Experts say the sector is infiltrated by dodgy operators cashing in on $1bn obsession with beauty
A huge increase in complications associated with cosmetic procedures has prompted a renewed push for increased regulation in a sector experts say has been infiltrated by dodgy operators cashing in on Australia’s $1bn obsession with beauty.
This week, a paper released by the journal of Plastic and Reconstructive Surgery found that across the globe almost 200 people suffered blindness after receiving dermal fillers in the past year.
The figure represents a 94% increase from the year before, and triggered warnings from doctors who say regulation around the industry has failed to keep pace with the surge in popularity of cosmetic procedures offering fuller lips and smoother skin.
“The trend in Australia and also worldwide is, I think, a really big, almost exponential increase in these procedures,” the president of the Australasian College of Cosmetic Surgery, Dr Irene Kushelew, told Guardian Australia.
“And because of that explosion in interest in these procedures there’s been, at the same time, an explosion in the number of clinics setting up and offering these services.
“The reality is that some of those clinics are really not well set up, the people working in them are often not up to the training standards they should be, and it’s often very hard for patients to know the difference.”
Health regulators have repeatedly warned of an increase in sub-par practitioners using illegally imported substances in unregulated environments. In 2018 Four Corners revealed that an Australian woman had gone permanently blind after having dermal filler injected into her face by a nurse at a clinic where there was no doctor physically present.
The year before, the Health Care Complaints Commission prohibited Pu Liu (also known as Mabel Liu) from conducting cosmetic or surgical procedures for at least three years after an investigation by the Sydney Morning Herald revealed how the unregistered practitioner had been conducting procedures advertised via WeChat from her Five Dock apartment.
At the heart of the problem, industry insiders say, is a lack of regulation around who can call themselves a cosmetic surgeon.
“The term cosmetic surgeon is unregulated, and what that means is that any med practitioner, regardless of their training experience or qualifications, can call themselves a cosmetic surgeon,” associate professor Gazi Hussain, the president of the Australian Society of Plastic Surgeons, said.
“So you can be someone fresh out of medicine school without any significant training in surgery and can hang up a sign saying you’re a cosmetic surgeon. You could be a cardiac surgeon who has spent your career looking after people having heart attacks and then the next day call yourself a cosmetic surgeon.”
Hussain said the major the term surgeon itself was not protected, meaning “the majority of people who call themselves cosmetic surgeons are not trained in surgery”.
A general practitioner “might have gone off an done a weekend course in some kind of cosmetic surgery and then started doing that operation”, Hussain said.
In 2017 following the death of Jean Huang after receiving breast enlargement surgery by a visiting Chinese surgeon the New South Wales government established an inquiry into cosmetic health service complaints.
In findings published last year, the inquiry recommended the government push the Coag health council to protect or restrict the term at a national level.
Coag released a consultation paper at the end of last year, and is expected to consider whether legislative changes are needed later in 2019.
The NSW inquiry also raised concerns about what it called the spread of “commercial operators who put profits before patients”. Industry estimates put the value of Australia’s cosmetic procedure industry at about $1bn, 40% larger per capita than the US.
Dr Michael Molton from the Cosmetic Physicians College of Australasia told the inquiry there was a “fundamental difference” between “commercial” and “medical” operators.
Molton told the inquiry that if a person is a client and not a patient “you are going to sell that person everything you possibly can whether they need it or not, regardless of any other circumstances”.
Hussain also acknowledged the problem, and said the ASPS was looking to establish “ethical guidelines” around social media and other advertising.
“What happens is because it’s an unregulated area and it’s an area of growth fuelled by social media there has been a real commercialisation of this whole area, and a commodification of patients,” he said.
“We actually are aware of that and we want to be part of the solution. But the thing is if we are arguing to our members that we are going to hold ourselves to a higher standard we would expect regulators to make sure other practitioners are also abiding to a higher standard.”