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KN85004
KEY NOTE Market Report : COSMETIC SURGERY UK : October 2004

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This report covers: cosmetic surgery,non-surgical procedures, botox injections, laser treatments, laser surgery, laser hair removal, epilation, collagen, and, fat, therappy, fat transfer, redistribution, hyaliform, dermabrasion, microdermabrasion, chemical peeling, fat reuction, body sculpture, liposuction, liposculpture, abdominoplasty,apronectomy stomach lift, tummy tuck, lower body lift, upper arm lift, brachioplasty, buttock augmentation, breast enhancement, breast augmentation, augmentation mammoplasty, breast uplift, mastopexy, pectoral, male chest, augmentaion, male breast reduction,gynaecomastia, face lifts, and, associated operations, rhytidectomy, brow lift, eyelid rejuvination blepharoplasty, nose job, rhinoplasty, rhino tip, ear correction, otoplasty, facial implants, cellulite, treatment, endermologie, hair transplants, scalp reduction, cosmetic orthaognathic surgery, jaw alterations, sclerotherapy, tatooing, micropigmentation, male cosmetic surgery, non-invasive injectable cosmetic treatments, key trade associations,

Companies and associations covered include: American Society for Aesthetic Plastic Surgery, British Association of Plastic Surgeons, British Medical Association, European Association of Plastic Surgeons, International Confederation for Plastic, Reconstructive and Aesthetic Surgery, Royal College of Surgeons, of England, Royal COllege of Physicians, BUPA Hospitals, The Cosmetic Surgery Clinic, Cromwell Clinic, The London Laser Clinic, Nuffield Hospitals, Pountney Clinic, Transform Medical Group,

EXECUTIVE SUMMARY

The UK's cosmetic surgery market is a fast-growing subdivision of the private healthcare industry. Key Note estimates the value of the UK's cosmetic surgery industry at £224.6m in 2003. This industry has been experiencing strong growth over the past 5 years and between 2002 and 2003, the value increased by an estimated 9.4%.
The cosmetic surgery industry can be analysed in terms of four distinct sectors: non-surgical cosmetic procedures, fat reduction and body sculpting, breast enhancement, and face lifts and associated operations. Over the past 5 years the best performing sectors of cosmetic surgery in terms of year-on-year growth have been the fat reduction and body-sculpting sector and the breast enhancement sector.
Socio-economic factors are driving demand for cosmetic surgery in the UK. Low unemployment, increasing disposable incomes and ease of access to credit are bringing cosmetic surgery into the reach of more and more people. As a society, the UK has been following the US regarding the adulation of youth and beauty. Many people now feel under pressure both at home and in the workplace to maintain a youthful, toned appearance.
Women are the main customer base of the cosmetic surgery industry and the various types of cosmetic breast surgery are very popular in the UK. Media images of busty celebrities combined with a desire to look more feminine, youthful or 'normal' are increasing demand for cosmetic breast surgery. Face lifts and associated operations have been declining slightly in popularity over the last 5 years. This is largely due to increasing use of Botox® and other injectables such as collagen, which are less invasive than surgery. Demand for fat reduction and body-sculpting surgery has increased strongly during the early 21st century. Increasing levels of obesity, alongside celebrity use and endorsement of liposuction and other body-sculpting surgery are behind the rising demand. However, non-surgical cosmetic treatments are becoming increasingly popular because they are less invasive and are perceived as being less risky compared with conventional surgery.
Cultural emphases on youth and beauty are set to prevail in the UK over the next 5 years, so the outlook for the cosmetic surgery market is very favourable especially as the current economic stability is likely to continue until at least 2008. Demand for fat-reducing surgery and body sculpting is likely to continue due to an ever-increasing number of obese and overweight people. Non-surgical cosmetic procedures have proved popular since the late 1990s and advances in technology are likely to sustain demand within this sector over the coming 5 years.

