From 1 July 2023, there will be significant changes to the regulation of cosmetic surgery in Australia. These changes will have an impact not only on surgeons and practitioners conducting cosmetic surgeries and non-surgical procedures but also on GPs and dentists. These reforms are a direct outcome of the final report from the Independent Review of the Regulation of Medical Practitioners who Perform Cosmetic Surgery. The report, commissioned by Ahpra and released on 1 September 2022, recommended the establishment of clear standards for the approach to and advertising of cosmetic surgery and procedures, along with increased transparency regarding the qualifications and expertise of medical practitioners involved in cosmetic surgery.

What are the key changes?

The reforms will focus on four key areas:

  1. Cosmetic surgery standards
  2. Advertising guidelines
  3. Registration standard for cosmetic surgery endorsement
  4. Amendments to the National Law

1. Cosmetic surgery standards

The Medical Board of Australia has created new and updated Cosmetic Surgery standards. These Standards set out the rules around the performance of cosmetic surgery and procedures, as well as the assessment, examination, and consent of patients. In particular, the Standards now require:

  • a GP referral for all cosmetic surgery;
  • more thorough screening and psychological evaluation of patients prior to surgery;
  • clarity around informed consent (including the need for cooling off periods);
  • those non-disclosure agreements not be used.

Specific consent requirements

Consent requirements:

  1. Must be obtained by the person undertaking the surgery.
  2. At least two pre-operative consultations.
  3. Must not be asked to consent at the first consultation.
  4. Consent discussions must be in person.
  5. Cooling off period (7 days for adults and 3 months for people under 18 years) – must not request any money until after this period.
  6. Must discuss benefits, risks, alternatives, and any evidence in support of the proposed procedure.
  7. Must explain own qualifications and experience (including whether or not they have an endorsement)
  8. Whether any photos will be taken – by whom, for what purpose, and how they will be stored and used.

Financial consent:

  1. Total costs – surgery AND the cost of any implants.
  2. Costs of assistants and anaesthetists.
  3. Theatre costs.
  4. Must explain that there is no Medicare rebate.
  5. Must not encourage patients to take on debt/ or offer debt arrangements.
  6. Must not offer “bundling” – discounts if booking multiple procedures or if booking before a certain date.

2. Advertising guidelines

Tougher Advertising Guidelines now ban the use of testimonials, social media influencers, before-and-after images, sexualised images, hashtags, emojis, and non-clinical terms such as “mummy tummy”, “tummy tuck”, “Brazilian butt lift”, or “designer vagina”. In addition, the guidelines now require specific consent to be obtained from patients before using their images in any advertising, and the inclusion of information about the practitioner’s registration and whether or not they have an endorsement. 

Ahpra has indicated that it will commence auditing websites for compliance against the Advertising guidelines from 3 July 2023.

Specific requirements within the advertising guidelines.

  1. Must give balanced and accurate information
  2. Must demonstrate realistic results
  3. Must observe title protections (see below)
  4. Must positively represent normal body variation
  5. Must accurately represent your qualifications, registration and experience
  6. Must use clinical images with caution and must obtain specific consent for their use
  7. Must not exploit patient’s insecurities
  8. Must not target vulnerable patients, such as those with BDD
  9. Must not use hashtags that result in unrealistic expectations
  10. Must not use testimonials – although not responsible for the comments of patients, they should not actively seek comments and reviews from social media influencers
  11. Must not use sexualised images

3. Registration standard for cosmetic surgery endorsement

A new Registration Standard for Cosmetic Surgery Endorsement has also been created. This will allow practitioners who perform cosmetic surgery to obtain an AMC-accredited qualification in cosmetic surgery. Although the new endorsement registration standard commences on 1 July 2023, there are currently no approved qualifications available. It is unclear when or if any qualifications will be available in the future. Furthermore, practitioners will be allowed to continue performing cosmetic surgery even if they choose not to obtain a qualification that leads to an endorsement in cosmetic surgery.

4. Amendments to the National Law

Amendments to the National Law are expected later this year which will restrict the use of the title “surgeon” to medical practitioners who hold specialist registration in surgery, ophthalmology, or obstetrics and gynaecology.

Title protections – as currently drafted and expected to be passed

  1. Must not knowingly or recklessly use the term “surgeon” unless a member of a surgical class.
  2. “Surgical class” includes ophthalmologist, O&G, or surgeon with AMC accredited fellowship.
  3. “Surgical class” may also include other classes of medical practitioners that may be prescribed in the future by regulations made by the Minister.
  4. Breach of title protections incurs $60,000 fine, 3 years imprisonment or both
  5. Includes use of the title “surgeon” in combination with other words such as “cosmetic”.
  6. Does not apply to dentists or podiatrists.

Where can I find out more?

The Medical Board of Australia has developed a dedicated cosmetic surgery hub, which includes links to the new and updated guidelines, a summary of key reforms, FAQ's and factsheets.

Finally, the upcoming MIPS webinar scheduled for August will explore the recent cosmetic surgery reforms, with a specific emphasis on their implications for General Practitioners. We encourage you to register via the email invitation closer to the time.  

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