The 2023 cosmetic surgery reforms

2.1 Timeline

Effective dates

The Medical Board’s and Ahpra’s pages give 1 July 2023 as the start of each of these:

• 1 July 2023The revised guidelines for doctors who perform cosmetic surgery and procedures.
• 1 July 2023The guidelines for doctors who advertise cosmetic surgery, covering existing websites and social media as well as new advertising.
• 1 July 2023The registration standard for an endorsement in cosmetic surgery.
• 1 July 2023A GP referral for anyone considering cosmetic surgery.

The Medical Board’s FAQ says there are no approved qualifications for the endorsement yet. Victoria’s Better Health Channel notes that if a doctor holds an endorsement in cosmetic surgery, it appears on their registration.

2.2 Sequence

The steps before surgery

1. Referral

   Every patient seeking cosmetic surgery must have a referral, preferably from their usual GP, or if that is not possible, from another GP or another specialist doctor. The referring doctor must work independently of the doctor who will operate, and must not perform cosmetic surgery or non-surgical cosmetic procedures themselves.

   Ahpra explains the point of it: the referral passes important medical information to the doctor who will operate, and it is an extra safety measure before surgery.

2. Assessment

   The doctor who will operate must check whether the patient has an underlying psychological condition, such as body dysmorphic disorder, that may make surgery unsuitable, and must screen for body dysmorphic disorder with a validated psychological screening tool. If screening suggests significant underlying psychological issues that may make the patient unsuitable for the surgery, the patient must be referred to a psychologist, psychiatrist or general practitioner for evaluation, and that practitioner must work independently of the doctor who will operate. A GP who provides cosmetic surgery or non-surgical cosmetic procedures does not count for this referral. The doctor who will operate must discuss other options, including surgery, procedures or treatment from other health practitioners and the option of not having surgery, and must decline to operate if they believe it is not in the patient’s best interests.

   The guidelines set further duties at this step; they are in the Medical Board’s guidelines.

3. Two consultations

   At least two consultations before the operation, with at least one in person with the doctor who will operate. A patient cannot consent to cosmetic surgery until that in-person consultation has happened.

4. Information

   The doctor who will operate must give the patient enough information to decide whether to go ahead. Ahpra’s page lists what a patient should be told besides the doctor’s qualifications:

   • what the operation involves
   • its risks and possible complications
   • how long recovery takes, and any restrictions or extra treatment you will need
   • the full cost: deposits and when payments are due, whether deposits are refunded, the cost of follow-up care, and possible further costs for revision surgery or more treatment
   • how complaints work, and how to make one

   The list is on Ahpra’s page for people thinking about cosmetic surgery.

5. Consent

   Only the doctor who will operate may obtain informed consent; it cannot be handed to anyone else. Consent is taken at least seven days before the day of surgery, at a consultation held in person or by video. It is confirmed again on the day and recorded, and the patient receives a copy of the signed form.

6. Cooling-off period

   At least seven days must pass after the two consultations and the signed consent before the surgery can be booked or a deposit paid.

2.3 Cooling-off periods

Adults and patients under 18

For patients under 18, the Medical Board’s guidelines add these rules to every other requirement for cosmetic surgery. Doctors must know and follow the laws of their state or territory that restrict cosmetic surgery for this age group. The doctor who will operate must assess the patient’s capacity to consent and be satisfied that they have it. The doctor should, as far as practicable, consider the views of a parent or guardian, including whether they support the surgery. Before any cosmetic surgery, every patient under 18 must be referred to and evaluated by a psychologist, psychiatrist or general practitioner who works independently of the doctor who will operate, to identify any significant underlying psychological problems that may make surgery unsuitable. A GP who provides cosmetic surgery or non-surgical cosmetic procedures does not count for this evaluation. The cooling-off period is at least three months between informed consent and the surgery, and the patient should be encouraged to talk with their GP about why they want it during that time.

2.4 After surgery

Implants, travel and money

For any cosmetic surgery that includes an implantable device, the patient must receive the TGA-approved patient information leaflet before the surgery and the patient implant card after it.

When a doctor operates away from their main place of practice, visiting or flying in to a second, rural or interstate location, they must remain available there for at least 24 hours after the operation.

Doctors must not encourage patients to take on debt, such as a personal loan or a remortgage, or to draw on superannuation to pay for cosmetic surgery.

2.5 Title rule

The title “surgeon”

As at 8 October 2026, the Medical Board’s and Ahpra’s pages say the only medical practitioners who can call themselves “surgeon” are those with specialist registration in surgery, in obstetrics and gynaecology, or in ophthalmology. The restriction follows an amendment to the National Law that introduced section 115A(2). Both pages also say the amendment is expected to take effect in New South Wales, South Australia and Western Australia once those states complete their own legislative processes.

Doctors with general registration, or with specialist registration in another specialty such as general practice or dermatology, cannot call themselves “surgeon”, and that includes “cosmetic surgeon”. The section applies only to registered medical practitioners. It leaves unchanged the title rules for specialist dentists and podiatrists, and for dentists who use “dental surgeon”.

To check a doctor’s registration type, search Ahpra’s register of practitioners. Section 4 covers titles and claims in cosmetic advertising.