We are encouraged by news that the Medical Board of Australia has completed its review of the cosmetic surgery industry and has today introduced what the ABC calls “tough new guidelines for doctors” practising in this ever growing area.

Almost a year ago, we blogged about the need for reform in the cosmetic surgery industry. Since then there have been more cases coming to light of dangerous practices in the cosmetic industry which are increasingly putting patients at high risk of adverse (including life-threatening) events.

Recently the Health Care Complaints Commission (HCCC) – the health regulatory body in NSW – has been investigating incidents at The Cosmetic Institute (TCI), the largest provider of cosmetic surgery in Australia.  According to ABC coverage of the HCCC investigation, the HCCC revealed that six patients in the last year had suffered life threatening complications during the insertion of breast implants. These arose as a result of levels of sedation being used above those the TCI was licensed to use. Indeed, two of the TCI’s patients suffered cardiac arrests and had to be rushed to hospital. This serves to highlight the fact that the clinics where procedures are performed are not adequately equipped to deal with serious surgical complications. This not only puts patients at risk but also shifts the burden of follow-up care onto the public health system.

What the new Guidelines say

A link to the guidelines is found here:  In summary, they include:

• Recognition of the potential conflict of interest between competing a practitioner’s financial interests and the best interests of their patient
• Cooling off periods for all patients considering a major procedure (including breast surgery, liposuction, rhinoplasty and face lifts)
• Greater protection for minors under 18 years old (longer cooling off periods as well as mandatory counselling)
• Mandatory face to face consultations (including Skype) for patients considering prescription-only injectables like Botox and fillers
• The need for detailed written information about costs for patients
• A ban on practitioners offering financing schemes to patients (other than credit cards)
• A comprehensive list of the type of information required to be provided to patients to obtain informed consent
• Restrictions on advertising to prevent glamorising procedures, minimising complexity, overstating results or implying unrealistic outcomes are achievable
• Provision to the patient of information as to the medical practitioner’s qualifications and experience
• Procedures to be performed in a facility appropriate for the level of risk involved, appropriately staffed and equipped to manage possible complications and emergencies
• Treating practitioners to take responsibility for post-operative care and explicit written instructions to be given to patients regarding follow up

What the Guidelines don’t cover

• Drugs and poisons legislation
• Licensing and regulation of private clinics particularly in regard to use of sedation and anaesthesia such as the recent problems revealed by the HCCC’s investigation into TCI which instead fall to be dealt with by the NSW Health Minister

In our view, the Guidelines represent a welcome and genuine effort to establish some much-needed clarity, guidance and consumer protection in this area. Their effectiveness will be determined by how diligently the guidelines are followed. Only time will tell if they make a difference to protect those undergoing cosmetic surgery.