In less 3 months, we have gone from the Australian Broadcasting Corporation (ABC) airing a report on the horrors of what can go wrong with cosmetic surgery in Australia, to the national regulator and medical board releasing details of an independent review into this area of medical practice. How did this unfold?

On 25th October 2021 the ABC’s Four Corners broadcasted Cosmetic Cowboys, a damning investigation that revealed (hopefully) the worst of what is happening in the cosmetic surgery industry in Australia. Some of the footage contained in the broadcast was so appalling that Mark Ashton, Professor of Surgery at The University of Melbourne said “It is dangerous, disrespectful, it is bewildering. If you didn’t show me these people, you’d think, oh, this can’t be happening in Australia. And here it is.”

On Tuesday 26^th October 2021 the Royal Australasian College of Surgeons, the Australian Society of Otolaryngology, the Australasian Society of Aesthetic Plastic Surgeons and the Australian Society of Plastic Surgeons issued a joint statement citing their concerns about reports of patients falling victim to adverse outcomes when elective cosmetic procedures are performed by medical practitioners who do not have specialist medical registration in a surgical discipline. The joint statement highlighted the confusion that exists for those looking to undergo cosmetic surgical procedures because a significant proportion of those advertising these procedures will not have an Australian specialist registration in the field of surgery. They stated that “Like any form of surgery, cosmetic procedures need to be performed by a practitioner who is trained in the procedure, including appropriate proper post-operative care. Risks include problems related to anaesthesia and surgery, excessive bleeding, infection, scarring and failure to heal.” They also highlighted that in Australia, the Royal Australasian College of Surgeons is the only provider of accredited training for nine surgical fields of specialist medical practice. The joint statement suggested that “a relatively minor but potentially effective reform would be one which prevented medical practitioners not registered in a specialty with a significant surgical scope, and who have not been trained in an AMC (Australian Medical Council) accredited surgical training program from representing themselves as ‘cosmetic surgeons’ and advertising to the general public as such.”

The Australian Medical Association (AMA), on Tuesday 26^th October 2021 also released a statement which called for a tightening of the title “surgeon”. Their position is that only those medical practitioners with a Fellowship from an AMC accredited specialist medical college, whose training program includes a surgical component relevant to their field of expertise, should be allowed to be titled as surgeons. AMA President Dr Omar Khorshid said “Many Australians will be shocked to know you can call yourself a cosmetic surgeon without any specific surgical training whatsoever as there’s no restriction on the use of the term ‘surgeon’ by doctors or by other health practitioners.”

By 30^th October 2021, the Medical Board of Australia had accepted a legally enforceable undertaking from Dr Daniel Lanzer, the cosmetic surgeon featured at the centre of the controversy in the Four Corners Broadcast.

On 29^th November 2021 the Australian Society for Plastic Surgeons stated that consumers needed to be educated in identifying those practising cosmetic surgery to look for those who had completed their training with the Royal Australasian College of Surgeons.

On 30^th November 2021 the Australian Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia announced a review of patient safety issues in the cosmetic sector. AHPRA stated that the review would consider its own existing regulation and regulatory practices as well as that of the relevant National Boards to better protect the public. They stated that “Health Ministers have already committed to a national consultation on changing the National Law to protect surgeon as a title.” The Australian Society of Plastic Surgeons (ASPS) welcomed this announcement by AHPRA and the Medical Board of Australia. ASPS President Dr Dan Kennedy said “Tightening of regulations is necessary, and so too is strong enforcement of these regulations. Penalties must be strengthened to provide a genuine disincentive against risky behaviour – small fines and warnings are not enough.”

On 14^th January 2022 AHPRA and the Medical Board of Australia announced that those appointment for the review are:

• Mr Alan Brown – Lead Reviewer – outgoing Queensland Health Ombudsman
• Mr Alan Kirkland – CEO, CHOICE
• Conjoing Professor Anne Duggan – Chief Medical Officer, Australian Commission on Safety and Quality in Health Care
• Ms Richelle McCausland – National Health Practitioner Ombudsman

AHPRA has stated that the review will call for submissions in early 2022 and that the report of findings and recommendations will be released in mid-2022.