TABLE OF CONTENTS

Executive Summary 1
1. Market Definition 8
REPORT COVERAGE 8
MARKET SECTORS 8
Non-Surgical Cosmetic Procedures 8
Botox® Injections 8
Laser Treatments 8
Laser Surgery 8
Laser Hair Removal (epilation) 9
Collagen and Fat Therapy 9
Fat Transfer and Redistribution 9
Collagen Replacement Therapy 9
Hyaliform 10
Restylane® 10
Dermabrasion 10
Microdermabrasion 10
Chemical Peeling 10
Fat Reduction and Body Sculpture 11
Liposuction 11
Liposculpture 11
Abdominoplasty and Apronectomy (stomach lift or 'tummy tuck') 11
Lower Body Lift 12
Thigh Lift 12
Upper Arm Lift (Brachioplasty) 12
Buttock Augmentation 12
Breast Enhancement 12
Breast Augmentation (augmentation mammoplasty) 12
Breast Reduction (mammoplasty) 13
Breast Uplift (mastopexy) 13
Pectoral (male chest) Augmentation 14
Male Breast Reduction (gynaecomastia) 14
Face Lifts and Associated Operations 14
Face Lift (rhytidectomy) 14
Brow Lifting 14
Eyelid Rejuvenation (blepharoplasty) 15
Nose Job (rhinoplasty and rhino tip) 15
Ear Correction (otoplasty) 15
Facial Implants 15
Other Miscellaneous Procedures 16
Endermologie/Cellulite Treatment 16
Hair Transplants and Scalp Reduction 16
Cosmetic Orthaognathic Surgery (jaw alterations) 16
Sclerotherapy 16
Micropigmentation (cosmetic tattooing) 17
Male Cosmetic Surgery 17
Market trends 17
Non-Invasive and Injectable Cosmetic Treatments Drive Growth 17
Blurring of the Distinction Between Medical and Non-Medical Procedures 17
Growing Demand for Surgery Abroad 17
Cult of Celebrity Influences Demand for Cosmetic Surgery and Treatments 18
'His and Hers' Cosmetic Surgery 18
ECONOMIC TRENDS 18
Gross Domestic Product 18
Table 1: UK Gross Domestic Product at Current and Annual Prices (£m), 1999-2003 18
Inflation 19
Table 2: UK Rate of Inflation (%), 1999-2003 19
Unemployment 19
Table 3: Actual Number of Unemployed Persons (million), 1999-2003 20
Population 20
Table 4: UK Resident Population Estimates by Sex (000), Mid-Years — 1999-2003 21
Household Disposable Income 21
Table 5: Household Disposable Income (£ and %), 1998-2002 21
Market Position 22
The UK 22
Overseas 22
2. Market Size 23
THE TOTAL MARKET 23
Table 6: The Total UK Market for Cosmetic Surgery and Cosmetic Procedures by Value at Current Prices (£m at rsp), 1999-2003 24
By Market Sector 24
Non-Surgical Procedures 24
Table 7: The Non-Surgical Cosmetic Procedures Sector by Value at Current Prices (£m at rsp and %), 1999-2003 25
Fat Reduction and Body Sculpture 25
Table 8: The Fat Reduction and Body-Sculpting Sector by Value at Current Prices (£m at rsp and %), 1999-2003 26
Breast Enhancement 26
Table 9: The Breast Enhancement Sector by Value at Current Prices (£m at rsp and %), 1999-2003 27
Face Lifts and Associated Operations 27
Table 10: The Face Lifts and Associated Operations Sector by Value at Current Prices (£m at rsp and %), 1999-2003 28
OVERSEAS TRADE 28
3. Industry Background 29
RECENT HISTORY 29
NUMBER OF COMPANIES 29
Table 11: Number of Private Hospitals and Clinics Offering Cosmetic Surgery and Procedures, 2003/2004 29
Employment 30
REGIONAL VARIATIONS IN THE MARKETPLACE 30
Table 12: Number of Private Hospitals and Clinics Offering Cosmetic Surgery and Procedures by Region, 2003/2004 31
DISTRIBUTION 31
HOW ROBUST IS THE MARKET? 31
LEGISLATION 32
KEY TRADE ASSOCIATIONS 32
American Society for Aesthetic Plastic Surgery 32
British Association of Aesthetic Plastic Surgeons (BAAPS) 32
