A recent study revealed that more than seven million Australians were considering undergoing cosmetic surgery in the next 10 years, with the prime motivation for almost half of the respondents being to feel better about themselves.
The most popular cosmetic surgeries include rhinoplasty, breast augmentation, blepharoplasty, rhytidectomy, abdominoplasty, platysmaplasty, brachioplasty, gluteal lift, and genital surgery. These procedures constitute major surgery, requiring the patient to undergo a general anaesthetic and typically have significant recovery times.
In addition to cosmetic surgery, increasing numbers of Australians are undergoing non-surgical cosmetic procedures such as anti-wrinkle injections, fillers, hair transplants, cryolipolysis, sclero therapy, laser hair removal, dermabrasion, chemical peels, skin rejuvenation, and resurfacing. These procedures are undertaken to change the appearance, colour, texture, structure or position of bodily features.
Whilst cosmetic surgeries and non-surgical cosmetic procedures were once reserved for celebrities and the wealthy, they are now increasingly accessible. Social media and changing societal standards of beauty means these surgeries and procedures are perceived as more desirable and within reach for the average person.
The size of the cosmetic industry in Australia is difficult to accurately quantify because cosmetic procedures are not covered by Medicare or private health insurance. As procedures are funded privately, there is no centralised funding data. It is, however, estimated that the industry is worth over $1 billion dollars in Australia, a figure which is not projected to decrease anytime soon.
The changing face of Australia’s cosmetic industry
On 30 November 2021, an Independent Review was commissioned by the Australian Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia to examine patient safety issues in the cosmetic surgery industry.
Prior to the commission of the Independent Review, there had been increasing reports in the media (including the ABC Four Corners episode, “Cosmetic Cowboys”) about rogue medical practitioners and adverse patient outcomes.
In March 2022, the “Independent review of the regulation of health practitioners in cosmetic surgery” report (“the Report”) was published.
The Report made 16 recommendations across the four broad themes: Education, Training and Qualifications; Management of Notifications; Advertising Regulation; and Influencing Practice.
The recommendations led to the implementation of the “Guidelines for registered medical practitioners who perform cosmetic surgery and procedure” on 1 July 2023.
The 2023 Guidelines focused on four main areas:
- Title protection: which means that medical practitioners can only use the title of “surgeon” if they are registered and have completed training in surgery, ophthalmology, obstetrics and/or gynaecology. Previously, cosmetic surgery was not recognised as a medical speciality, meaning that any medical practitioner could hold themselves out to specialise in cosmetic surgery despite having little to no dedicated training and/or experience.
- Area of practice endorsement: which aims to make it clear on the public register if a doctor has met cosmetic surgery standards which are set by the Australian Medical Council and Medical Board of Australia. The endorsement aims to make it easier for consumers to identify who is trained and qualified to perform cosmetic surgery safely. In theory, this is a welcome reform but in practice, the authors of this article were unable to locate any practitioners holding the endorsement after a search of more than 30 practitioners known to specialise in cosmetic surgery.
- Licensing standards: which regulate licensing framework for facilities where cosmetic procedures are performed.
- Advertising reforms: which aim to ensure that consumers are subject to ethical, honest and responsible advertising, providing accurate information to allow them to make informed decisions.
Having introduced the reforms which applied to cosmetic surgery, AHPRA turned its sights to non-surgical cosmetic procedures.
The “Guidelines for practitioners who perform non-surgical cosmetic procedures” were implemented in September 2025 together with the “Guidelines for practitioners who advertise higher risk non-surgical cosmetic procedures”.
The 2025 Guidelines aimed to bring reform to a previously unregulated (for the most part) industry. They focus primarily on the topics of conflicts of interest, patient suitability, consultation, patients under the age of 18, informed consent, prescribing, patient management, complaints, education and experience, qualifications and titles, advertising, infection protection, facilities, and financial agreements.
