The progress in the 1980's meant that cosmetic surgery could be performed safely with reliable results under a minimum of general anaesthesia. THis allowed cosmetic surgery to quickly move from the traditional hospital setting into the private surgical offices and clinics. Quickly commercial forces entered the profession. Large scale advertizing, via posters and magazines first, but surpassed quickly by the internet in the latter half of the nineties.
Business oriented companies with often aggressive sales strategies successfully took up a large part of the market. They have in common that they work with anonymous, often foreign doctors and surgeons, that can be replaced frequently. Admittedly, their competitive systems reduced the prices down to sometimes unrealistic proportions. As a result, at times quality suffered to the extend of being judged unacceptable by controlling bodies. Meanwhile, individual surgeons who withstood the pressure and kept their practices contained to their individual service gained reputability. They tend to distance themselves from the company system, and rely on general hospitals for the bigger procedures.
Analogous to the fashion industry currently the term "boutique" has entered the profession to indicate a comprehensive facility to allow the full spectrum of activity to take place under the same roof. It involves the necessary space, staff and equipment to serve the public with a definite surgical range, performed by the same surgeon.
In summary, the recently appearing boutique practices combine the comfort, safety and privacy of a private clinic, with the guarantee of a surgeon who will at all times be accountable and has his reputation to live up to every working day again.