Dear Editor,We reviewed with great interest the article reviewing plastic surgical training in the UK: results from a national survey of trainee experiences. In particular we would like to consider the authors point with regards to aesthetic surgery. It is well known that aesthetic services are becoming increasingly more accessible due to the increasing number of health practitioners providing them. However; we feel that this subject is still considered ‘taboo’, within the Plastic surgery field; with many trainees feeling unable to express a desire to develop such skills let alone openly pursue training in them. This leads to practitioners from other specialties leading the way with the provision of these services, and in many cases therapists with no medical qualifications at all.Unfortunately patient safety is an underlying issue within aesthetic surgery as highlighted by the Department of Health (DOH), who found low compliance to national guidelines set up to protect patients from harm. The materials used in many aesthetic procedures have the potential to be harmful to patients when used in unskilled hands without adequate training. Moreover, many centers offer monetary discounts with multi-buy offers to entice customers which arguably raises ethical considerations with regards provision of treatments. With the increased demand for aesthetic procedures and the potential financial incentive associated with delivering them; we are concerned of the possibility that risks are being under appreciated and those delivering these services may not have an in-depth understanding of the potential harm that can be caused. Furthermore, we argue that those delivering the procedures should only do so if qualified to recognize and manage potential complications that may arise. Surely with the clinical and ethical complexities of aesthetic practice those best placed to deliver this service are those with comprehensive training in the soft tissues and anatomy of the human body, such as plastic surgical trainees.There is also a significant financial burden arising from attending courses outside the scope of surgical training in order to develop experience with aesthetic skills. We echo the authors’ sentiments that perhaps it is time to reintegrate aesthetic surgery into the plastic surgery curriculum due to the fact that plastic surgical trainees will be expected to manage patients presenting with complications from their privately provided aesthetic procedure. We also feel it is a waste of resources having experienced tutors adept in these procedures but who are restrained from training plastic surgery trainees as part of their existing scheduled training.We would support more focus on aesthetic surgery within the surgical curriculum at an earlier stage so that trainees feel equipped to provide these services and manage the complications effectively. This would help with the move away from aesthetics as a ‘taboo’ subject amongst trainees, encouraging the development of these skills in a timely fashion facilitating a more informed appreciation and understanding of the physical, psychological and financial implications associated with aesthetic procedures.