Cosmetic surgery scandal
Young people will face new obstacles before undergoing cosmetic surgery amid a surge in demand for celebrityinspired procedures. Clair Weaver reports.
AUSTRALIAN teenagers will be forced to undergo a psychological assessment and cooling off period of at least three months before being allowed breast implants, liposuction and nose jobs, under new guidelines to be introduced later this year.
The move is part of a crackdown on the booming $1 billion a year cosmetic surgery industry, to better protect people seeking cosmetic procedures, which have become increasingly mainstream, socially acceptable and affordable in the past couple of decades.
Under-18s will face the strictest criteria under the Medical Board of Australia’s guidelines, which come into force on October 1. With barely an eyebrow raised at cosmetic surgery by celebrities, there are reports of girls getting breast implants for their 16th birthdays and lip fillers as a reward for hard work at school.
Dr Joanna Flynn, chair of the Medical Board of Australia, told The Weekly it was worrying that teenagers were pursuing major procedures such as breast augmentation before their bodies were fully matured.
“We are aware there are more and more young people – young women in particular – seeking out cosmetic procedures,” she says. “The issues we are most concerned about are maturity in making decisions, vulnerability to peer pressure and issues around body image and self-esteem.
“We think it’s essential people have sufficient time to think it through.”
Children as young as 14 or 16 can legally give consent to medical treatment, although this varies across states and territories. Under common law, an older child’s maturity, intelligence and understanding must be considered.
Dr Gazi Hussain, vice-president of the Australian Society of Plastic Surgeons, is concerned about how celebrity culture and reality TV have
There are reports of girls getting breast implants for their 16th birthday.
radically changed the way we perceive cosmetic surgery.
“Over the past 20 years, there’s been a real trivialisation of cosmetic surgery,” he says. “It’s almost a commodity now. But these are invasive surgeries and you should think about it the same way you would for gall bladder surgery. These TV shows have made it look like it’s a fairly simple nip and tuck and off you go again. That’s not the case.”
Comprehensive data is not collated about cosmetic surgery in Australia, but it’s estimated there are at least 16,000 breast augmentations and 15,000 liposuction surgeries carried out each year. In addition, an estimated 15,000 people go overseas annually for cheaper surgery in countries such as
Thailand and Malaysia, despite warnings of extra medical risks.
Dr Hussain says many patients get good results and are happy with their cosmetic surgery – but he also emphasises the permanency of it. “Once you get breast implants in, it’s a life-long commitment,” he says. “Even if you have them removed, the skin has been stretched and you can be left with sagging tissue and scarring.”
Experts who psychologically evaluate teenagers seeking cosmetic surgery will have to consider their maturity and understanding of the risks and alternatives, plus screen them for underlying conditions such as eating disorders or mental health conditions. “For example, there are some young women with anorexia who want to have a surgical procedure [but] who wouldn’t meet the criteria,” says Dr Flynn.
Under the new rules, patients aged under 18 will also have a seven-day cooling off period (and psychological evaluation if deemed necessary) for minor procedures, such as skin treatments and chemical peels.
The guidelines do not apply to non-medical practitioners such as nurses and beauty therapists. However, if a prescription is required – as for injectables such as Botox – the prescribing doctor should have a faceto-face consultation with the patient first, either in person or via video link. “Most of what’s in the new guidelines are what sensible practitioners would do anyway,” says Dr Flynn.
Yet, in real life, Dr Hussain says rules and ethical considerations aren’t always enforced, as some unscrupulous operators may be more motivated by profits or have lower standards.
Injectables, which also include fillers, have become relatively routine in recent years, commonly available in suburban shopping malls and through cut-price packages sold on discount coupon websites.
There will be tighter restrictions for adult patients under the new rules, too, including a seven-day cooling off period for major procedures, which involve cutting beneath the skin. The treating doctor or surgeon will be required to give them detailed written information about costs beforehand, as well as a clear explanation of the risks and possible complications.
The doctor or surgeon will also be officially compelled to take responsibility for their patients’ post-operative care and ensure that emergency facilities are available when using anaesthetic.
Risks from cosmetic surgery can include anaesthetic complications, infections and bleeding. In the past 10 years, two Australian women have died from complications after having liposuction.
According to a report by leading research company, IBISWorld, the Australian plastic surgery industry has annual revenue of $1 billion, with the greatest demand coming from women aged over 35. While this figure includes reconstructive surgery, it does not include cosmetic procedures and surgery performed by doctors and other health and beauty practitioners.
Demand for procedures such as liposuction, tummy tucks and facelifts has surged, fuelled by middle-aged and older women, and the nation’s expanding waistbands. “Growing acceptance of plastic surgery among the community and greater discretionary income has made potential candidates less hesitant to undergo procedures, further increasing industry demand,” the report stated.
There is a long-running “turf war” between plastic surgeons and cosmetic surgeons in Australia. Plastic surgeons have to undertake at least five years of specialist surgical training after their medical degree, while cosmetic surgeons must have at least a medical degree, but don’t necessarily have formal surgical qualifications. This is because cosmetic surgery is not officially recognized as a surgical speciality.
“These TV shows have made it look like a fairly simple nip and tuck.”