AHPRA reveals next phase of cosmetic medicine crackdown

From blistering burns to cheek abscesses, the booming cosmetic medicine industry is leaving some patients scarred and searching for answers.
 
The sector, which is already the focus of new AHPRA regulations passed in July, rakes in more than a billion dollars each year in Australia, thanks to a spike in customer demand.
 
But while initial reforms focused primarily on surgical procedures, the regulator has announced a new crackdown on Botox injections, fillers, fat-dissolving injections, and thread lifts performed by doctors, nurses, dentists, and other healthcare practitioners.
 
The stronger safeguards for non-surgical patients include new guidelines for registered practitioners and the advertising of aesthetic treatments, and build on the 16 recommendations released last year following an independent investigation.
 
Australasian College of Aesthetic Medicine President Dr Gabrielle Caswell told newsGP further regulatory tweaks should focus on responsibility to patients, scripting, and training and treatment environments.
 
‘The balance is ensuring that patients can access their preferred treatments they would like, as adults with informed consent, but not to be so regulated that it may cause “backyard” treatment circuits to appear,’ she said.

‘Like all medical procedures cosmetic medicine should be delivered in a medical environment, after an assessment for patient’s suitability for treatment, and treatment outcome.
 
‘Used well with an experienced and well-trained practitioner, the results can be very good for patients.’
 
One case investigated by the regulator saw a patient undergo intense pulsed light treatment leading to significant burns and large purple blistering.
 
The patient claimed the doctor did not obtain correct consent for the treatment, did not first test the treatment on her, used an incorrect setting, and did not stop when she complained.
 
In another case, a patient suffered an infection in her cheek following thread lift procedure, requiring two rounds of surgery to remove an abscess and restore her appearance.
 
The medical professionals involved in both procedures received sanctions from AHPRA.
 
In response to a rising number of similar stories, consultation will soon begin on the proposed new practice guidelines for practitioners.
 
‘The planned overhauls are likely to place a stronger emphasis on informed consent and pre-procedure consultation, including a patient suitability assessment,’ AHPRA and the MBA said.
 
‘There will also be a focus on prescribing and administering prescription-only cosmetic injectables.’
 
Proposed new advertising guidelines are set to focus on the use of ‘before and after’ images, claims about expertise and qualifications, and affirm the ban on the use of testimonials.
 
Clear rules are also expected to be introduced for influencers and social media advertising.
 
Dr Jeremy Hudson, Chair of RACGP Specific Interests Dermatology, told newsGP any strengthening of guidelines could have both positive and negative outcomes for already stretched GPs.
 
‘I think some of it will have the benefit of protecting patients, but on the other hand, it may also increase the workload for GPs and create barriers for some people,’ he said.
 
‘I’m very supportive of regulation on advertising, particularly which targets young people … with the increase of social media, and body awareness and the amount of criticism that they can get online.’
 
Since a Cosmetic Surgery Hotline was established in September last year, it has received 428 calls from patients and doctors.
 
It has also received 179 formal complaints or notifications, resulting in 14 medical professionals no longer practising cosmetic surgery or having significant restrictions in place.
 
Dr Ronald Feiner, a GP turned cosmetic physician told newsGP there needs to be a paradigm shift in the way many cosmetic clinics currently operate.
 
‘It’s directly proportional to the proliferation of cosmetic clinics being everywhere, every shopping centre, every street,’ he said.
 
‘Doctors and nurses in these clinics are not working under the same roof, they’re not in the same location and that raises an issue that doesn’t happen in any other medical field.
 
‘If somebody has a vascular occlusion, that’s a serious problem. That independent person, usually a nurse working in a clinic on his or her own, needs to contact the prescribing doctor to arrange a remedy to manage the situation, and that just doesn’t work.’
 
Public consultation on the proposed guidelines will open in coming months and they are set to be released in the first half of next year.
 
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