Australia: Putting cosmetic surgery under the microscope

Despite the seemingly increased popularity of cosmetic procedures, it might surprise many Australians that the industry here is far less regulated than other areas of medicine.

It's no question that the cosmetic surgery industry is continuing to grow rapidly, perhaps as a consequence of the image-obsessed world in which we live in.

It is estimated that 15,000 Australians spend $300 million a year travelling overseas for cosmetic procedures, let alone the numbers who undergo cosmetic surgery here in Australia.1

Yet as thousands flock to have cosmetic surgery, many people may not know that a cosmetic surgeon does not need to hold the same level of specialised training as a plastic surgeon or that a cosmetic surgeon can undertake procedures in facilities other than hospitals and which may not be properly equipped if something goes wrong.

So, who are cosmetic surgeons and how can they operate?

Plastic surgeons vs. cosmetic surgeons – Is the training the same?

One of the most significant differences between plastic surgeons and cosmetic surgeons is the level of training.

In Australia, in addition to holding a Bachelor of Medicine & Bachelor of Surgery ('MBBS') plastic surgeons must complete a specialisation by way of a fellowship (FRACS (PLAS)) and thereby completing an additional 5-10 years in education and training.

On the other hand, any registered practitioner with an MBBS can call themselves a cosmetic surgeon without any specialty training or surgical qualifications from FRACS.

Plastic surgeons vs. cosmetic surgeons – Where they can operate?

Cosmetic surgery procedures can be performed in both licensed facilities such as hospitals as well as in unlicensed facilities such as private operating rooms.

The only restriction placed on cosmetic surgery procedures in unlicensed facilities is the level of anaesthesia that surgeons are permitted to use. For example, general anaesthetics can only be administered in licensed facilities.

However, a cosmetic surgery practitioner may use what is known as "twilight/conscious sedation" where patients are given doses of anaesthetics but essentially remain awake.

This means that medical practitioners can legally perform for example, a breast augmentation in an unlicensed facility if they are not using a general anaesthetic.

Unlicensed facilities do not have to adhere to the same strict hospital protocols or safety standards and there are very few, if any, rules governing equipment, staffing or hospital back-up in case of an emergency.

So what could possibly go wrong?

When using twilight/conscious sedation an anaesthetist may not necessarily be present and in these situations the surgeon undertaking the procedure is also administering the anaesthetics.

This poses a number of issues to the patient.

Amongst other things, anaesthetists' sole responsibility is to monitor the vital signs of a patient and keep them alive during the procedure. The anaesthetist is trained to understand the subtleties and nuances of the transition from consciousness through to sedation and can respond to any emergencies. Some of the risks an anaesthetist is trained to recognise and respond to include overdoses, cardiac arrests, toxicities, infections, seizures and oxygen deficiencies.

Additionally unlicensed facilities may lack requisite machinery and equipment needed to manage an emergency, and may also not be in close proximity to hospitals.

The law and what you need to know

The law requires certain information be provided to a patient, such information includes a description of the procedure including its inherent risks and side effects in an easily comprehensible way; also, what particular form of pain relief will be provided (e.g. local anaesthetic, sedation or general anaesthetic) – such information forms the basis of informed consent.2

In addition a patient would be wise to ask questions such as:

  • Who will be performing the procedure?
  • Who will be monitoring me during the procedure (e.g. anesthetist or another person who will be monitoring my pain relief and breathing)?3
  • Where the procedure is going to take place; and
  • What facilities are available in the event of an emergency?

As with any negligence claim, a patient who alleges that a medical practitioner is liable for failing to warn of a procedure's material risk must establish that the duty owed was breached, i.e. a material risk was not disclosed, and that the harm sustained was caused by that breach.

Regulatory Measures

In 2016 the Medical Board of Australia issued a set of mandatory guidelines for all medical practitioners performing cosmetic medical and surgical procedures. The guidelines apply to all medical practitioners including specialist plastic surgeons and cosmetic surgeons, regardless of their qualifications.

