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The medical regulator has announced a major review of patient safety in the cosmetic surgery sector, in the wake of a joint investigation by Four Corners and Nine newspapers.
The Australian Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia will look at how to strengthen regulations to better protect patients.
They will also examine the role of advertising and social media.
It comes a month after a joint investigation by Four Corners, the Sydney Morning Herald and The Age into clinics operated by Dr Daniel Lanzer.
Since the initial investigation, more than 100 Lanzer clinic patients have come forward to share their harrowing experiences.
The investigation uncovered serious hygiene and safety breaches and procedures by Dr Lanzer that left patients in extreme pain, requiring further medical treatment and suffering from ongoing physical and psychological issues.
Dr Lanzer has since given a legally enforceable undertaking to stop practising medicine in Australia while AHPRA completes an investigation.
His associate Dr Daniel Aronov was banned from practising cosmetic surgery earlier this week.
AHPRA's review, led by the outgoing Queensland Health Ombudsman Andrew Brown, will examine the advertising of cosmetic surgery, the current codes of conduct and protocols around how complaints are handled.
AHPRA CEO Martin Fletcher said the review was triggered by the joint investigation.
He said the cosmetic industry had "worrying features" which made it riskier than other areas of medicine.
"Among them, corporate business models that are allegedly placing profit over patient safety, procedures being undertaken for no medical need, limited factual information for consumers and the exponential growth in social media that often emphasises benefits and downplays risks.
"Cosmetic practice has rapidly grown as a multi-million dollar entrepreneurial industry with practices and marketing methods that raise ethical dilemmas."
Public consultation for the review will begin in early 2022 and it will report by the middle of the year.
Kathy Hubble, a former patient of Dr Lanzer, said the review was “absolutely necessary".
Ms Hubble ended up in hospital with the serious bacterial infection cellulitis after two liposuction procedures in November 2018 at Dr Lanzer’s Sydney clinic.
Three years after her procedure, Ms Hubble says she is still suffering from chronic pain, and last month she told her story to Four Corners.
She said she was happy AHPRA was reviewing the sector.
“High five Four Corners. I am so pleased to hear this and it makes me feel like telling my story was beneficial,” she said.
Melbourne's Alfred Hospital has treated a number of medical emergencies from Dr Lanzer's Malvern clinic in the past nine months.
Suzanne Steward was rushed to hospital in March this year after her oxygen plummeted to emergency levels after a liposuction procedure at the clinic.
She ended up in the intensive care unit at the Alfred with a collapsed lung and other complications.
"There was a lot of blood loss around my back and around the front and the ICU doctor decided that I needed a blood transfusion," she says.
Ms Stewart said APHRA should have taken action sooner.
"It has taken all of these women and men to come forward for APHRA to look into the cosmetic industry. Enough is enough, people are suffering because of their stuff-ups," she told Four Corners.
Review panel member Alan Kirkland, CEO of CHOICE, said he was "appalled" by some of the personal stories that had come out in recent weeks.
He said that was why he decided to join the expert panel.
"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 us from unsafe practices," he said.
"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.
"The cosmetic surgery industry has changed enormously since the current regulatory framework was introduced, with procedures now promoted through Instagram and TikTok and available in shopping centres across the country.
"I'm keen to explore whether consumers are being adequately informed about the risks of some procedures and whether the regulators have the powers they need to prevent harm."
The Australasian Society of Aesthetic Plastic Surgeons slammed AHPRA's review as "too little, too late".
President Dr Robert Sheen said what was really needed was a crackdown on the use of the term "cosmetic surgeon".
"Every day, registered specialist plastic surgeons are faced with the task of correcting botched jobs performed by practitioners who hold out to be registered specialist surgeons," he said.
As it stands, anyone with a basic medical degree is able to call themself a "cosmetic surgeon", but state health ministers are currently consulting on possible changes to national laws to protect the title of "surgeon".
AHPRA said it welcomed the consultation process.
AHPRA has limited powers. It can caution a practitioner, make sure a practitioner can practise with restrictions, or refer a complaint to another body. But it does not have the power to order a practitioner to pay compensation, give a refund or apologise.
However one law firm is preparing to launch legal action on behalf of several of Dr Lanzer's former patients.
Daniel Opare, from Shine Lawyers, said his firm was investigating multiple complaints in the wake of the ABC/Nine newspapers investigation.
"I don't think there's enough awareness about people's legal rights surrounding cosmetic surgery, but hopefully there will be more as more people come forward," he said.
He said patients were often reluctant to consider their legal rights because they felt ashamed to have undergone cosmetic procedures, or had signed waivers.
"Cosmetic surgery is a choice, but that doesn't negate the obligation of the surgeon to provide reasonable care," he said.
"A lot of people think, 'I chose this, I signed a waiver and there are risks' … people need to know that just because they've signed a waiver, it definitely doesn't exonerate the surgeon."
You can watch the full investigation on ABC iview.