British Association of Plastic Surgeons (BAPS) 33
British Medical Association 33
European Association of Plastic Surgeons (EURAPS) 33
International Confederation for Plastic, Reconstructive and Aesthetic Surgery (IPRAS) 33
Royal College of Surgeons of England 34
Royal College of Physicians 34
Other Trade Associations 34
4. Competitor Analysis 35
THE MARKETPLACE 35
MARKET LEADERS 35
BUPA Hospitals Ltd 35
Company Structure 35
Current and Future Developments 35
Financial Results 36
The Cosmetic Surgery Clinic Ltd 36
Company Structure 36
Current and Future Developments 36
Financial Results 36
Cromwell Clinic Ltd 36
Company Structure 36
Current and Future Developments 36
Financial Results 37
The London Laser Clinic Ltd 37
Company Structure 37
Current and Future Developments 37
Financial Results 37
Nuffield Hospitals Ltd 37
Company Structure 37
Current and Future Developments 37
Financial Results 37
Pountney Clinic Ltd 38
Company Structure 38
Current and Future Developments 38
Financial Results 38
Transform Medical Group (CS) Ltd 38
Company Structure 38
Current and Future Developments 38
Financial Results 38
OUTSIDE SUPPLIERS 39
Collagen 39
Other Injectables 39
Botox® 39
Restylane® 39
Skin 39
Breast Implants 40
Lasers 40
Marketing Activity 40
Table 13: Main Media Advertising Expenditure for Cosmetic Surgery and Cosmetic Procedures (£000), Year Ending December 2003 41
Exhibitions and Tradeshows 42
5. Strengths, Weaknesses, Opportunities and Threats 44
STRENGTHS 44
WEAKNESSES 44
OPPORTUNITIES 45
THREATS 45
6. Buying Behaviour 46
CONSUMER PENETRATION 46
Breast Enhancement 46
Table 14: Customer Penetration of Breast Enhancement by Sex, Age, Social Grade and Region (% of all adults), 2004 47
Face Lifts and Associated Operations 48
Table 15: Customer Penetration of Face Lifts and Associated Operations by Sex, Age, Social Grade and Region, (% of all adults), 2004 49
Fat Reduction and Body Sculpture 50
Table 16: Customer Penetration of Fat Reduction and Body Sculpture by Sex, Age, Social Grade and Region, (% of all adults,) 2004 51
Non-Surgical Cosmetic Procedures 52
Table 17: Customer Penetration of Non-Surgical Cosmetic Procedures by Sex, Age, Social Grade and Region, (% of adults), 2004 53
Cost of Cosmetic Surgery 55
Table 18: Guide Prices for Cosmetic Surgery at BUPA Hospitals (£), 2004 55
7. Current Issues 56
THE ROLE OF THE INTERNET 56
HEALTH ISSUES 56
PRODUCT DEVELOPMENT 57
SOCIAL CHANGES and CONSUMER DEMAND 58
LEGISLATIVE CHANGES 58
8. The Global Market 59
TOTAL MARKET SIZE 59
Table 19: Global Overview of Cosmetic Surgery Market by Country (% and rank),† 2002 59
MAJOR TRENDS 60
Table 20: Percentage of People Worldwide Who Have Surgery by Type of Operation (%), 2002 61
CONSUMER BEHAVIOUR 62
THE FUTURE 62
9. Forecasts 63
INTRODUCTION 63
FORECASTS 2004 to 2008 63
Table 21: The Forecast UK Cosmetic Surgery and Cosmetic Procedures Market by Value at Current Prices (£m at rsp and %), 2004-2008 64
FUTURE TRENDS 64
Demographics 64
Market Segmentation 64
Product Development 64
Technological Changes 65
Competition 65
10. Company Profiles 66
INTRODUCTION 66
DEFINITIONS 66
Turnover (Sales) 66
Pre-tax Profits 66
Profit Margin 66
Average remuneration 66
Bupa Hospitals Ltd 67
Nuffield Hospitals 69
11. Further Sources 71
Associations 71
Publications 72
General Sources 72
Government Publications 73
Bonnier Information Sources 74

Text © 2004 Key Note

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