Cosmetics industry in dire need of stronger overall oversight

October 31, 2021 â€" 6.30am

The exposure of unsavoury practices by a well-known cosmetic surgeon has lifted the lid on the cosmetic treatments industry more broadly.

While last week’s joint investigation by The Age and the ABC’s Four Corners program brought to light allegations of questionable conduct at the network of clinics run by celebrity cosmetic surgeon Dr Daniel Lanzer, accompanying expert testimony clearly revealed the entire industry is in dire need of stronger overall oversight and transparency.

Cosmetic surgeon Daniel Lanzer in happier times.

Without dwelling on the unquestionably gory details, the Lanzer allegations included serious hygiene and safety breaches, botched procedures, questions of consent over treatment videos posted on social media, and evidence that patients and staff were pressured to post favourable reviews online and to bury negative ones.

Suffice to say anybody who saw the graphic images or read some of the patients’ frankly gruesome testimony would have not only reacted with revulsion but asked: how could this have been allowed to occur?

The answer, apparently, is a system of regulation with more loopholes than a crocheted beanie.

Among them, a push to regulate the use of the title “surgeon” â€" which suggests a high level of qualification â€" has languished for years, tangled in red tape.

While registered specialist surgeons, such as plastic surgeons, have to undergo eight to 12 years of postgraduate surgical training to receive their accreditation from the Royal Australasian College of Surgeons, anybody with a medical degree can call themselves “cosmetic surgeons” and perform surgery. Entirely legal. But also misleading.

Another concern: because cosmetic treatments are usually performed in day clinics, without general anaesthetic, some experts such as Dr Margaret Faux â€" a health regulation consultant who has worked in the sector for 40 years â€" believe they are not as scrutinised by regulators as hospital procedures. Cosmetic treatments were “completely invisible” to regulators, she told this masthead, because “the government has no eyes on what happens in the cosmetic sector, in the outpatient setting”.

Professor Allan Fels, a former chairman of the Australian Competition and Consumer Commission, suggests regulators have not paid enough attention to the industry because “it is perceived as being not about sick people but about people who are concerned about their appearance”.

For its part, the Australian Health Practitioner Regulation Agency is at pains to point out on its website that as cosmetic surgeons are not required to be registered as such “we do not specifically count how many notifications [complaints] are made about cosmetic surgeons”.

The national regulator also notes that while a practitioner may be registered as a doctor, “they may have very little experience or knowledge of the specific procedures or surgery you want” and suggests would-be patients “ask about their qualifications and experience”. In other words: buyer beware.

More broadly, there is the complex nexus of cosmetic treatments, mental health and self-image in the fertile ground of social media, with concern that the stream of “perfect” posts from beauty-conscious “influencers” can create the desire for unnecessary or potentially harmful cosmetic procedures.

While the biggest increase in procedures is in non-invasive injectables and Botox, according to Dr Gemma Sharp, head of the Body Image Research Group at the Monash Alfred Psychiatry Research Centre, they are also seeing an increase in invasive procedures like liposuction and breast augmentation. “The Brazilian butt lift is the latest craze,” he told The Age.

On Friday, it was revealed that following the Age/Four Corners investigation Dr Lanzer had given a legally enforceable undertaking to AHPRA to stop practising medicine in Australia in any form.

Yet, this crackdown must not be allowed to end with just a single ceremonial scalp: the Lanzer allegations are unlikely to be an isolated example.

On the contrary, some have described this episode as the tip of the iceberg. Authorities must shake off their apathy towards cosmetic treatments, install an effective regulatory framework that enforces training, certification and accreditation requirements â€" and pull this burgeoning industry sharply into line.

The Age's View â€" Since The Age was first published in 1854, the editorial team has believed it important to express a considered view on the issues of the day for readers, always putting the public interest first.

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