When it goes wrong
Whilst the Guidelines aim to protect consumers of cosmetic surgery and non-surgical cosmetic procedures, consumers continue to experience adverse outcomes in practice.
In the 18 months following the publication of the Report, AHPRA reported receiving a significant increase in complaints. Some of those complaints included:
- A patient with a history of mental illness who had disclosed to her doctor that she had a history of body image issues and had previously undergone 10 non-surgical cosmetic procedures which she was unhappy with. Despite that, the doctor administered filler injections. AHPRA’s investigation found that the doctor had failed to manage the patient’s mental health concerns, continued with treatment despite the patient’s body image issues, and did not properly gain consent. The doctor had conditions placed on their registration as a result.
- A patient with several known skin conditions was administered dermal fillers despite her skin conditions making them inappropriate and dangerous. The patient suffered an adverse reaction to the treatment requiring the fillers to be dissolved and a course of steroid treatment to be prescribed. The nurse also altered her treatment notes after the complaint was made. As a result, AHPRA imposed conditions requiring the nurse to undertake formal education and provide a report reflecting on how they will change their practice in future.
- A patient who underwent intense pulsed light treatment to improve the appearance of the skin on her neck suffered significant burns which included large purple blistering. AHPRA found that the doctor did not obtain correct consent from the patient, did not test the procedure on her, used an incorrect setting, did not stop when the patient complained that it was hurting and failed to refer her to a specialist to treat the burns. Following its investigation, AHPRA required the doctor to be supervised.
Some other examples of cosmetic surgeries gone wrong include:
- In 2019, a patient underwent a tummy tuck and liposuction on her abdomen and thighs. She was not advised of the potential risks of the surgery. Instead of being discharged after a few days, postoperative complications resulted in her being transferred by ambulance to two other hospitals. The patient’s post-surgical wounds were black and oozing pus in parts, and her flesh was breaking down and rotting. The patient’s nurse described the smell emanating from the surgical wounds as “putrid.” The patient was diagnosed as being septic. The patient described suffering a mental breakdown as a result of her experience. The doctor had restrictions placed on his medical registration prohibiting him from performing tummy tucks, arm lifts, buttock lifts, liposuction lipectomies, and thigh lifts. His conditions have since been eased allowing him to act as a surgical assistant on body contouring surgeries.
- A practitioner faced a number of complaints to the Health Care Complaints Commission after carrying out surgery on nine patients in an unlicensed private health facility. He also inappropriately sat sedated patients up during surgery to have them comment on breast implants and invited friends and family into the operating theatre to also comment. The practitioner’s registration was cancelled and he is unable to make an application for review until 2027.
Beyond the scalpel: what comes next?
In 2023, the then AHPRA CEO, Martin Fletcher was quoted as saying “getting these services is not like getting a haircut – these procedures come with risk”.
Although the term “cosmetic surgery” often brings to mind procedures like breast augmentation, rhinoplasty. or abdominoplasty, the reality is that a significant portion of people in today’s society have undergone some form of cosmetic enhancement, whether surgical or non-surgical.
For many, treatments like laser hair removal, chemical peels, or skin rejuvenation, are now so commonplace that they are approached with the same casualness as getting a haircut. When these procedures go wrong, consumers can suffer permanent injuries and disfigurement that can last a lifetime.
Concerningly, some consumers do little research before undergoing non-surgical cosmetic procedures and even surgical procedures. The Report quoted a statistic that revealed that 78% of survey respondents said that a doctor’s qualifications are very important but only 9% said they actually searched the practitioner’s qualifications on the AHPRA website.
AHPRA has developed their Cosmetic Hub which provides resources to consumers in a user-friendly manner. The next challenge lies in transforming consumer attitudes towards cosmetic procedures, encouraging a more cautious approach, and encouraging consumers to seek out reliable information such as that published by AHPRA.
Originally published in the November edition of the Law Society of South Australia’s Bulletin.