Recently, it seems like a week hasn’t gone by without reading an article on a news website about a “dodgy” cosmetic surgeon. We are often surprised to discover that many people who chose to have cosmetic surgery, didn’t have a good understanding of what training a “cosmetic surgeon” was required to have to operate lawfully in Australia. So, what are cosmetic surgeons? How do they differ from plastic surgeons, and why are there so many complaints about their work? And, most importantly, is there any consumer protection and what options do you have if something goes wrong?
What is cosmetic surgery?
Cosmetic surgery is defined as an operation that involves cutting beneath the skin to revise or change the appearance of normal bodily features where there is no clinical or functional need for a procedure.
Common examples of cosmetic surgery include the insertion of breast implants, liposuction, surgical face lifts, rhinoplasty and a tummy tuck (abdominoplasty).
Cosmetic surgery does not include cosmetic treatments such as antiwrinkle injectables, dermal fillers, laser treatments, reconstructive plastic surgeries, or surgeries that serve a clinical or functional need.
Cosmetic surgery is not covered by Medicare or private health insurance in Australia.
Who can be a cosmetic surgeon in Australia?
Shockingly, the cosmetic surgery sector sits predominantly outside the health system framework. It is not a recognised medical specialty and does not have a recognised specialist registration and training requirements.
Australian Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia are involved with the regulation of cosmetic surgery in Australia. However, they are not the sole regulator. National and state laws, regulators and standards may also apply.
There is a gaping hole regarding the lack of education, training and the requirement for national qualifications of practitioners undertaking cosmetic surgery. There are no minimal national standards as to what additional training a medical practitioner is required to do, to be able to call themselves a cosmetic surgeon or to offer and perform invasive cosmetic surgical procedures.
This means that a general practitioner, without additional training or assessment, can call themselves a cosmetic surgeon and offer to perform invasive surgeries, including a surgical facelift or inserting breast implants!
It is deeply concerning that the public is expected to determine whether a cosmetic surgeon has the suitable training and experience to perform a surgical procedure and that regulatory bodies are unable to determine a national standard for cosmetic practice.
How are cosmetic surgeons different to plastic surgeons?
Unlike cosmetic surgeons, plastic surgeons are required to obtain specialist registration and follow a traditional medical training pathway.
Specialist plastic surgeons, unlike cosmetic surgeons, have extensive surgical training, which includes a minimum of 12 years of medical and surgical education and at least 5 years of specialist postgraduate training. Plastic surgeons are registered as a Fellow of the Royal Australasian College of Surgeons (FRACS) once they have completed their training.
Plastic surgeons are the only accredited medical practitioners recognised by AHPRA to perform both aesthetic and reconstructive surgeries.
They must demonstrate that they are able to perform procedures to a recognised standard before they are able to practice as a plastic surgeon.
Why are cosmetic surgeons often in the news?
Recently, there has been a focus in the media raising concerns about the conduct of medical practitioners practising as cosmetic surgeons.
The key issues raised have been around poor hygiene practices, patient safety issues, poor patient care, unsatisfactory surgical outcomes and inappropriate advertising.
Questions about cosmetic surgery practice are being asked, specifically around how the sector is regulated to protect the public.
What is being done to protect the cosmetic surgery consumer?
On 30 November 2021, the AHPRA and the Medical Board of Australia announced the establishment of an independent review of the regulation of medical practitioners who perform cosmetic surgery.
In August 2022, they released a report that set out 16 recommendations to improve the regulation of the cosmetic surgery sector.
On 1 September 2022, AHPRA released a media statement confirming that they would establish a Cosmetic Surgery Enforcement Unit to work with the Medical Board to:
- set clear standards;
- crack down on mis-leading advertising;
- tackle under-reporting;
- strengthen patients’ voices;
- reinforce and strengthen existing guidelines; and
- change the way they deal with complaints.
Further, they stated that:
“… governance and oversight of this work will be sharpened by a Cosmetic Surgery Oversight Group (CSOG). The CSOG will report publicly on progress and provide assurance to the community, governments and professional stakeholders that they are doing what we they have committed to do, as quickly as possible”.
It will be interesting to see if AHPRA complies with the CSOG’s recommendations. As at November 2022, none of the recommendations have been implemented. Nor has the Cosmetic Surgery Enforcement Unit or the CSOG been established.
What options do you have if your cosmetic surgery goes wrong?
It is clear that cosmetic surgeons are not required to undergo the same training and education requirements as plastic surgeons. As a result, a cosmetic surgeon may not perform an aesthetic procedure to the same standard as a plastic surgeon, which may result in a poor cosmetic outcome.
Not all poor outcomes are the result of negligent treatment. However, some poor outcomes can be caused by poor procedural performance or by poor choice of procedure. There may have been inadequate aftercare that has directly caused an unsatisfactory outcome.
If you have experienced a poor cosmetic outcome following a cosmetic procedure, the best person to advise you as to whether you may be able to make a medical negligence claim for compensation is a lawyer who specialises in medical law.
You may be able to seek compensation for your ongoing injuries, reimbursement of your medical expenses and the costs associated with future treatment.
If possible, gather any medical records you have, as well as before and after photos, before getting legal advice. These will assist a medical negligence lawyer in providing you with advice regarding a potential claim.