Cosmetic procedures

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Cosmetic procedures

Cosmetic procedures are performed to reshape structures of the body and to alter a person’s appearance. Like any form of surgery, cosmetic procedures need a medical practitioner trained in the procedure, including appropriate recovery time, healing and proper care. Risks include problems related to anaesthesia and surgery, excessive bleeding, infection, scarring and failure to heal.

Changes to laws that affect cosmetic procedures

In 2018, amendments were made to the Health Services Act 1988 to regulate all surgery, including cosmetic surgery. The changes specified that:

• all surgery must be carried out in a registered private hospital or day procedure centre
• liposuction and anaesthesia, including intravenous sedation and anything more than a low dose of local anaesthetic, must be carried out in a registered private hospital or day procedure centre.

This means that it is now illegal for:

• any surgery (including cosmetic surgery) to be performed in facilities that are not registered with the Victorian Department of Health *
• liposuction to be performed in an unregistered facility – this includes all procedures during which more than 200 ml of ‘lipoaspirate’ (fat) is removed from a person in total
• anaesthetic (other than low doses of local anaesthetic) to be administered in an unregistered facility.

How do I know if a facility or health service establishment is registered?

To find out if a facility is registered, you can:

• visit the Department of Health Private hospitals page and expand the ‘contact details for private hospitals’ link
• email the Department’s Private Hospitals Unit privatehospitals@health.vic.gov.au
• ask to see the facility’s certificate of registration (this is usually on display in an obvious place where consumers can see it easily).

You can also contact the unit to report suspected illegal activity or for further queries regarding liposuction, cosmetic surgery or anaesthesia in Victoria.

Finding a qualified medical practitioner

Choose a qualified and reputable medical practitioner. Ask them about their specific training and experience in performing the procedure. You may want to ask your doctor for a referral to a reputable medical practitioner.

All doctors practising in Victoria must be registered with the Medical Board of Australia (the Board). Find out if your medical practitioner is registered with the Board by searching on the AHPRA website.

Practitioners may have completed additional accredited training in cosmetic surgery. In July 2023, the Medical Board of Australia’s registration standard for cosmetic surgery endorsement came into effect. Further information about the standard can be found on the Medical Board of Australia website. The standard outlines minimum requirements for:

1. granting endorsement of registration of registered medical practitioners for the approved area of cosmetic surgery, and
2. granting renewal of endorsement of registration of registered medical practitioners for the approved area of cosmetic surgery.

If your medical practitioner holds an endorsement in cosmetic surgery, this information will appear on their registration.

Expectations of cosmetic procedures

Before you choose to have a cosmetic procedure, it is important to think carefully about your expectations and get a full explanation of the anticipated results.

Ask about possible side effects or complications and what you can expect after the procedure. The technique or procedure will change your appearance and may improve your self-confidence, but it won’t necessarily deliver your ‘ideal’ body image or change your life.

Don’t be swayed by advertisements that promise amazing results. If they sound too good to be true, they probably are. Think about the impact on your financial situation, as cosmetic procedures do not usually qualify for rebates from Medicare or private health insurance companies. You should have a ‘cooling off’ period after attending your first consultation. This will give you time to think about your decisions.

It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or stress about the operation. Don’t be shy about discussing these feelings with your medical practitioner. If you don’t feel comfortable with the medical practitioner, seek a second opinion.

Types of cosmetic procedures

In cosmetic procedures, a variety of techniques and procedures are used, including facelift, eyelid surgery, body contouring, dermabrasion, laser skin resurfacing, implants and liposuction. Injections of botulinum toxin Type A (available in Australia as Botox® or Dysport®) or soft tissue (dermal) fillers, such as collagen or fat, may also be used.

Facelift (meloplasty)

The skin is cut in the scalp and around the ear. It is then separated from the underlying tissue, pulled tighter and stitched. Leftover skin is cut away. The procedure can be done under local or general anaesthetic and may take anywhere from two to four hours.

The face will be bruised and swollen for some weeks. Numbness or an uncomfortably tight sensation are common reactions and may continue for months after surgery.

Learn more about meloplasty (facelift).

Eyelid surgery (blepharoplasty)

The eyelids are cut along their full length to the ‘crow’s feet’ wrinkles at the outer corners. Excess skin and fat are removed. Laser resurfacing may also be performed to treat remaining wrinkles. This procedure may take one to two hours and can be done under local or general anaesthetic.

The eyes will be bruised and swollen for a few weeks. Side effects include blurred vision, overproduction of tears and changed shape of the eyes (usually only temporary).

Learn more about blepharoplasty (eyelid surgery).

