Cosmetic surgery needs better quality control

At a time when Botox treatments are as common as spray-tans and procedures are becoming more affordable, unapproved ...

At a time when Botox treatments are as common as spray-tans and procedures are becoming more affordable, unapproved drugs imported from overseas pose a serious threat to public health. Photo: Getty

Many people who get cosmetic procedures like fillers, Botox or breast implants don’t admit to them.

They fear being judged as vain, or want their wrinkle-free face or plump lips to appear natural. Fair enough - why admit to not being genetically blessed?

But when they experience harm or side effects as a result of those treatments, this mentality may prevent them from coming forward to make a formal complaint. Yet walking in for a procedure as a perfectly healthy patient and coming out of it in pain and with side effects can be extremely traumatic.

One issue is patients may have difficulty distinguishing between genuine side effects disclosed before the procedure, and side effects occurring because the product was faulty or being carried out by someone lacking experience.


But no matter what procedure they are getting, elective or not, patients have every right to expect a high standard of treatment and to speak out when they suspect a procedure is not up to standard, they’ve received a dodgy product or the clinician may be unqualified.

As I reported in the Sydney Morning Herald on Wednesday, it can be hard for the consumer to tell if they are suffering a statistically unfortunate but genuine, uncontrollable side effect, or are a victim of malpractice.

A senior research fellow from the University of Melbourne's centre for health policy, programs and economics, Marie Bismark, says for every cosmetic patient to complain, dozens more did not.

A doctor and lawyer, she has conducted comprehensive research into medical negligence and patient complaints in Australia.

''There were very clear patterns,'' she says.

''Women were going in for one procedure and then reporting feeling pressured to make a decision quickly for more procedures than they had initially wanted on the day of the treatment.

''Patients felt there weren’t given time to ask questions or think about what’s involved.''

There was a trend of doctors overselling the benefits of cosmetic surgery and not making patients properly aware risks, or that the procedure may not work at all.

''In the US where most of data comes from cosmetic procedures are one of fastest rising areas of medical malpractice litigation,'' Dr Bismark said.

''It is harder to know the figures in Australia because of a lack of data, but we suspect as procedures increase complaints will rise as well.''

Driving a rise in procedures is the frequent advertising of what may be otherwise unaffordable treatments through the use of group discount websites like Groupon, Scoopon and Cudo.

What patients may not realise is that many of the treatments are being sold for far below cost prices. How do the doctors afford it then? Professional bodies, including the Australasian College of Cosmetic Surgeons, believe some clinics and doctors are importing cheap, unregulated and untested products from overseas suppliers and dirt-cheap prices, allowing them to sell them cheaply but with significant profit here.

Patients also may not be aware that the doctor who will be carrying out the procedure – whether a Botox injection or liposuction – must be named on the consent from before the patient signs.

Research by Dr Bismark and her colleagues, published in the Medical Journal of Australia, found out of nearly 10,000 Australian medicolegal cases resolved between 2002 and 2008, 16 per cent involved cosmetic procedures. Plastic surgeons, orthopaedic surgeons, vascular surgeons, and dermatologists experienced disproportionately high rates of consent disputes – in other words, patients feeling like they were not given enough information to make an informed choice when consenting to the procedure.

At a time when Botox treatments are as common as spray-tans and procedures are becoming more affordable, the Australasian College of Cosmetic Surgeons has warned unapproved drugs imported from overseas pose a serious threat to public health.

''The Australasian College of Cosmetic Surgery has had presented to it strong circumstantial and direct evidence that an Australian doctor appears to be sourcing and injecting patients with unapproved Botulinum toxin,'' their formal complaint to the Therapeutic Goods Administration read.

They lodged the complaint this week because a patient was brave enough to come forward with her story. Hopefully, it will give other patients the confidence to speak up so poor operators previously given a slap on the wrist can be held to account. Because they too should be bound by medical ethical guidelines to ''do no harm''.

Melissa Davey is a health reporter with the Sydney Morning Herald and is studying a Masters of Public Health at the University of Sydney. Twitter - @MelissaLDavey


  • Funny that the College of Cosmetic Surgeons is warning the public about misinformation and quality control when you do not need any surgical qualification to practice cosmetic surgery. Indeed, not one Doctor on their council has a qualification from the College of Surgeons.

    Must be plenty of money in it though, as they charge triple per year of training what the College of Surgeons does.

    Not a Dr
    Date and time
    March 07, 2013, 3:30PM
    • Surely this is mysogeny to an extent never before experienced. Why do women, in far higher proportions than men, feel compelled to have plastic surgery. We should be worshiping older women as the ancients did proudly showing our post-menopausal status as a recognition of wisdom gained during the female life; see Venus de Milo and other goddess figures. Why play up to the myopic male testosterone fueled vision of always being sexually attractive. Plastic surgery is a wonder for accident victims and that is where it should stay.

      Date and time
      March 07, 2013, 3:59PM
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