RACGP continues to push for overhaul of the cosmetic surgery industry



Ongoing review of industry regulations is essential to ensure patient safety “comes first,” the college says.

A number of practitioners have been banned from performing cosmetic surgery due to complications and injuries to patients.

Late last year, the Australian Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia launched a independent review regulation of health practitioners in the cosmetic surgery industry.

The review was announced in response to the discover unsafe and unregulated practices which the health regulator says raise “significant issues for patient safety”.

Since announcing its review in November 2021, AHPRA received hundreds of submissions from doctors, patients and medical organizations, including the RACGPwhile a number of practitioners have already been banned from practicing cosmetic surgery.

Assistant Professor Karen Price, chair of the RACGP, said stronger regulation is “clearly” needed to ensure patient safety and care, as is greater consultation with GPs.

“Recent reports of patients who have suffered due to shoddy practices in the cosmetic surgery industry have been disturbing to say the least,” she said.

“It is important to note that in many cases GPs are not given the opportunity to have a conversation with people who are considering cosmetic medical or surgical procedures, as consumers often bypass their usual GP and ask are aimed directly at cosmetic practitioners.

“Making changes here to ensure consumers see their GP or an appropriately trained healthcare professional could make a real difference.”

Overall, the college asks:

  • consultation with a GP or other trained healthcare professional before a major cosmetic procedure
  • specialist advice before surgery for patients under 18
  • measures to ensure that all patient consents are considered and informed, including translators to assist people from diverse cultural and linguistic backgrounds
  • tighter controls on the advertising and marketing of cosmetic procedures, including on social media
  • accreditation of clinics to ensure high quality standards in infection prevention and control for patient safety
  • clear guidelines for patients to lodge a complaint if they are unhappy with a service.

The use of terms such as “cosmetic” and “doctor” for providers of cosmetic surgery procedures is also recommended as an important safety measure, with the college recently warning against the inappropriate use of the title “surgeon.”

In addition, the RACGP calls for better public education so that patients know the meaning of each title and the level of training received.

“Treatments should only be given if the person performing them has the appropriate training and experience,” Professor Price said.

“The potential harms associated with cosmetic surgery are related to the extent to which the skills held by the practitioner match the scope of practice.”

Prof Price also says pre-operative consultations with a GP would go a long way to improving informed decision-making.

“A GP would be able to assess the patient for the appropriateness of the procedure and screen for underlying physical and mental health issues that may need to be considered,” she said.

“GPs should also have access to resources to help patients in these situations, including questions to ask a provider before a procedure and guidance on a cooling-off period before committing to surgery.”

She also pointed out that GPs are able to discuss the lack of evidence supporting a procedure and the potential for complications or injury, and counsel patients when a medical procedure is not approved and comes with unproven benefits.

Meanwhile, in a Submission 2015 at the Medical Board of Australia, the RACGP warned that as cosmetic procedures, such as Botox and collagen injection treatments, are often performed by a beautician or nurse, it is ‘likely there are cases’ where an attending physician does not supervise.

“That’s why we think it’s important for clinical groups to agree on a delineation of cosmetic surgery services based on the complexity of the procedures – and ensure that the person performing the procedure has the training, appropriate expertise and experience,” Professor Price said.

“A person performing a procedure must be able to manage all routine aspects of care and all likely complications.

“Patient safety and care must come first.”

Professor Price says new and emerging cosmetic procedures such as female genital cosmetic surgery are of particular concern.

“These procedures are not medically indicated and they are advertised with commercial labels that can be misleading, such as ‘custom laser vaginoplasty,’ ‘revirgination,’ and ‘G-shot,'” she said.

“These are invasive procedures, but there are no evidence-based guidelines for them, and no formal training is required, meaning anyone with a medical degree can perform them.”

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