PLASTIC surgeons are to be issued with a checklist to weed out the increasing number of patients who are becoming “addicted” to cosmetic surgery to improve their appearance.

Adam Searle, the president of the British Association of Aesthetic Plastic Surgeons (Baaps), will tell fellow surgeons at a conference to be on the lookout for patients hooked on cosmetic surgery or Botox treatments and those who have “imagined ugly syndrome”, also known as body dysmorphic disorder.

The ready availability and increasing social acceptability of cosmetic surgery have fuelled demand. Research by Baaps released in May found there were 22,041 cosmetic operations excluding Botox injections in Britain last year, up 35% on 2004. These included 5,646 breast enlargements.

Even surgeons who profit from the boom are now admitting some of this treatment may be unnecessary. Searle is drawing up a checklist for fellow surgeons to help them avoid treating patients who return for repeat procedures simply because they get a “buzz” from their new looks or because they are fixated with perfecting the appearance of a particular part of their body.

“There are people who develop a dependency on the support they appear to get from cosmetic surgery. Cosmetic surgery is potentially habit-forming,” said Searle.

“These people feel a sense of psychological wellbeing after one procedure and this fuels the notion that they would feel even better if they had another.”

Patients with “imagined ugly syndrome” may never be happy with the changes brought about by surgery. Searle will warn surgeons that if they treat a patient with this disorder they may exacerbate the condition. The patient is unlikely to be content with the outcome and may blame the surgeon for making what they regard as a deformity worse.

“These patients . . . will be surprisingly vague about what they believe to be wrong with the part of their anatomy they are unhappy with. They will say, ‘It is just not right’.”

Patients using Botox injections to reduce facial wrinkles are particularly prone to compulsive behaviour. One study to be presented at the Baaps conference shows 40% of patients using Botox expressed a compulsive drive for futher treatment.

The research, by Martin Kelly, a plastic surgeon with London Plastic Surgery Associates, says: “Botox injection is the fastest-growing cosmetic procedure yet the addictive appeal surrounding Botox has been largely ignored.”

The rise of celebrity culture has played a significant part in the growth of cosmetic surgery. Sharon Osbourne, the television presenter, has spoken openly of spending up to £300,000 on plastic surgery, including having her breasts, legs and bottom altered.

Dr Eileen Bradbury, a consultant psychologist at the Alexandra hospital in Cheadle, near Manchester, treats patients who have become hooked on cosmetic procedures.

“People can become addicted to the anticipation, the excitement and the attention they receive,” said Bradbury. “There is a short-lived result of feeling fabulous. But the post-procedure high fades, life goes back to normal and all the mundane problems come back so you need to go for another fix.”

Cindy Jackson, 50, from London, has spent a reported £50,000 on nine operations involving 21 procedures since 1988, which she documents on her website. She has had cheek implants and reshaped her knees by using liposuction from her waist.

At one stage she had her breasts enlarged from a C to a D cup, but then changed them back again because she was uncomfortable with the silicone. She also submitted to dermabrasion, a procedure in which the skin is removed with a rotating wire brush until raw. As it heals, the skin thickens to give a more youthful appearance.

The appearance of Jocelyn Wildenstein, the 60-year-old US socialite, is a stark warning to cosmetic surgery candidates. She was dubbed “Catwoman” and “the Bride of Wildenstein” after she spent a reported £2m on plastic surgery.

Additional reporting: Will Iredale

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