Cosmetic Surgery Reforms: are you ready?

Cosmetic Surgery Reforms: are you ready?

On 1 July 2023, the Medical Board of Australia introduced tight regulations on medical practitioners practising cosmetic surgery and non-surgical cosmetic procedures. Here’s what you need to know.

The reforms draw a distinction between cosmetic surgery (involves cutting beneath the skin) and non-surgical cosmetic procedures (does not involve cutting beneath the skin but may involve piercing the skin).

Medical practitioners need to clearly inform their patients of their registration type and must not make claims about their expertise or qualifications that could mislead patients. Where a medical practitioner’s scope of practice includes cosmetic surgery, they must undertake continuing professional development that includes activities pertaining to cosmetic surgery.

Cosmetic Surgery

All patients seeking cosmetic surgery will need a referral from another medical practitioner (preferably their usual GP) who has no association with the medical practitioner to whom they are referred. The referring doctor must not perform cosmetic surgery or non-surgical cosmetic procedures.

Medical practitioners must decline to perform cosmetic surgery where they believe it is not in the patient’s best interest. Medical practitioners performing the surgery must explicitly discuss and keep a record of each patients’ motivations for having cosmetic surgery. This includes administering a valid screening assessment for underlying psychological conditions like body dysmorphia disorder.

If there are indications of a significant underlying psychological issues that may make the patient unsuitable, the medical practitioner must refer the patient to a psychiatrist, psychologist or GP who works independently of the medical practitioner for assessment.

Patients must have at least two pre-operative consultations with the medical practitioner who will perform the surgery, one of which must be in person.

A patient must not be asked to sign consent forms at the first consultation by the medical practitioner performing the surgery.

Patients must be given a cooling-off period of at least seven days after the two consultations and provide informed consent before the surgery can be booked or a deposit paid.

There are additional requirements for patients under the age of 18 years. All patients must be referred to and evaluated by a psychologist, psychiatrist or general practitioner who works independently of the medical practitioner who will perform the surgery. Regard, to the extent that is practicable, is to be had to the views of the parent or guardian of the patient, and there must be a cooling off period of at least three months between provision of informed consent and the surgery being performed.

Facilities where cosmetic surgery is performed must be registered with an Australian Commission on Safety and Quality in Health Care accredited agency from 1 July 2023 and be accredited by 1 July 2024.

Cosmetic procedures

Medical practitioners who perform cosmetic procedures or prescribe a cosmetic injectable must discuss and assess the patient’s reasons and motivation for requesting the procedure. The patient’s expectations must be discussed to ensure they are realistic.

As with cosmetic surgery, if there are indications of a significant underlying psychological issue that may make the patient unsuitable, the medical practitioner must refer the patient to a psychiatrist, psychologist or GP who works independently of the medical practitioner for assessment.

There is no cooling-off period for patients over 18 years of age, and for those under 18, the cooling-off period is at least 7 days.

Be it for cosmetic surgery or procedures, the Guidelines make it clear that it is the medical practitioner’s responsibility for patient management and the provision of adequate post-operative care. For example, for medical practitioners performing cosmetic surgery in a location that is not their primary place of practice, they will be required to be available at that location for at least 24 hours after the patient’s surgery. There must be a protocol for managing complications and emergencies during the procedure or in the immediate post-operative period.

Patients must be provided with all relevant information regarding the total costs. Financial inducements and payments prior to the ‘cooling-off’ period are prohibited as are financial schemes.

Medical practitioners are required to provide all patients with information regarding available complaint pathways. If there is a non-disclosure agreement in place, the medical practitioner must ensure the patient is aware that this does not displace the right of the patient to make a complaint to AHPRA, the Health Care Complaints Commission or the Medical Council of NSW.

Advertising guidelines cosmetic surgery

There are also new additional guidelines for advertising of cosmetic surgery. Advertising refers to all forms of verbal, printed and electronic communication that promotes and seeks to attract a person to use a regulated health service provider or service.

Advertising requires regular checks and balances to ensure it accurately depicts the risks and recovery involved with surgery so as not to mislead patients or create unrealistic expectations.

Advertising must be clear, accurate and easily understood, and it cannot work in a way which exploits the insecurities of individuals. Young people are particularly vulnerable in this space. Medical practitioners must not advertise any kind of incentive to encourage people to have cosmetic surgery, including discounts or ‘bundling’ of multiple procedures.

The use of testimonials is prohibited because of the risks of unrealistic expectations. A medical practitioner will be deemed to have used a testimonial in advertising if they have published it, shared it via a link, re-shared it on posts or ‘stories’ or interacted with a review by ‘liking’ or commenting.

All images used in advertising must include prominent warnings that the results displayed are specific to one patient and outcomes are subject to variation in accordance with individual factors like genetics, diet and exercise. ‘Before and after’ images must not be edited, and they must be presented side-by-side or as just the ‘before’ image.

• ie No sexualised images
• ie No Taglines and hashtags
• ie Use of non-clinical terms and descriptors

Practice endorsement

The Board has introduced a Registration Standard establishing a practice endorsement for those practising cosmetic surgery. The new standard commences from 1 July 2023 and will require practitioners to apply to the Board for recognition based on approved qualifications (which are yet to be nominated) later in 2023.

These reforms have been introduced to protect patients. Medical practitioners should familiarise themselves with the Guidelines.

If you have any questions about the Guidelines, please contact the AMA (NSW) Workplace Relations Team at
workplace@amansw.com.au or on (02) 9439 8822.

Contributed by Dominique Egan and Kristin Kendrick-Little