The updates are part of a cosmetic surgery reform package that includes higher standards, tougher advertising requirements and the introduction of a new endorsement on registration. 

The reforms follow a public consultation in December 2022 and act on the recommendations made by last year’s independent review. 

‘There is a lot of money at stake in cosmetic surgery reform. Our reform package prioritises patient safety over vested interest. It reflects what is legally possible and what will help keep patients safe,’ said Medical Board of Australia Chair, Dr Anne Tonkin AO. 

‘Patients choosing cosmetic surgery deserve safe care. We’ve put together and delivered a reform package that raises standards and increases safety measures to stop patients being exploited and reduce the risk of harm,’ Dr Tonkin said.

Practice updates

The reforms apply to doctors practising in two areas:

• cosmetic surgery (involves cutting beneath the skin - including breast augmentation, facelifts and liposuction), and  
• non-surgical cosmetic procedures (which may pierce the skin but doesn’t cut beneath it, such as injectables, thread lifts and laser treatments).

Under the reforms, patients seeking cosmetic surgery will need a referral from their GP.  

This new measure adds a layer of protection for patients, who will in future be able to discuss their motivation for cosmetic surgery with their GP who has the best knowledge of their medical history and can share this with the doctor being referred to. 

The Board does not expect GPs to have a detailed knowledge of cosmetic procedures or to seek the patient’s informed consent for cosmetic procedures they are not personally providing. 

Other changes in the revised and strengthened Guidelines for registered medical practitioners who perform cosmetic surgery and procedures include: 

• higher standards for cosmetic surgery premises, with accreditation against Australian Commission on Safety and Quality in Health Care (ACSQHC) standards, required for cosmetic surgery premises from 1 July 2023 
• improved patient assessment by practitioners before surgery, including more scrutiny for signs of body dysmorphic disorder.

Advertising overhaul 

New advertising guidelines specific to cosmetic surgery come into effect on 1 July 2023. 

The new guidelines, with a strong focus on online and social media advertising, are in addition to the existing code of conduct and advertising guidelines and address the unique features of cosmetic surgery. They provide greater clarity about what is not acceptable.

Advertising must not:

• be false, misleading or deceptive
• offer discounts without terms and conditions
• use testimonials
• create unreasonable expectation of beneficial treatment, or
• encourage indiscriminate use.

Additionally, from 1 July 2023:

• medical practitioners must include clear information about their registration type and their registration number
• clear information about risks and recovery must be easily found
• videos and images must be used responsibly and not for entertainment
• videos and images must not be sexualised or include gratuitous nudity
• the use of negative body language is banned
• cosmetic surgery advertising must be identified as adult content.

‘We’re reforming cosmetic surgery to raise standards, improve consent about surgery and raise the bar in advertising. We’re making it very clear what is not acceptable behaviour by practitioners,’ Ahpra CEO, Martin Fletcher, said.  

Practitioners have three months to get familiar with the changes and to clean up their advertising in line with the guidelines. 

Delia Rickard, former Australian Competition and Consumer Commission Deputy Chair and now Chair of the Cosmetic Surgery Oversight Group, said this was a significant step in cleaning up this sector. 

‘These developments are important for patients and mark a real turning point. The line has been drawn for practitioners about what is not acceptable,’ Ms Rickard said. 

Maddison Johnstone and Michael Fraser from Operation Redress have been monitoring online advertising in the cosmetic sector for years. 

‘It is important that the medical regulator took the concerns of brave whistle-blowers and patients seriously, and investigated the deeply troubling practices exposed by the media. The new Medical Board guidelines, combined with the use of software to proactively monitor advertising, are significant steps towards increasing patient safety, protecting the public and putting Australia on a path to being a leading country in regulating the cosmetic surgery sector. 

‘Young people are particularly vulnerable to cosmetic procedure advertising, so these changes will contribute to protecting young people and children from exposure to advertising that is known to impact their self-esteem,’ Mr Fraser said.

Ahpra has been proactively auditing cosmetic surgery advertising since September 2022 and found high rates of non-compliance. The Medical Board has taken regulatory action where necessary. We will be continuing our audit program against the new rules from 1 July 2023. Practitioners should use this time to review their advertising and address any issues.

Endorsement pathway on track 

Health ministers have approved a new registration standard for cosmetic surgery endorsement to help patients know who is trained and qualified to perform cosmetic surgery safely. 

The endorsement will make it clear on the public register if a doctor has met cosmetic surgery standards set by the Australian Medical Council (AMC) and the Medical Board of Australia. 

The Board can’t limit surgery to surgeons – that’s not how the law works. Already, every day, hospitals across rural and regional Australia employ doctors who are not specialist surgeons to provide surgery to patients. Changing this would grind surgical services to regional and rural Australians to a halt.

‘Creating an endorsement is the strongest regulatory tool in our kit. We’re introducing it to make patients safer. An endorsement will tell patients who is trained and qualified. Without it, patients will be no better informed than they are now and the opportunity to clean up the cosmetic industry will be lost,’ Dr Tonkin said.

‘We absolutely acknowledge the expertise of specialist surgeons and endorse health ministers’ decision to protect the title ‘surgeon’ to stop anyone without specialist registration in surgery, obstetrics and gynaecology or ophthalmology from calling themselves a surgeon, she said.

‘Both will help patients understand who is qualified.’

The same rigorous process that accredits the training programs of specialist medical colleges (like the Royal Australasian College of Surgeons), is setting the standards of training (accreditation standards) required for cosmetic surgery endorsement.  

The cosmetic surgery accreditation standards are expected to be published shortly and will determine which qualifications will be recognised for endorsement. 

Cosmetic surgery training providers will apply for accreditation of their training program. If their program meets the accreditation standards, their graduates will be eligible for endorsement.