This lack of regulation posed significant risks to patient safety and fuelled confusion among the public regarding the qualifications required for cosmetic surgery.
Prior to recent changes, any doctor with a basic medical degree could legally market themselves as a "cosmetic surgeon" and offer surgical procedures like breast augmentations, facelifts, and liposuction. The title "cosmetic surgeon" did not necessitate specialised surgical training or board certification, allowing individuals with limited expertise to perform complex operations.[1]
This regulatory gap led to an increase in unqualified practitioners performing cosmetic surgeries, often in substandard facilities without proper safety measures in place. Numerous cases of botched procedures, disfigurements, and life-threatening complications emerged, highlighting the urgent need for stricter oversight and patient protection.[2][3]
Investigating the Cosmetic Surgery loophole
In November 2021, the Australian Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia initiated an external review concerning patient safety within the cosmetic surgery industry, including how to improve regulatory measures for “cosmetic surgeons”.
Released on 1 September 2022, the findings of the Independent Review of the Regulation of Medical Practitioners Performing Cosmetic Surgery revealed an absence of universal minimum standards for education, training, and qualifications when it came to cosmetic surgery in Australia. Consequently, this made it possible for any medical practitioner to undertake and perform invasive cosmetic surgical procedures without the appropriate training or the accumulation of supervised experience to attain an acceptable level of competency.
Key findings:
Unqualified practitioners performing invasive procedures
Any doctor with just a basic medical degree could legally market themselves as a "cosmetic surgeon" and perform complex surgical procedures like breast augmentations, facelifts, and liposuction, despite lacking the necessary expertise and specialised training in plastic and reconstructive surgery.[5][6]
Increased risk of complications
The proliferation of unqualified individuals performing cosmetic surgeries led to numerous cases of botched procedures, disfigurements, and life-threatening complications. Several high-profile incidents, including patient deaths, highlighted the urgent need for stricter oversight and patient protection.[5][6]
Substandard facilities and safety measures
Many "cosmetic surgeons" operated in substandard facilities without proper accreditation, safety protocols, or emergency equipment, further increasing the risks to patients undergoing invasive procedures.[7]
Lack of accountability and oversight
Without clear regulations or credentialing requirements, there was minimal accountability for "cosmetic surgeons" who fell short of expected professional standards or caused harm to patients.[5][6]
Consumer confusion and misinformation
The loophole allowed individuals with limited expertise to misrepresent their qualifications, leaving consumers ill-equipped to discern whether their chosen practitioner was adequately trained to perform the desired procedure safely.[7]
AHPRA Addressing the loophole
AHPRA took decisive action to address this loophole and establish clear standards for cosmetic surgery practice. AHPRA announced its intention to establish a Cosmetic Surgery Enforcement Unit, in collaboration with the Medical Board of Australia, to set clear standards and create an area of practice endorsement in cosmetic surgery. At the time of writing, AHPRA has not clarified what these ‘endorsements’ will be; however, they are aimed at assisting consumer awareness regarding trained and qualified cosmetic surgery practitioners. A doctor’s inclusion on the public register will indicate if they have met the clear standards in cosmetic surgery set by the Australian Medical Council and the Medical Board of Australia.
AHPRA clarified that the title "cosmetic surgeon" is not a recognised medical specialty in Australia. Only medical practitioners who have completed extensive postgraduate training in plastic and reconstructive surgery, culminating in a Fellowship from the Royal Australasian College of Surgeons (FRACS), can safely perform invasive cosmetic procedures.[3][4]
This regulatory change aimed to protect patients by ensuring that cosmetic surgeries are performed exclusively by board-certified plastic surgeons with specialised training in surgical techniques, anatomy, and patient safety protocols. Individuals without proper qualifications are now prohibited from advertising themselves as "cosmetic surgeons" or performing surgical cosmetic procedures.
What you need to consider with Cosmetic Surgery
As of 1 July 2023, you must obtain a referral from your GP before scheduling a consultation with the doctor responsible for your cosmetic surgery, even if you're consulting with a specialist like a plastic surgeon. This referral gives the surgeon essential medical information about you and improves patient safety before your procedure.
When selecting the right qualified person to undertake your cosmetic procedures like breast augmentation, it is important to choose a practitioner registered to practice in Australia. You can verify their registration status through the national online register of practitioners offered by AHPRA. If your doctor isn’t listed on the register, simply ask for their registration number for verification.
It is also important to make sure you have thorough discussions with your preferred surgeon regarding your goals and know the associated risks and any potential complications that may arise from the procedure. Understanding the full scope of these factors is key to making informed decisions about your health and future well-being. Also, take the time to carefully assess and comprehend the financial implications of the procedure, including all associated costs and any potential additional expenses that may arise throughout the process.
Clinic vs. Hospital: Where to undergo the procedure
The choice between a clinic and a hospital for a procedure depends on various factors, including the type of surgery, the surgeon’s recommendation, and the patient’s preferences and medical history. While some cosmetic procedures can be safely performed in an accredited outpatient clinic, more complex surgeries may necessitate the resources and facilities available in a hospital setting.
Depending on whether the procedure is conducted by a plastic surgeon or a “cosmetic surgeon”, it may influence the choice of venue. Plastic surgeons, with their extensive training in both reconstructive and cosmetic procedures, will have access to operate in a fully accredited hospital under general anaesthetic administered by a fully qualified anaesthetist accredited with ANZCA (the Australian & New Zealand College of Anaesthetists). They can also provide emergency care if needed.
Some “cosmetic surgeons” may predominantly operate in outpatient clinics equipped for elective aesthetic procedures. To ensure patient health and safety, the Department of Health and Aged Care advises verifying that your surgery will be conducted in a licensed facility. This is crucial because certain surgeries must be performed within licensed facilities, depending on the clinic's location. All states and territories restrict where cosmetic surgeries can take place.
While plastic surgery and cosmetic surgery share a common goal of enhancing appearance, their distinctions lie in their scope, specialisation, and training. Understanding these differences can help you make informed decisions regarding where and with whom to trust your surgical procedure.
- https://deanwhite.com.au/blog/plastic-surgeon-vs-cosmetic-surgeon-whats-the-difference/
- https://www.artisteplasticsurgery.com.au/difference-plastic-surgeon-cosmetic-surgeon-doctor/
- https://www.shapeclinic.com.au/cosmetic-vs-plastic-surgeon/
- https://www.lawyersalliance.com.au/opinion/cosmetic-vs-plastic-surgery
- https://theconversation.com/doctors-may-soon-get-official-endorsements-to-practise-cosmetic-surgery-but-will-that-protect-patients-202136
- https://www.abc.net.au/news/2016-05-09/crackdown-on-cosmetic-surgery-includes-cooling-off-periods/7394774
- https://plasticsurgery.org.au/unregulated-office-based-cosmetic-surgery-a-risk-to-patient-safety/