Patients are being put at risk by cosmetic surgery firms, with a failure to monitor them proving a "recipe for disaster", according to a damning report.
Fewer than half of sites performing operations have a fully equipped operating theatre and far too many firms will just "have a go" at procedures.
The report, from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD), said the regulation of the cosmetic surgery industry "remains poor".
It found training in cosmetic surgery is available at just 16% of sites, with the rest failing to provide any training.
Almost one in five (18%) units have no policy on what to do if patients needed readmitting in an emergency following their operation, with the "default position" being the NHS will pick up the tab and provide care.
The report also found many units do not carry out enough procedures on their "menu" to ensure their surgeons retain expertise, despite the fact "experience and competence run hand in hand".
It said: "With the exception of breast augmentation, the majority of centres performed fewer than 20 of the offered procedures per year."
Experts also revealed that 32% of firms do not offer a "cooling off" period as laid down in rules from the General Medical Council on obtaining proper consent, while 22% do not have a member of resuscitation staff on duty at all times.
There was also evidence of companies flouting rules on advertising and promotions, with the existence of a voluntary code of conduct being "insufficient to regulate unscrupulous advertising that could take advantage of the vulnerable patient."
Just 64 out of more than 350 sites said they referred patients to the Government's independent information on cosmetic surgery and only 35% of sites carried out routine psychological assessments before patients went ahead with surgery.