Why did nobody stop me wasting £1m to be the world's most nipped and tucked woman? Alicia Douvall's 16 boob jobs, six nose jobs and 308 cosmetic treatments

She has had more than 330 cosmetic  procedures and operations – far outstripping American Cindy Jackson, usually credited with being the world’s most surgically-enhanced woman.
Former English glamour model Alicia Douvall – best known for her kiss-and-tell affairs with celebrities including music mogul Simon Cowell – claims to have spent more than £1 million on boob jobs, facelifts and even toe shortening operations.
But it has all come at a cost. Ms Douvall claims the work has turned her into an enhancement addict who has been treated in rehab on three occasions – and she has now turned on the plastic surgeons she says should never have encouraged her obsession with looking like Barbie. 
Ms Douvall, who has been linked to a series of celebrities including actor Mickey Rourke and former Simply Red singer Mick Hucknall, said she had undergone so many potentially dangerous and painful operations and procedures – at one point at the rate of one a week – because she was  convinced she was ugly.
A grown woman saying her primary reason for wanting cosmetic surgery is to ‘look more like Barbie’ would be a cause for concern, even to those with no medical training.
Yet unscrupulous  surgeons agreed to operate on her  for just this bizarre reason not once, but more than 50 times.
She claims to have spent up to £1 million on these and other cosmetic procedures such as injections of Botox and fillers, telling surgeons she wanted to be ‘perfect’.
‘I often used that word,’ says the 34-year-old. ‘I took a Barbie doll to one medical consultation to show them exactly what I was after.
'I was unwell; addicted to surgery. But none of those doctors tried to stop me. I think they just wanted my money.’
Alicia is speaking candidly about her predicament as part of our Stop The Cosmetic Surgery Cowboys campaign.
We are calling for a raft of legislative changes to protect public safety, one of which is that patients must have a 30-minute consultation with their surgeon where they are properly assessed – physically and mentally – before being booked in for cosmetic surgery.
Consultant plastic surgeon Kevin Hancock, of the British Association of Aesthetic and Plastic Surgeons (BAAPS), says: ‘A sizeable minority of those seeking cosmetic surgery aren’t psychologically suitable for a life-changing procedure – particularly if they seem excessively concerned about an imagined defect, or worry their perceived flaw is unduly affecting other aspects of their life.
‘BAAPS surgeons regularly turn away one in five patients, in many cases for mental health reasons, but the sad reality is that, even when we urge them to seek support from a psychotherapist, they may simply continue to shop around until they find a less-conscientious provider who will treat them.’
The association is developing a standardised questionnaire that would flag up those at risk – a tool that could be adopted by all clinics.

Patients would be asked if they’d had multiple operations and assessed for unrealistic expectations. Under these criteria,  multiple areas for concern would have been raised over Alicia.
Since her first breast augmentation when she was just 17 – and she has had 16 such operations – the former model and mother of two has undergone six nose jobs, 11 operations on the skin around her eyes, surgery on her cheeks to add and then remove implants, and a facelift.
She has also had a rib shortened to give her a slimmer silhouette, her toes shortened ‘so they looked better in heels’, a tummy tuck,  bottom implants and chin implants which were later removed.
Everything else – her home, clothes, even food – was secondary to spending money on more surgery.

Looking for perfection: Alicia Douvall, who has had over 50 procedures over the years, says surgeons should have stopped her and that more psychological checks for vulnerable patients are needed

At one point, her desperation to change her body led her to have one operation each week. Again, it doesn’t take a degree in psychology to recognise something was seriously amiss.
‘Apart from my daughter’s education, I spent nothing on anything but surgery. I ate beans on toast and never had a holiday. I even persuaded boyfriends to pay for operations.’
Is she now happy? Far from it. ‘I’ve had so much surgery, my face doesn’t move. I can’t smile properly and can’t breathe through my nose. If I’d never had surgery, I’d be far better looking than I am now.’

OUR FIVE DEMANDS

1. A MINIMUM STANDARD FOR SURGEONS
All doctors who carry out cosmetic surgery must have valid training and experience in the procedures they perform.

2. PROPER REGULATION
Set up a regulatory body to register all cosmetic surgeons. Members must hold UK insurance and keep an annual log of outcomes of all their operations.

3. END THE HARD SELL
Special offers, deals and glossy advertising undermine the seriousness of these operations, and may cause patients to rush decisions.

4. SAFETY FIRST
Patients must have a 30-minute consultation with their surgeon and a two-week cooling-off period before consenting, and see the same surgeon after the operation.

5. BOTOX TRAINING
Only professionals trained to a medical standard should carry out injections of Botox, fillers and laser therapy. All must register with the regulator.