Chemical peel

A chemical peel removes the surface layers of skin. A solution is wiped over the face, which may then be left uncovered or masked with lotion or tape. The chemicals burn the skin and the healing process promotes new growth. Deep burns remove the most wrinkles, but also increase the risk of complications such as scarring and infection.

Dermabrasion

A device similar to an electric sander is applied to the face under local or general anaesthetic. The rough surface of the rapidly rotating pad rubs off the skin surface. The healing process promotes new growth. Deep dermabrasion removes the most wrinkles, but also increases the risk of complications such as scarring and infection.

Wrinkle reduction

Wrinkles can be reduced using friction or they can be ‘plumped out’ with a variety of technologies. Laser skin resurfacing uses a laser beam to burn the skin. Injectable fillers can be used in small doses to paralyse the underlying muscles responsible for forming the skin wrinkles. This can be a safe and effective temporary treatment for fine facial lines and wrinkles.

Injections of fat or collagen can be piped along wrinkles to smooth them out. Botulinum toxin Type A (available in Australia under the brand names Botox® or Dysport®) is sometimes used to treat frown lines between the eyebrows.

External ear surgery (otoplasty)

Ears that stick out from the head can be repositioned any time after the age of five or six years. The fold of skin behind the ear is cut and the excess cartilage is reduced or remodelled. The procedure takes around one hour. Bandages need to be worn for a few weeks to help manage the bruising and swelling.

Learn more about otoplasty (external ear surgery).

Nose surgery (rhinoplasty)

In most cases, nose surgery is performed through incisions in the nostrils, leaving no visible scars. Bone and cartilage are trimmed, and the nose reshaped. Nostril packs and splints may be required. This procedure takes around two hours. Bruising and swelling may take three or four months to fully subside. Complications such as bleeding or infection are comparatively rare. Sometimes, a chin implant is inserted at the same time to balance the profile.

Learn more about rhinoplasty (nose surgery).

Facial implants

Facial implants are used to fill out a receding chin or flat cheekbones. The implant is inserted through a small incision in a concealed place – for example, inside the mouth.

Lip enhancement

Thin lips can be fattened with a variety of procedures that offer short or long-term results. Injections of collagen or fat are both eventually reabsorbed by the body. A permanent implant similar to a small foam rod can be threaded through the lip.

Liposuction

Liposuction is a procedure that removes fat from the abdomen, thighs, buttocks, arms and throat. A narrow tube (cannula) is inserted through a skin incision and the fat is sucked out with a powerful suction pump. The procedure can be done under local or general anaesthetic. A pressure garment needs to be worn for some months to help the skin to contract and contour.

The area will be bruised and swollen for weeks or months. Complications can include failure of the skin to contract, causing a corrugated look. A lipectomy is an operation that removes extra skin as well as fat.

Learn more about liposuction.

Tummy tuck (abdominoplasty)

Excess skin and fat from the abdomen are removed and the underlying abdominal muscles are tightened. Often, the navel will need to be relocated. Incisions are generally made along the ‘bikini line’ to minimise the visibility of scarring. This procedure is done using general anaesthetic.

Numbness and sensations of uncomfortable tightness are common and may continue for some months after surgery. Complications include infection and the formation of fluid pockets.

Learn more about abdominoplasty (tummy tuck).

Breast augmentation surgery (breast implants)

Augmenting or enlarging the breasts (also known as augmentation mammoplasty) requires the insertion of saline or silicone implants. An incision is made under the breast or in the armpit and the implant is pushed through. It may be positioned either behind or in front of the chest pectoral muscle. There will be bruising and swelling for a few weeks.

Complications include the formation of hard scar tissue around the implant, deflation of the implant, and implants that move out of position.

Learn more about breast augmentation surgery (breast implants).

Breast reduction (reduction mammoplasty)

Incisions are made beneath each breast and around the areolae of the nipples. Excess skin and fat are removed. The remaining breast tissue is remodelled, and the nipples are repositioned and stitched in place. Scars can take up to one year to fade but will remain visible for life. Complications include reduced nipple sensation.

Learn more about breast reduction surgery.

Where to get help

• Your GP (doctor)
• A medical practitioner specially trained and experienced in performing cosmetic surgery
• A second opinion from another medical practitioner specially trained and experienced in performing cosmetic surgery
• Your psychologist, councillor or psychiatrist
• Cosmetic surgery hub and hotline, Australian Health Practitioner Regulation Agency (AHPRA) Tel. 1300 361 041
• Cosmetic surgery, Department of Health and Aged Care, Australian Government
• Private Hospitals Unit, Department of Health Email privatehospitals@health.vic.gov.au
• Australian Society of Plastic Surgeons Tel. (02) 9437 9200
• Royal Australasian College of SurgeonsTel. (03) 9249 1200
• Australian Health Practitioner Regulation Agency (AHPRA) Tel. 1300 419 495