The guidelines require:

  • A seven-day cooling off period for adult patients and a three-month period for under 18s,
  • The treating practitioner to take explicit responsibility for post-operative patient care and for making sure there are emergency facilities when using sedation and anaesthesia, and
  • The medical practitioner to provide clear information to consumers about their credentials and experience, risks and possible complications and detailed written information about costs.

Things to know if your are considering a cosmetic procedure:

  • Not all surgeons are the same when it comes to training
  • Plastic surgeons undertake 5 to 10 years on top of a basic medical degree
  • Anyone with a medical degree can practise as a cosmetic surgeon
  • Ask about where it will be undertaken and facilities available if an emergency occurs
  • Ask if the facility is licensed or unlicensed
  • Ask what kind of anaesthetic will be used and if a specialised anaesthetist will be present

If something goes wrong?

  • Seek immediate medical advice and treatment – do not delay
  • There are legal remedies available – seek independent legal advice as soon as you can



2 See 'Guidelines for registered medical practitioners who perform cosmetic and surgical procedures', published 1 October 2016, guideline 4. < HTTP://WWW.MEDICALBOARD.GOV.AU/NEWS/2016-05-09-MEDIA-STATEMENT.ASPX >

3 Ibid, guideline 5, 6 & 8.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on

Click to Login as an existing user or Register so you can print this article.

Bill Madden
Some comments from our readers…
“The articles are extremely timely and highly applicable”
“I often find critical information not available elsewhere”
“As in-house counsel, Mondaq’s service is of great value”

Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Check to state you have read and
agree to our Terms and Conditions

Terms & Conditions and Privacy Statement (the Website) is owned and managed by Mondaq Ltd and as a user you are granted a non-exclusive, revocable license to access the Website under its terms and conditions of use. Your use of the Website constitutes your agreement to the following terms and conditions of use. Mondaq Ltd may terminate your use of the Website if you are in breach of these terms and conditions or if Mondaq Ltd decides to terminate your license of use for whatever reason.

Use of

You may use the Website but are required to register as a user if you wish to read the full text of the content and articles available (the Content). You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these terms & conditions or with the prior written consent of Mondaq Ltd. You may not use electronic or other means to extract details or information about’s content, users or contributors in order to offer them any services or products which compete directly or indirectly with Mondaq Ltd’s services and products.


Mondaq Ltd and/or its respective suppliers make no representations about the suitability of the information contained in the documents and related graphics published on this server for any purpose. All such documents and related graphics are provided "as is" without warranty of any kind. Mondaq Ltd and/or its respective suppliers hereby disclaim all warranties and conditions with regard to this information, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. In no event shall Mondaq Ltd and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use or performance of information available from this server.

The documents and related graphics published on this server could include technical inaccuracies or typographical errors. Changes are periodically added to the information herein. Mondaq Ltd and/or its respective suppliers may make improvements and/or changes in the product(s) and/or the program(s) described herein at any time.


Mondaq Ltd requires you to register and provide information that personally identifies you, including what sort of information you are interested in, for three primary purposes:

  • To allow you to personalize the Mondaq websites you are visiting.
  • To enable features such as password reminder, newsletter alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our information providers who provide information free for your use.

Mondaq (and its affiliate sites) do not sell or provide your details to third parties other than information providers. The reason we provide our information providers with this information is so that they can measure the response their articles are receiving and provide you with information about their products and services.

If you do not want us to provide your name and email address you may opt out by clicking here .

If you do not wish to receive any future announcements of products and services offered by Mondaq by clicking here .

Information Collection and Use

We require site users to register with Mondaq (and its affiliate sites) to view the free information on the site. We also collect information from our users at several different points on the websites: this is so that we can customise the sites according to individual usage, provide 'session-aware' functionality, and ensure that content is acquired and developed appropriately. This gives us an overall picture of our user profiles, which in turn shows to our Editorial Contributors the type of person they are reaching by posting articles on Mondaq (and its affiliate sites) – meaning more free content for registered users.

