The young and beautiful Kate Middleton, Duchess of Cambridge, has inspired fan sites like So Kate Middleton and fashion followers like the Kate Middleton Style Blog, to name just a few. But taking any idea too far can cross the line from interesting and fun to ridiculous and dangerous.

An advertisement in a UK media outlet that promotes liposuction as a way to ‘get a waist like Kate’ crosses that line and has brought the age old problem of over-promising and under-delivery in cosmetic procedures back into discussion. Considering the vast popularity of such procedures worldwide, both in the UK and here in Australia, this is a problem that needs to be addressed.

Surgeons, bloggers and traditional media are criticising the ad and its misleading premises. It is not easy or even possible to ‘get a waist like Kate’ or come close to getting one, especially after only having liposuction.

For one thing, waist size is determined by many more factors than just how much fat can be removed through liposuction from around the waist area. Liposuction only removes the superficial layers of fat deposited close to the skin. Intrabdominal fat—deposited in deeper layers and around organs—which also has an impact on waist size, cannot be removed with liposuction.

According to surgeons, other factors that determine waist size, include the width of the pelvic bone and the height of the mid torso have a large genetic component. Cosmetic surgical procedures such as tummy tucks can reduce the levels of fat deposits in the tummy and around the waist and help tighten up the muscles. Beyond that, unless you’ve won the genetic lottery, you cannot realistically hope to get a waist like Kate’s.

Even for those who have inherited a body type and shape similar to the young Duchess, and a body frame with little fat or muscle, will still need an ongoing workout regime or a starvation diet to maintain that shape. No one interested in his or her health and wellbeing would recommend the latter course.

Unrealistic expectations in cosmetic surgery

Consumers’ unrealistic expectations about what cosmetic surgical and non-surgical procedures can achieve did not grow to such huge proportions overnight. On its website, the British Association of Aesthetic Plastic Surgeons (BAAPS), which is associated with the Royal College of Surgeons sets out a timeline of what it calls Cosmetic Surgery’s Wild West.

As you read this timeline, think of how things have changed in Australia during the same period, and how such developments can lead to fantastic and utterly unrealistic expectations of what is possible with cosmetic medicine.

  • In 2004, BAAPS warned the public against unrealistic expectations set by ‘makeover’ TV shows and against increasingly advertised cosmetic surgery vacations.
  • The same year they issued consumer safety guidelines for people considering cosmetic surgery. The guidelines urged consumers to make their own decisions, to be informed, to be comfortable and to get to know their surgeons. They also stressed the need to beware of free consultations, booking fees or non-refundable deposits.
    BAAPS guidelines also advised consumers to take their time and remember that they can always change their minds.
  • The following year (2005), BAAPS cautioned teenagers considering cosmetic surgery, warning them against multiple surgeries being touted as ‘total body overhauls’ and surgical procedures offered as competition prizes by media outlets (magazines and radio stations). They also mentioned that such deals were being offered via loyalty cards and through discount and Christmas vouchers.
  • By 2006, BAAPS felt it necessary to comment on schemes offering travel vouchers in exchange for booking ‘summer body’ surgical procedures. They also noted the launch of a ‘Divorce Feel-Good’ package. It was at this point that the BAAPS Annual Meeting focused on the theme of psychological readiness for surgery, highlighting top warning signs in patients.
  • In 2007, a lottery was launched by texting in to win surgery abroad. Other disturbing trends included a website asking women to post suggestive photos offering boob jobs and anti-wrinkle-injections going on sale in a clothing catalogue. BAAPS also cautioned the public against a proliferation of medi-spas: Non-surgical does not mean non-medical.
  • In 2008, in addition to launching the UK’s first breast augmentation survey, BAAPS expressed concern about plans for deregulating laser and IPL treatments and called out advertisers using inappropriate methods of promoting cosmetic surgery.
  • By 2009 BAAPS was warning consumers against growing complications from inexpert use of dermal fillers and injectables available for sale on the Internet. It reported that one in four surgeons had to correct problems caused by faulty products and unskilled injecting techniques.
  • 2010 brought the PIP implant scandal.
  • By 2011, injectables were being offered to passersby at consumer trade shows; breast augmentation and anti-wrinkle-injections were being given as raffle prizes at a nightclub; and unproven procedures promoted as ‘non-surgical’ and ‘lunchtime’ treatments were getting airtime on morning chat shows. Consumers were bombarded with cut-price surgery offered through discount websites like Groupon, and magazine readers were invited to vote on which competition hopeful was ‘most worthy’ of winning surgery each week.

And things go on…


As you can see from the UK timeline—which is not that far off from what was and is currently happening in Australia—things gradually grew to the stage where product and service promoters who unscrupulously over-promised were actually getting away with it.

The responsibility cannot entirely be left to the regulators of truth and fairness in advertising. Consumers who fail to do their homework about products, procedures and service providers will continue to fall prey to fantastic promises.

You can find many plastic and cosmetic surgery horror stories on the internet. The women whose stories are reported in the links below lost their lives in the quest for beauty and perfection.

If you read these and other stories—and there are many—you will find in all of them the common threads of inexperienced or untrained surgeons, unlicensed doctors, unaccredited facilities, improper use of anaesthetics and unsuspecting badly informed consumers.

If research tells you that deaths are indeed rare in cosmetic surgery, it assumes that the procedures are performed under proper conditions with experienced, well-trained and accredited surgeons and anaesthesiologists, in accredited facilities using proper materials, and with high levels of post-operative care. If any one of these is missing in the equation, your safety and life are at risk.

Some of this is your responsibility. Unscrupulous people involved in promoting these practices are unlikely to tell you the real risks. They will only deliver fantastic promises, like a waist like Kate’s.

Evaluating such claims is a vital part of doing your homework before any procedure. Every cosmetic procedure has its inherent elements of risk. In very rare cases, some can cause death. Some consumers, due to their genetic makeup, medical conditions or lifestyles, face higher levels of risk than others. Only ethical and professional surgeons and service providers will tell you what your risks are and obtain informed consent.

Lack of a thorough discussion of risks and an informed consent process prior to a procedure is a huge red flag that prospective patients must never ignore.

Beware of fantastic promises. Be informed. Be cautious and be safe. Don’t rush in to any cosmetic procedure. That death and life-threatening complications are rare in cosmetic medicine means nothing if your life is the one at risk.

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