Nose jobs, breast implants and Botox all come with their share of risks and those seeking the procedures should find appropriate, certified doctors, warned The Quebec College of Physicians Tuesday.

The advisory comes on the heels of four suspensions by Quebec doctors for inappropriate conduct, and an effort by the medical body to set stricter guidelines.

Cosmetic procedures from plastic surgery to injections has risen dramatically in recent years, prompting the College to create a working study group in 2008. The group is compiling a directory for potential clients.

The directory, not yet complete, will include a list of doctors, note their credentials, and explain what surgeries they are qualified to perform, as well as the risks associated with each procedure.

"There are 20,000 physicians in Quebec, and there are not 20,000 doing (plastic surgery) for patients. It's only a few, in fact," said Dr. Yves Lamontagne, president of the Quebec College of Physicians.

Lamontagne is aiming to create a small bank of about 120 specialized plastic surgeons in the province who would advertize themselves as such and would be properly trained in elective procedures.

Dr. Gilles Beauregard of the Quebec Association of Plastic Surgeons supports the decision.

"When you do surgery you have to cut the skin, and whenever you do surgery, you need training," he said.

The college also wants to curb the current practice of manufacturers of products such as Botox and Restylane instructing doctors how to use their products, instead of doctors making the appropriate decisions themselves, based on their training.

"Physicians go for a course, like a weekend somewhere paid by the company, and they start doing the thing the week after. This has to be controlled much better than it is now," said Lamontagne.

Once the college's directory is complete - sometime next year - it will be posted on its website.