‘Profit over patient safety’: Health regulator launches review into cosmetic surgery industry

The national medical regulator has announced a sweeping review of the multibillion-dollar cosmetic surgery industry, acknowledging that a profit-driven culture had led to dangerous practices that sparked widespread concerns about patient safety.

The Australian Health Practitioner Regulation Agency (AHPRA) said the external review into the booming industry, which will be led by the outgoing Queensland Health Ombudsman Andrew Brown, will look at ways to better protect patients, as well as examining the use of social media by some cosmetic surgeons to promote their services.

An investigation by The Age and Sydney Morning Herald has sparked a sweeping review of the cosmetic surgery sectorCredit: Jamie Brown

It follows a joint investigation by The Sydney Morning Herald, The Age and the ABC’s Four Corners which uncovered a litany of disturbing practices at a network of clinics run by celebrity cosmetic surgeon Dr Daniel Lanzer, including allegations of serious hygiene and safety breaches and botched surgeries that left some patients in extreme pain.

Dr Lanzer, who has an extensive presence on television and social media, last month gave a legally enforceable undertaking to stop practising medicine in Australia while AHPRA completes an investigation. His senior associate Dr Daniel Aronov, who is the most followed cosmetic surgeon in the world on TikTok with more than 13 million followers, was banned from practising cosmetic surgery earlier this week.

AHPRA CEO Martin Fletcher said the inquiry was triggered by the joint media investigation. “Obviously we were very concerned by the material that was broadcast on Four Corners and although some of that was known to us and were matters we were actively investigating, there was an awful lot of information we didn’t know.”

The media investigation revealed audio recordings of Dr Lanzer telling staff to never admit mistakes to patients. “You do not own up to nothing! Zero! … Never, ever, ever, ever own up to anything”. Dr Lanzer also told staff to never send a patient to a GP or hospital. Photos were obtained that appeared to show human fat stored in fridges and freezers, and decanted syringes of filler with masking tape. Communications showed a nurse instructing co-workers to use expired medication, and fill in blank signed prescriptions, and other evidence that Google reviews were being doctored.

Dr Daniel Lanzer (left) and Dr Daniel AronovCredit: Stephen Kiprillis

It showed the use of social media including posting confronting videos of a very thin 36-kilogram female getting breast implants. Other videos show a doctor holding up a hunk of a female patient’s own flesh and showing it to her while she is still on the operating table.

Mr Fletcher said the cosmetic surgery industry had developed unique elements which made it different to other areas of medicine.

“Some worrying features of the cosmetic industry set it apart from conventional medical practice, including corporate business models which are alleged to place profit over patient safety, no medical need for cosmetic procedures, limited factual information for consumers and exponential growth in social media that emphasises benefits and downplays risks,” Mr Fletcher said.

Kathy Hubble, a former Lanzer clinic patient who ended up in hospital for almost a week after developing a serious infection after liposuction procedures on her legs and abdomen, said the inquiry was “absolutely necessary and had to happen”. “It’s unfortunate it took so long for the authorities to put the sector under the magnifying glass,” she said.

Suzanne Steward, who was rushed to hospital in March this year after both lungs were punctured following a liposuction procedure at Dr Lanzer’s cosmetic surgery, said the review was long overdue. “It has taken all of these women and men to come forward for AHPRA to look into the cosmetic industry. Enough is enough, people are suffering,” she said.

Former clinic nurse Justin Nixon said he hoped regulations in the cosmetic surgery industry were tightened. “It is my hope that significant change will occur to prevent further catastrophic medical events from occurring.”

Public consultation for the review will begin in early 2022 and it will report by mid-2022.

Panel member Alan Kirkland, CEO of CHOICE, said he was “appalled” by some of the personal stories that had been featured in media reports in recent weeks about issues in cosmetic surgery and was the key reason he decided to join the expert panel. “I have a strong interest in consumer protection,” he said.

“We’ve all got a right to assume that the system is protecting us from harm, protecting us from being misled about the nature of particular procedures or the risks involved in them and protecting them from unsafe practices and I’m really keen to understand through this process how well the system is currently doing that and where there might be opportunities for improvement.”

He said social media had changed the landscape of cosmetic surgery with procedures now promoted through Instagram and TikTok and available in shopping centres across the country.

Others on the panel include professor Anne Duggan, chief medical officer for the Australian Commission for the federal agency Safety and Quality in Health Care, which has patient safety as its central remit and Richelle McCausland, National Health Practitioner Ombudsman.

AHPRA is being scrutinised in parliamentary inquiry headed by Greens senator Janet Rice.

Under the current law, anyone with a basic medical degree or a GP or dermatologist can call themselves a cosmetic surgeon, even though they aren’t registered specialist surgeons, who receive eight to 12 years of postgraduate surgical training like plastic surgeons.

State health ministers are consulting on possible changes to the national law to protect the title of ‘surgeon’.

The Australasian Society of Aesthetic Plastic Surgeons (ASAPS) said it had been calling for change for years and said the inquiry was “too little, too late” for those maimed by botched surgeries.

ASAPS president Dr Robert Sheen said: “the laws exist, they are simply not being enforced. AHPRA is not regulating ... It is time for AHPRA to exercise the responsibilities given to it under the National Law - a law that gives AHPRA the power to prevent patient harm in the first place.”