Stephanie McLean When regulation becomes punishment – The cost of compliance in aesthetic medicine.
Australia’s regulatory overhaul is no longer just a policy shift; its impact is being felt in real time. From solo practitioners to established practices, the financial and emotional toll is mounting — and for many, the burden has become unsustainable.
“We’ve seen at least 17 clinics close in the past 12 months alone,” says Sherilee Knoop, President of the Cosmetic Nurse Association. “Not because they were unsafe, but because they simply couldn’t absorb the cost of keeping up with evolving compliance expectations that seem to shift month by month.”
These costs are significant. From legal consultations and reworking marketing materials to product compliance, signage updates, and hours lost to administrative tasks, the resources required to remain compliant are extensive. “It’s not just about being compliant,” Sherilee adds. “It’s about proving compliance in a system where the goalposts constantly move. For small businesses, that’s financially crippling.”
Ironically, those who ignore the rules often face the least scrutiny. “Clinics that advertise illegally or offer unsafe treatments rarely self-report,” she explains. “And with a complaints-based enforcement model, they can fly under the radar — while ethical clinics bear the brunt of regulatory pressure.”
A Culture of Silence
This imbalance isn’t just frustrating — it’s demoralising. Many clinicians report feeling disillusioned, unsupported, and fearful of saying the wrong thing.
“You become a target,” says one senior injector who asked to remain anonymous. “If you question the narrative publicly or raise concerns about the process, there’s a real risk you’ll be investigated — not because you’ve done anything wrong, but because you dared to challenge the dominant voices.”
Even experienced professionals are pulling back from public discussion. They’re rethinking what they share, how they educate, and whether to stay in the industry. “It’s no longer enough to be safe and ethical. You have to be invisible,” they add.
One voice pushing back is Dr Niroshan Sivathasan, a doctor with extensive international cosmetic sector interests and medicolegal experience.
“Part of the reason why the aesthetic field has been misrepresented is because of the widespread failure of the Medical Board of Australia (MBA) to acknowledge the positive impact that cosmetic interventions frequently provide, such as a boost in confidence and social engagement,” he says. “When added to the hyperbolic, media-driven articles which involve more salaciousness than substance, AHPRA then intervenes in an ill-considered fashion.”
“Accordingly, I have a modicum of sympathy for those at AHPRA who are tasked with addressing expectations from government ministers in an arena of loud, emotive representations. However, the result is that both practitioners and patients are failed by the ill-directed and ill-executed interventions. AHPRA’s failure to include senior doctors actively practising in cosmetic medicine in its discussions has, arguably, been the biggest point of failure.”
Dr Sivathasan’s comments highlight a widespread frustration within the industry: reforms are being shaped by individuals who are disconnected from the treatment room, often without consulting those who truly understand the daily clinical realities.
It’s this passion for change that led him to take further action, spearheading the upcoming “The Misdeeds of AHPRA” seminar in Sydney on May 3rd. The event aims to bring together clinicians, legal experts, and policymakers, and politicians, to foster more transparent and inclusive meaningful discussions around regulation.
What Patients Deserve
At its core, this isn’t just an industry issue. It’s a patient issue. Patients deserve safe, ethical care — delivered by trained professionals who feel supported, not penalised, for doing the right thing.
“Patients want to know they’re in good hands,” says Kelly George RN. “But right now, the messaging they’re receiving is that no one can be trusted — and that’s simply not true. We’ve worked hard for years to build trust with our patients. We deserve a regulatory framework that supports that, not undermines it.”
A Call for a More Collaborative Future
There’s a growing consensus that things need to change — but not in the way they currently are. Practitioners aren’t calling for deregulation. They’re calling for consultation. For consistency. For clarity. And for a system that protects patients without punishing providers who are doing the right thing.
“It’s time to move beyond the hysteria and start having real conversations,” says Sherilee. “Not just between regulators and media outlets, but with those on the ground. The people who see patients every single day. The people who’ve built careers — and clinics — around safety, ethics, and care.”
As the conversation around aesthetics continues to develop — in boardrooms, on social media, and in the press — we must also look inward. Because while the media may be loud, sometimes the most damaging noise comes from within our own ranks.
“Right now, those who profit from division and controversy are louder than us. If we want the public — and regulators — to trust us, we must first trust each other,” says ABIC (Aesthetic & Beauty Industry Council).
It’s a powerful reminder that meaningful progress doesn’t begin with policy alone—it begins within the industry itself. It starts with the way we speak about each other, how we show up in support of our peers, and the integrity we bring to every patient interaction.
If we want change, the narrative must reflect the reality. We can’t afford to wait for others to reshape the story—we need to take ownership and lead it ourselves.
Because right now, as compliance pressures mount, it’s the ethical clinics doing the right thing that are feeling the weight—while those who cut corners continue to operate unchecked. That’s a system in need of rebalancing—and it starts with us.
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