THOUSANDS of women are getting breast enlargements, tummy-tucks and nose jobs on the National Health Service, prompting calls for a review of the number of operations being carried out for cosmetic and lifestyle reasons.

In the past five years almost 2,500 women had plastic surgery at NHS hospitals, at a cost of about £200m. Most have been carried out in Glasgow where, last year, £17m was spent on operations. In the past five years there have been 2,000 breast and tummy-tuck operations.

The release of the figures under the Freedom of Information Act coincides with mounting calls from surgeons for a clampdown on cosmetic surgery for non-medical reasons which, they claim, is wasting scarce NHS resources.

Demand at private clinics is booming, fuelled by the fashion for surgically enhanced celebrities such as the the glamour model Jordan, the celebrity Sharon Osbourne and the television presenter Anne Robinson.

While the bulk of breast operations on the NHS is to repair damage caused by cancer surgery, the new figures include a large number of breast reductions, tummy tucks and cosmetic procedures such as liposuction, rhinoplasty (nose jobs), pinnaplasty (an operation to pin back the ears) and penis enlargements.

Plastic surgeons in Scotland have drawn up strict new guidelines designed to limit the number of unnecessary operations being carried out at the public’s expense. Unless patients meet stringent psychological or clinical criteria they will not be referred to a hospital consultant. The guidelines have already been introduced in Greater Glasgow and are expected to be rolled out to other health board areas shortly.

Eileen Bradbury, a consultant health psychologist who assesses patients before they undergo cosmetic surgery, said: “It’s like putting your finger in a dam — demand for these procedures is growing exponentially. People do make up stories to get treatment. It’s not difficult to make up some tale about how you can’t cope because your nose is too big or breasts are too small.

“We have to make a proper evaluation, but there is a shortage of psychologists, which means that the decision is left to GPs, who may refer the patient because they are so insistent, and junior doctors, who may buy the story.”

John McGregor, a consultant plastic and reconstructive surgeon at St John’s hospital in Livingston, said: “There has been concern that the pressure of work on plastic surgeons in the NHS is such that we have to limit the number of people we have been dealing with who want purely cosmetic things done.

“Although the guidelines will allow plastic surgery where a psychologist or psychiatrist believes it might improve someone’s quality of life, we will not accept someone who wants a face-lift or breast augmentation when their features are normal.

“GPs are getting the message that if someone wants surgery purely for cosmetic reasons, they are unlikely to get it.”

In Fife, there have been 27 operations to pin back people’s ears since 2003, at a cost of £72,000. Last year, the health board spent £283,000 on plastic surgery. In Grampian, which spent £4.7m on cosmetic surgery in 2005, there were 26 breast enlargements, three liposuction procedures and four nose jobs last year, while Highland has notched up more than 200 tummy tucks, breast and nose jobs since 2000.

Lanarkshire’s figures include 58 circumcisions between 2001 and 2005, four liposuction operations, one face-lift and one thigh-lift. Lothian health board spent £10.8m on plastic surgery last year, followed by Grampian and Tayside, which spent £3.6m. Ayrshire and Arran, Highland and Argyll and Clyde spent £216,000, £70,000 and £77,000 respectively. Plastic surgery operations totalling £1.9m were carried out at the Golden Jubilee hospital in Clydebank.

Last year more than 20,000 Britons underwent plastic surgery, with an 80% rise among men seeking cosmetic treatment. Figures compiled by the British Association of Aesthetic Plastic Surgeons, revealed a 50% in the number of breast enlargements and a 35% increase in cosmetic surgery operations overall. The number of procedures to combat ageing, such as face-lifts, eyelid-lifts and brow-lifts rose by more than a third.

Surgeons have also blamed celebrity-obsessed magazines and television programmes for a dramatic increase in the number of schoolchildren undergoing cosmetic surgery.

Although many are suffering from depression and other psychological problems, there is evidence that the obsession with celebrity is making teenagers increasingly anxious about their appearance. The most popular procedures — which can cost up to £3,000 for private treatment — include nose reductions and breast enhancement.

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