be addressed by adequate regulations. It can outline the obligations of the practitioners in terms of delivering suitable aftercare, handling complications, and making certain that appropriate follow-up consultations are held. This is essential for the health and recovery of patients and can assist in quickly identifying and resolving any postoperative problems.

7. Data Collection and Surveillance: A legal framework makes it possible to gather precise information about cosmetic surgery, such as figures on procedures performed, complications, and results. For research, analysis, and monitoring of industry practices, as well as for evidence-based decision-making and quality improvement, this information is crucial.


Current global trends show that the number of Cosmetic surgeries increasing at a higher pace, which also created a parallel black market, unethical practice & caused mistrust and fear among patients for cosmetic surgeries.   Hair transplant surgery is the most popular surgery in the world, particularly in India, and a lack of regulation has increased repair or botched hair transplants. Other cosmetic procedures, such as surgical and non-surgical rhinoplasty, Botox® and filler treatments, liposuction, facelift, and breast enlargement, are also affected.  

As a result, an urgent regulatory framework for cosmetic surgeries in India is required to prioritize patient safety, standardize practices, prevent unethical behavior, raise consumer awareness, address medical tourism risks, ensure postoperative care, and facilitate data collection and surveillance. These regulations have the potential to improve the overall quality of cosmetic surgical procedures, protect patients, and foster a responsible and accountable industry.

Dr Mohd Asif is the co-founder of Cara Clinic

The opinions expressed in this article are those of the author's and do not purport to reflect the opinions or views of THE WEEK