Her friends did try to intervene. ‘Even when my daughter begged me to stop having surgery, I carried on. I was convinced the next operation was going to make everything OK, so I didn’t listen.’
She adds: ‘I hold myself responsible, but the doctors who agreed to operate on me when I was clearly not well have a lot to answer for.
'Now I know the problem wasn’t with my breasts or nose, but how I saw myself. But they always agreed that they could improve me.'
Alicia suffers from body dysmorphic disorder (BDD), also called dysmorphia. A mental illness linked to anxiety and obsessive compulsive disorder, or OCD, sufferers obsess over their appearance and have a distorted perception of the way they look.
Even minor ‘flaws’, such as naturally  uneven features or a small scar, become a source of great distress.
Those with BDD believe they are ‘ugly’ and that others see them in this way, too.
Patients can become reclusive and often suffer depression and eating disorders. Seeking medical treatment for their perceived defects, such as cosmetic surgery, is another common symptom. And often they will have  multiple operations.
Alicia says: ‘I was on anti-depressants because I was so upset about what I had done to myself, and it was my psychotherapist who suggested I might have dysmorphia.
'I was sent to rehab, where they treated me like any other addict. I had a lot of psychotherapy and have had to build myself up from scratch.
'I may need surgery again to correct damage caused by too many operations, but I won’t if I can help it.’

Fresh faced: Aged 15, Alicia Douvall was still Sarah Howes, and had yet to have her first operation

It was the arrival of Alicia’s second daughter, Papaya, now 15 months, and a sister to Georgia, 17, that spurred her to seek help for a third time, and she has not had an operation for a year.
Dr Heather Sequeira, a psychologist who treats patients with BDD, says: ‘Patients often think all their problems will be solved by an operation, and obsess over it.

VULNERABLE PATIENTS NEED PROTECTING

A study in the Annals Of Plastic Surgery in 2010 suggested that almost one in ten of those who go for plastic surgery have body dysmorphic disorder (BDD).
But only one in 100 of these said that surgery actually reduced their symptoms, and many said it instead caused them to become more preoccupied with their appearance.
BDD is a psychiatric condition in which patients are preoccupied with a perceived imperfection in their appearance which causes them severe distress.
Of the patients with the disorder who asked for surgery, only one in 20 was refused the operation by the doctor on health grounds.
More than one per cent of Britons are thought to suffer BDD and although the exact cause is not known, traumatic childhood incidents are thought to play a role.

'But the nature of the disorder means even if they do have surgery, they will find something wrong with the result or fixate on a new body part.’
She supports stricter psychological testing for all potential cosmetic surgery patients. ‘Someone coming to a surgeon clutching a Barbie saying they want to look perfect is clearly a concern.
'It would be straightforward to design a screening questionnaire to flag up those at risk of BDD. These should be referred for psychological treatment, not surgery.’
For Alicia, born Sarah Howes, a key to explaining her actions may lie in her ‘difficult’ childhood. ‘I was the youngest of three and had a different father from my two older sisters. My dad used to put us all down.
'He’d joke and tell me I was ugly. But he also had a temper, and would often say the same thing in anger. It was a daily occurrence – we were always on tiptoes around him.’

Unsurprisingly for a woman famous for a string of lurid affairs with high-profile married men, Alicia had some serious ‘self-esteem issues’.
As a youngster, she idolised Cindy Jackson, the ‘human Barbie’ who holds the Guinness world record for cosmetic surgery, with 14 major operations and 38 minor procedures such as Botox.
Alicia’s own tally far outstrips this. She says she has been seen at High Street clinics and those on Harley Street.

Support: Alicia says her two daughters, Georgia, aged 17, and Papaya, 15 months, made her seek help for a third time and it is now a year since she last went under the knife

Changing face: Alicia Douvall pictured in 2001 and 2003, showing the effects of her operations over the years

Disorder: Alicia kept making drastic changes to her body, as these pictures from 2006, left, and in 2010, show

At every appointment with a surgeon she had to list previous  procedures. But doctors continued to operate.
‘One I saw emailed me later to say I needed implants and a facelift when I hadn’t even asked about them. But when a doctor lists things you need done, you think they must know best.
‘Whenever I was recovering I was always thinking about the next operation,’ she says. ‘It was because each time I had surgery, I saw the results and felt it still wasn’t perfect.’
Alicia, who is single, backs The Mail on Sunday’s call for clinics to stop offering financial incentives. ‘The guy who operated on me as a teenager should have sent me home, and told me there was nothing wrong with how I looked. But implants need replacing, things need touching up. They must have seen me and my insecurities and thought: kerr-ching!’
Alicia is now building a skincare company. Yet the legacy of her addiction will stay with her forever.
‘I look at pictures of myself before I had surgery and realise I wasn’t bad looking. I wish one of those doctors had told me to get help. I have had a lot of reconstructive work done by very good surgeons but now I look in the mirror and all I see is scars.’

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