「经济学人」TikTok, fillers and fraud

The world-famous medical district wants science, not salmon-sperm facials

Harley Street, a famous medical district in London, is an unusual place. It is highly successful, accounting for 40% of the capital’s private-health-care market by revenue—and 10% of Britain’s. It is almost entirely owned by aristocrats: the Howard de Walden Estate controls around 850 properties in Marylebone, one of the poshest parts of the capital. Go for a consultation and you may find yourself entering a Georgian town house with a plaque outside honouring a former occupant. “Florence Nightingale left her hospital on this site for the Crimea” is carved into the brickwork of one dental clinic. Leave with a swollen mouth and a sense of history.

Its stock-in-trade is excellence. Foreigners fly in for surgery at the London Clinic and King Edward VII’s, private hospitals which treat kings and queens. In April the de Walden Estate opened Hale House, an innovation hub for health-tech startups and life-sciences pioneers. Yet Harley Street has also long pulled in quacks. In 1830 an early practitioner tried to cure tuberculosis with a mix of egg yolk, vinegar and turpentine, only to kill two patients (he does not have a plaque). Today’s bad boys are rogue plastic surgeons.

Last year a doctor was suspended from treating patients after performing a “penis-filler” operation and offering “Barbie-tip” rhinoplasty and lip filler as prizes during lockdown. An influencer is suing a physician over breast implants she claims are too large. For many potential clients, TikTok spreads the word: “Come get a nose job with me,” chirps one video from a patient. Laser facelifts and salmon-sperm facials (yes, involving injections of fish semen) are popular.

This is not the image the de Walden Estate wishes to cultivate. “People overuse the Harley Street name,” sighs Mark Kildea, the estate’s chief executive, pointing to Harley Street clinics in Birmingham and Singapore. For the past decade the estate has tried to reduce its cosmetic practitioners, courting hospital groups and research institutes instead (the Cleveland Clinic, the Mayo Clinic and Fortius, Europe’s largest orthopaedics group, are among the tenants). In 2023-24 plastic surgery made up only 7% of private stays in the district. Cancer treatment accounted for 27%, digestive health 25% and orthopaedics 9%.

The area wants to excel at tackling “ageing diseases”. Mr Kildea points to Re:Cognition Health, a clinic leading trials for lecanemab, an Alzheimer’s drug. At the office where Lionel Logue helped King George VI overcome his stutter—featured in an Oscar-winning film, “The King’s Speech”—patients can now get same-day scans. Harley Street is changing its image in other ways. A decade ago number 29 was a hub of international fraud, housing more than 2,000 companies. Today? The estate bought the property back, says Mr Kildea. It is now a women’s health centre.

This article appeared in the Britain section of the print edition under the headline “Away with TikTok, fillers and fraud”(May 29th 2025)

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