DR MAX PEMBERTON: Meghan's deathly silence on Harry's woes says so much about their relationship. This is not what a successful marriage looks like...

Prince Harry’s gap year in Lesotho in 2004 led to him setting up the charity Sentebale in 2006 in memory of his mother to fight HIV/AIDS in Lesotho and Botswana.

Before a damning report came out this week into its operations by the Charity Commission, Harry had already stepped back in March.

He is said to be devastated. What’s puzzling is that Meghan has remained silent. No public words of support. Maybe behind closed doors she’s been his rock.

Meanwhile, she celebrated her 44th birthday last Monday. On Instagram she posted a picture in which she thanked ‘my husband’ in passing, she didn’t name him and there was no sign of Harry.

While Harry is battling court cases and losing his beloved charity, Meghan seems to be on a high with her As Ever brand and Netflix show.

In successful partnerships, there is always one person to lift you up when you fall down. Without someone like this, life is infinitely harder and less fun.

It feels that barely a week goes by without reading about a poor person who underwent a cosmetic procedure, performed by someone unqualified, only for it to go horribly wrong.

As a doctor, I’m always staggered that people will willingly have their faces and bodies altered without checking the credentials of the person carrying out the work.

This is why the Government last week announced a big crackdown on cosmetic cowboys. They warned that ‘rogue operators’ with no medical training are maiming and even killing people by carrying out invasive procedures in homes, hotels and pop-up clinics.

Under the new rules, only health workers who are ‘suitably qualified’ will be able to undertake high-risk procedures such as ‘Brazilian butt lifts’, where someone's fat from elsewhere in the body is injected into their backside to make it appear larger. Meanwhile, clinics offering Botox and fillers will need to be licensed by their local authority.

I welcome the move – although I’m astonished it wasn’t already in place. Like every NHS doctor working today, I’ve witnessed the fallout when patients receive shoddy care in the private sector, particularly the cosmetic surgery industry.

When I worked in breast surgery, I saw several cases of botched implants. Patients with horrendous infections and in great pain had been palmed off on the NHS because so many private clinics do not have the resources and facilities to fix the problems they create.

My view is that if these places don’t have the facilities or expertise, and have to rely on the NHS to put right their mistakes, then they should pay for the service.

While the Government’s crackdown is a step in the right direction, it won’t entirely solve the problem of botched work, because people will still be able to go abroad to places like Turkey, Thailand and Mexico.

Isn’t there a bigger issue here? Why are these procedures so popular in the first place, especially among the young?

A few years ago, out of curiosity, I did a qualification in anti-wrinkle injections and fillers. I was horrified at how young some of those wanting these procedures were. There were 18 and 19 year olds with beautiful, flawless skin clamouring to get frozen faces.

Worse still, every single one brought with them photographs from social media as an example of how they wanted to look. And all the images they presented had been digitally manipulated.

I felt like I was banging my head against a brick wall when I tried to explain that what they were looking at wasn’t real.

Yet the women remained completely unfazed, viewing the procedures as part and parcel of their beauty routine.

I blame the cult of celebrity where impressionable teenagers want to emulate famous people.

Celebrities like the Kardashians and many, many others. What these young people do not realise or realise far too late, is that ironically, they already have the youthful appearance these famous stars and influencers are chasing.

My experiences of this disturbed me so much that I shelved any idea of performing cosmetic injectables, despite qualifying.

It just didn’t seem ethical to exploit the insecurities of young women in this way.

Since then, I’ve noticed how many young people who have had Botox end up looking way older than their years.

The stark reality is that anti-wrinkle injections work by paralysing the underlying facial muscle. Because it can’t move, it begins to shrink.

In young people without established wrinkles, this has the paradoxical effect of causing the overlying skin to appear more wrinkled because of the loss of muscle volume.

A dermatologist I once spoke to said that no one should even consider anti-wrinkle injections until they are at least in their late 20s, if not older.

Even then, wouldn’t it be better if people could just learn to live with their wrinkles and imperfections?

Last week, this year’s batch of newly qualified junior doctors descended on to the wards across the country. Behind them is a legion of people who have contributed, and not just their loved ones supporting them.

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Yes, those who volunteer during exam time, but also people donating their bodies for dissection and their families, patiently waiting before they can bury their loved one, for example.

There are the unsung heroes living with chronic illnesses who attend tutorials in order to share their experiences. There are the patients who allow students to examine and perform procedures on them, often for the first time. There are the people lying in hospital beds who agree to participate in teaching ward rounds.

Each generation of doctors owes their very existence to countless individuals who, despite being unwell, scared or in pain, have assisted in their education. Often what these people have to endure is undignified, tiring or uncomfortable - and yet they receive no public acknowledgement for their remarkable altruism.

While doctors might help people, they would not be in a position to do so if people hadn’t helped them first.

Dr Max prescribes... ALTRUIST SUNSCREEN

Set up by consultant dermatologist and skin cancer surgeon, Dr Andrew Birnie to provide optimum protection against the sun’s harmful UVA and UVB radiation, exceeding EU standards.

It also offers top quality sunscreen at the cheapest possible prices so even familes on low incomes can afford it. The brand supports charities that help children with albinism in Tanzania and the rest of Africa.

Find out more at: altruistsun.com