Section 1 of 5Definitions
Surgical and non-surgical cosmetic procedures
In the regulators’ definitions, cosmetic surgery involves cutting beneath the skin, and a non-surgical cosmetic procedure does not, though it may pierce the skin. The difference matters because, together with who does the work, it decides which guidelines apply.
- Surgery
- Medical Board of Australia guidelines, required from 1 July 2023, which doctors also follow for non-surgical procedures
- Non-surgical
- Ahpra and National Boards guidelines, for registered practitioners other than doctors
General information, not medical advice. Call Triple Zero (000) in an emergency, or go to the emergency department of your nearest hospital. To check that a practitioner is registered, search Ahpra’s register of practitioners.
1.1 The test
The cosmetic test
The Medical Board’s definition turns on purpose. A cosmetic procedure revises or changes the appearance, colour, texture, structure or position of normal bodily features, and its “dominant purpose” is a look the patient sees as more desirable. Ahpra’s guidelines for non-surgical procedures use the same test.
Purpose can also take a procedure out of the cosmetic category. Ahpra’s guidelines say a procedure may be clinically justified when its dominant purpose is to restore, correct or improve body structures that are defective or damaged, whether from birth or through injury, disease, growth or development.
1.2 Cosmetic surgery
Cosmetic surgery examples
The Medical Board’s examples of cosmetic surgery run from breast augmentation, rhinoplasty and abdominoplasty to blepharoplasty, surgical face lifts and cosmetic genital surgery, with liposuction and fat transfer on the same list.
The Medical Board’s definitions add one exception. Removing a mole for the sake of appearance counts as non-surgical, even though it may involve cutting beneath the skin.
1.3 Exclusions
Procedures outside the definition
The Medical Board’s guidelines set three kinds of surgery apart from cosmetic surgery:
- Reconstructive surgery. It may use aesthetic techniques, but it restores form and function as well as a normal appearance.
- Plastic surgery for other reasons. The guidelines cover plastic surgery only when it is done purely for cosmetic or aesthetic reasons.
- Gender affirmation surgery. It is not considered cosmetic surgery.
healthdirect describes the same difference from the patient’s side: reconstructive surgery is done to improve how a damaged part of the body works or looks.
1.4 Non-surgical procedures
Higher risk non-surgical procedures
Ahpra defines non-surgical cosmetic procedures by the same purpose test, and notes that they may pierce the skin or alter other body tissue, such as teeth. Within that group, its guidelines single out the higher risk ones. These are procedures that may need a prescription-only medicine, may significantly alter bodily structures, may involve injecting medicines or products into and under the skin, and may reach the deeper layer of the skin with chemicals, lights, lasers, heat or cold.
Ahpra’s reason for singling them out is the harm they can do: they may be invasive, and the complications can be irreversible. They usually need a registered health practitioner, either to perform the procedure or for some part of it.
1.5 Guidelines
Two sets of guidelines
| Item | Cosmetic surgery | Non-surgical procedures |
|---|---|---|
| Written by | The Medical Board of Australia | Ahpra and the National Boards |
| Applies to | Every registered medical practitioner who performs cosmetic surgery or non-surgical cosmetic procedures, whatever their registration type or endorsement, including doctors who prescribe injectables for someone else to give | Registered health practitioners who perform non-surgical cosmetic procedures, except medical practitioners, who follow the Medical Board’s guidelines. They include nurse practitioners, registered and enrolled nurses, dental practitioners, podiatrists and Chinese medicine practitioners. |
| Status | Required from 1 July 2023 | Current Ahpra and National Boards guidance |
A guideline is not a licence. Ahpra’s non-surgical guidelines say they do not, by themselves, authorise any registered practitioner to perform these procedures, and that a procedure, or prescribing a cosmetic injectable, may fall outside a practitioner’s profession even when they believe they have the skill to do it safely. Section 3 covers who may prescribe and give cosmetic injectables.
1.6 Premises
Facilities and premises
Ahpra’s position is that all cosmetic surgery must be done in a facility suited to the level of risk of the procedure and of the patient. Beyond that, the states set their own rules, and healthdirect notes that the types of cosmetic surgery a doctor can perform depend on the state or territory where they work.
Victoria
All surgery must be carried out in a facility registered with the Department of Health. It is illegal to perform liposuction in an unregistered facility; the regulations allow only a very small amount (200 ml of lipoaspirate in total) to be removed outside one. It is also illegal for healthcare providers to give anaesthesia or IV sedation (as defined) in an unregistered facility.
New South Wales
Since March 2017, any facility in NSW doing certain cosmetic procedures (dental work aside) has had to be licensed. Those procedures may only be carried out in a public hospital or a licensed private health facility, and every private health facility in NSW must display a copy of its licence.
Ahpra adds a warning that holds anywhere: if the venue looks more like an apartment than a clinic, that may be a sign something is not legitimate. Section 2 sets out what must happen before cosmetic surgery is booked.