{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T03:39:21Z","timestamp":1787110761087,"version":"build-2736575974"},"reference-count":16,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T00:00:00Z","timestamp":1680652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The proliferation of providers and practitioners of cosmetic botulinum toxin and dermal filler has profound public health implications. The Advertising Standards Authority (ASA) regulates the use of advertising materials in the United Kingdom and prohibits the promotion of prescription\u2010only medicines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aim to perform a cross\u2010sectional analysis of the practitioners in London, UK to evaluate the distribution of clinics within Greater London, prices advertised for interventions, and compliance with the ASA code. We also aim to identify whether there are any differences in cost of botulinum toxin or dermal filler between the boroughs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between December 2021 and January 2022, we performed a systematic search using the internet search engine Google. Five searches were performed (1) [london] botox, (2) [london] botulinum toxin, (3) [london] anti wrinkle injection, (4) [london] filler, (5) [london] dermal filler. One hundred websites per search string were systematically reviewed and those which met the inclusion\/exclusion criteria of each search string were included and analyzed. Each clinic's product\/service range compliance with the ASA\/CAP code was assessed. Any reference to Botulinum Toxin or anti\u2010wrinkle injections was noted and analyzed. Further analysis would look to calculate price per milliliter (mL) of botulinum toxin and dermal filler per borough and to calculate whether there were any statistical differences between the 32 different London boroughs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 500 websites were visited and evaluated. After removal of duplicates, a total of 233 independent clinics was identified. A total of 206 out of the 233 clinics sampled (88%) were in direct infringement of the enforcement notice through advertising a prescription medicine. The overall average cost per mL of dermal filler was \u00a3330.89 and there was a statistically significant variance across London boroughs (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The overall average cost per mL of Botulinum Toxin was \u00a3284.45 and the variance across London boroughs was close to significant (<jats:italic>p<\/jats:italic>\u2009=\u20090.058).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This paper demonstrates poor compliance with the ASA\/CAP guidelines and further provides an insight into the industry mechanics associated with aesthetic injectables in a major UK city, identifying regional variance in price and clinic density. The advertising of prescription\u2010only medication may pose a potential risk to patients and will be an important consideration in proposed legislation to introduce licensing to the industry.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.15750","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T15:20:01Z","timestamp":1680708001000},"page":"2520-2527","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cosmetic business mechanics in London: A cross\u2010sectional analysis and audit of <scp>ASA<\/scp> compliance"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7105-6832","authenticated-orcid":false,"given":"David","family":"Zargaran","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Zargaran","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Sousi","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Woollard","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Davies","sequence":"additional","affiliation":[{"name":"UCL Global Business School for Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Weyrich","sequence":"additional","affiliation":[{"name":"Department of Computer Science University College London  London UK"},{"name":"Friedrich\u2010Alexander University (FAU) Erlangen\u2010N\u00fcrnberg  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afshin","family":"Mosahebi","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,5]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Botulinum Toxin Market to hit USD 11.5 billion by 2030 Says Global Market Insights Inc [Internet].https:\/\/www.prnewswire.co.uk\/news\u2010releases\/botulinum\u2010toxin\u2010market\u2010to\u2010hit\u2010usd\u201011\u20105\u2010billion\u2010by\u20102030\u2010says\u2010global\u2010market\u2010insights\u2010inc\u2010882989249.html[Accessed 25 May 2022]."},{"key":"e_1_2_11_3_1","article-title":"The quality of online information regarding non\u2010surgical aesthetic procedures","author":"Sinha V","year":"2020","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"1","key":"e_1_2_11_4_1","first-page":"78","article-title":"The five competitive forces that shape strategy","volume":"86","author":"Porter ME","year":"2008","journal-title":"Harv Bus Rev"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000743"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002763"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107689909200817"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.4.2.105"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.14357"},{"issue":"8","key":"e_1_2_11_10_1","article-title":"Marketing cosmetic surgery \u2013 a qualitative analysis","volume":"141","author":"Johansen VF","year":"2021","journal-title":"Tidsskr nor Laegeforen"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2022.06.029"},{"key":"e_1_2_11_12_1","unstructured":"Enforcement Notice: Advertising Botox and other botulinum toxin injections on social media \u2010 ASA | CAP [Internet].https:\/\/www.asa.org.uk\/resource\/enforcement\u2010notice\u2010botox\u2010social\u2010media.html[Accessed 28 December 2022]."},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000774"},{"key":"e_1_2_11_14_1","unstructured":"Stats finder A\u2010Z \u2013 Eurostat [Internet].https:\/\/ec.europa.eu\/eurostat\/en\/web\/main\/data\/stats\u2010finder\u2010a\u2010z#[Accessed 28 December 2022]."},{"key":"e_1_2_11_15_1","unstructured":"Government to crack down on unregulated cosmetic procedures \u2013 GOV.UK [Internet].https:\/\/www.gov.uk\/government\/news\/government\u2010to\u2010crack\u2010down\u2010on\u2010unregulated\u2010cosmetic\u2010procedures[Accessed 25 May 2022]."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2021.05.074"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjac036"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.15750","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T10:30:21Z","timestamp":1691749821000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.15750"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,5]]},"references-count":16,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1111\/jocd.15750"],"URL":"https:\/\/doi.org\/10.1111\/jocd.15750","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,5]]},"assertion":[{"value":"2023-01-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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