We are only able to provide the material on the Mondaq (and its affiliate sites) site free to site visitors because we can pass on information about the pages that users are viewing and the personal information users provide to us (e.g. email addresses) to reputable contributing firms such as law firms who author those pages. We do not sell or rent information to anyone else other than the authors of those pages, who may change from time to time. Should you wish us not to disclose your details to any of these parties, please tick the box above or tick the box marked "Opt out of Registration Information Disclosure" on the Your Profile page. We and our author organisations may only contact you via email or other means if you allow us to do so. Users can opt out of contact when they register on the site, or send an email to with “no disclosure” in the subject heading

Mondaq News Alerts

In order to receive Mondaq News Alerts, users have to complete a separate registration form. This is a personalised service where users choose regions and topics of interest and we send it only to those users who have requested it. Users can stop receiving these Alerts by going to the Mondaq News Alerts page and deselecting all interest areas. In the same way users can amend their personal preferences to add or remove subject areas.


A cookie is a small text file written to a user’s hard drive that contains an identifying user number. The cookies do not contain any personal information about users. We use the cookie so users do not have to log in every time they use the service and the cookie will automatically expire if you do not visit the Mondaq website (or its affiliate sites) for 12 months. We also use the cookie to personalise a user's experience of the site (for example to show information specific to a user's region). As the Mondaq sites are fully personalised and cookies are essential to its core technology the site will function unpredictably with browsers that do not support cookies - or where cookies are disabled (in these circumstances we advise you to attempt to locate the information you require elsewhere on the web). However if you are concerned about the presence of a Mondaq cookie on your machine you can also choose to expire the cookie immediately (remove it) by selecting the 'Log Off' menu option as the last thing you do when you use the site.

Some of our business partners may use cookies on our site (for example, advertisers). However, we have no access to or control over these cookies and we are not aware of any at present that do so.

Log Files

We use IP addresses to analyse trends, administer the site, track movement, and gather broad demographic information for aggregate use. IP addresses are not linked to personally identifiable information.


This web site contains links to other sites. Please be aware that Mondaq (or its affiliate sites) are not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of these third party sites. This privacy statement applies solely to information collected by this Web site.

Surveys & Contests

From time-to-time our site requests information from users via surveys or contests. Participation in these surveys or contests is completely voluntary and the user therefore has a choice whether or not to disclose any information requested. Information requested may include contact information (such as name and delivery address), and demographic information (such as postcode, age level). Contact information will be used to notify the winners and award prizes. Survey information will be used for purposes of monitoring or improving the functionality of the site.


If a user elects to use our referral service for informing a friend about our site, we ask them for the friend’s name and email address. Mondaq stores this information and may contact the friend to invite them to register with Mondaq, but they will not be contacted more than once. The friend may contact Mondaq to request the removal of this information from our database.


From time to time Mondaq may send you emails promoting Mondaq services including new services. You may opt out of receiving such emails by clicking below.

*** If you do not wish to receive any future announcements of services offered by Mondaq you may opt out by clicking here .


This website takes every reasonable precaution to protect our users’ information. When users submit sensitive information via the website, your information is protected using firewalls and other security technology. If you have any questions about the security at our website, you can send an email to

Correcting/Updating Personal Information

If a user’s personally identifiable information changes (such as postcode), or if a user no longer desires our service, we will endeavour to provide a way to correct, update or remove that user’s personal data provided to us. This can usually be done at the “Your Profile” page or by sending an email to

Notification of Changes

If we decide to change our Terms & Conditions or Privacy Policy, we will post those changes on our site so our users are always aware of what information we collect, how we use it, and under what circumstances, if any, we disclose it. If at any point we decide to use personally identifiable information in a manner different from that stated at the time it was collected, we will notify users by way of an email. Users will have a choice as to whether or not we use their information in this different manner. We will use information in accordance with the privacy policy under which the information was collected.

How to contact Mondaq

You can contact us with comments or queries at

If for some reason you believe Mondaq Ltd. has not adhered to these principles, please notify us by e-mail at and we will use commercially reasonable efforts to determine and correct the problem promptly.