Australia has surpassed the United States as the most cosmetic procedures per capita.1 With a dramatically growing industry comes opportunity, but also the need to regulate potential risks and loopholes.
Cosmetic surgery involves cutting beneath the skin and includes breast augmentation, facelifts and liposuction.
Non-surgical cosmetic procedures may pierce the skin but does not cut beneath the skin and includes injectable treatment, thread lifts and laser treatments. Reconstructive surgery differs from cosmetic surgery as it restores form and function as well as normality of appearance. The new guidelines apply to plastic surgery when it is performed only for cosmetic or aesthetic purposes. Gender affirmation surgery is not considered cosmetic surgery.
From 1 July 2023, the Australian Health Practitioner Regulation Agency (AHPRA) will welcome new Guidelines for registered medical practitioners who perform cosmetic surgery and procedures (Guidelines),2 following stronger guidance and higher standards that will apply to registered medical practitioners who perform cosmetic surgery and non-surgical cosmetic procedures.
Summarised in the table below, are some of the key requirements under these Guidelines:
| Guideline requirements | Cosmetic surgery | Non-surgical cosmetic procedures |
|---|---|---|
| GP referral | Yes. Required by GP or another specialist practitioner. The referrer must not work with the person performing the surgery and must not perform cosmetic medicine themselves. | Not required. |
| Consultations | Yes. A patient is required to have two pre-operative consultations with the practitioner performing the procedure or another registered health practitioner who works with the performing practitioner (not a patient advisor or an agent). Note: at least one of the two consultations must be in person. | Yes. A consultation is required either in-person or by video, with the performing practitioner each time a Schedule 4 (prescription only) cosmetic injectable is prescribed. |
| Cooling-off period | Yes. A cooling off period of seven days is required after the patient has had 2 consultations and signed consent forms. For patients under 18 years, the cooling off period is at least 3 months. | No, not required for patients over 18 years. For patients under 18 years, the cooling off period is at least 7 days. |
| Patient assessment | Yes. The practitioner to perform the cosmetic surgery must discuss and assess the patients' reasons, motivations and psychological conditions (Such as body dysmorphic disorder (BDD)). Where a patient is an unsuitable candidate, they must be appropriately referred for evaluation. | Yes. Same requirements as cosmetic surgery. Note: The Board considers that Botulinum toxin and dermal fillers should not be prescribed for patients under the age of 18 for cosmetic purposes. |
| Consent | Yes. Detailed informed consent information is required, including patient consent the use of any images or videos taken. The practitioner must have a verbal consent discussion with the patient. Note (Specific to cosmetic surgery): Consent forms cannot be signed at the first consultation. Informed consent must be obtained at a consultation (in person or by video) at least seven days before the day of the surgery and reconfirmed on the day of the surgery and documented appropriately. | Yes. Same general requirements as cosmetic surgery. We recommend reviewing your policies and practice with respect to informed consent including informed financial consent. There are considerable changes regarding the information a patient must be provided to make an informed decision about whether to have the procedure. |
| Qualifications | Yes. Cosmetic surgery must only be provided by medical practitioners with the appropriate knowledge, training and experience to perform the surgery and deal with all routine aspects of care and any likely complications. Note: This is a developing area.3 When an approved Area of Practice endorsement for cosmetic surgery is available as a new registration standard, an approved qualification eligible for endorsement for cosmetic surgery is appropriate training. An advance copy of the Endorsement of registration of registered medical practitioners for the approved area of cosmetic surgery is available on the AHPRA website. | Yes. Same requirements as cosmetic surgery. Where a medical practitioner is changing their scope of practice to include cosmetic procedures, they are expected to undertake the necessary skills training before providing treatment. |
| Facility accreditation | Yes, required for all cosmetic surgery. | No, however practitioners are still strongly encouraged to provide procedures in accredited facilities. |
Advertising
Advertising rules for cosmetic surgery have also been amended. We strongly recommend you seek advice regarding your advertising on websites, social media and past posts if necessary. The new advertising standards includes but is not limited to:
- specific consent for using a patient’s images in ads;
- no testimonials;
- use of social media influencers;
- use of single and ‘before and after’ images;
- no sexualised images;
- taglines and hashtags;
- use of non-clinical terms and descriptors;
- use of emojis; and
- include your registration type in ads.
There are also advertising changes to non-cosmetic procedures including the requirement for specific consent to use a patient’s images in ads for non-cosmetic procedures.
The above guidance is not an exhaustive list and may be subject to change at any time. Please read the Guidelines or seek further advice from our experts Scott Chapman, Angela Pale and the Sydney Health HWLE Team.
This article was written by Scott Chapman, Partner and Angela Pale, Senior Associate.
1Chan, G. (2021). Cosmetic Surgery Statistics, Australia and Around the World. Viewed 6 March 2021, https://www.thevictoriancosmeticinstitute.com.au/2020/01/cosmetic-surgery-statistics-australia-around-the-world/
2https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Cosmetic-medical-and-surgical-procedures-guidelines.aspx
3https://www.medicalboard.gov.au/Accreditation/Endorsement/Cosmetic-surgery-endorsement.aspx
