Stephanie McLean Yearly regulatory changes and a growing wave of negative narratives — but are we truly protecting patients, or simply creating more confusion?
Since 2021, the cosmetic industry has been operating under a cloud of doubt, fuelled by a narrative that paints practitioners as unsafe, unregulated, and even dangerous. While regulatory reform has long been needed, recent changes have left many practitioners questioning whether these updates are truly about patient safety — or simply a response to mounting media pressure.
The original Four Corners investigation, “Cosmetic Cowboys: The Unregulated World of Cosmetic Surgery,” triggered years of transformation. Those changes are now starting to spill over into the non-surgical space. As one health regulation consultant put it: “The industry is like the Wild West — but without the sheriffs.”
But who exactly are these “sheriffs”? The consultants and so-called advocates influencing regulation often operate behind the scenes or through headlines. Many in the industry are asking: who holds them accountable? And do they truly understand the realities of clinical practice?
At this year’s Cosmedicon conference, a panel titled “An Industry in Turmoil” explored these issues. While the discussion was broad and balanced, media coverage painted a narrower picture. The Sydney Morning Herald shared snippets that singled out Fresh Clinics, reinforcing an ongoing narrative of non-compliance — without providing the full context of the discussion.
What’s often lost in these reports is the genuine dedication of the practitioners behind the scenes. As Dr David Kosenko noted, “The vast majority of people working in aesthetics have a great sense of wanting to provide the best quality and care to the people they see.”
Yet their intent is increasingly met with regulatory roadblocks. “If you reach out to the TGA or AHPRA and ask, ‘Is this the right thing to do?’ the response is often, ‘We can’t give you guidance — you’ll have to figure it out yourself,’” he said. This leaves practitioners navigating a grey zone, where compliance often feels like guesswork.
This sentiment was echoed during the panel. When an audience member asked, “Has anyone here been contacted by governing bodies during the development of these guidelines?” not a single doctor or nurse raised their hand. The silence that followed spoke volumes.
In response, Kate Evans, Head of the Rapid Response Unit at AHPRA, noted that those consulted are simply “those who know that consultation is happening at that particular time.” While candid, her comment raised further concerns about transparency and inclusivity in the process.
AHPRA confirmed that only 150 responses were received during public consultation. Is that truly a large enough sample to reflect the complexity of this issue?
Dr Peter Callan, former President of the Australian Society of Plastic Surgeons, questions the evidence behind the reforms. “With hundreds of published papers demonstrating the quality-of-life improvements from cosmetic procedures — and ongoing confusion around how these treatments are categorised — how were these reforms introduced without proper scientific grounding?”
“Rather than driving these changes through emotion, let’s be the academics we are. Let’s base changes on evidence, outcome measures, and research,” he urged.
The Current Media Landscape
We asked Kelly George RN whether she believes the current media portrayal of the non-surgical cosmetic space reflects the full story.
“Absolutely not,” she says. “There are quite literally thousands of cosmetic patients treated in reputable, safe, nurse-led clinics who would happily speak about their long-term positive outcomes.”
Kelly also notes that media reports often mention complications without any context — omitting practitioner qualifications or the true rarity of adverse outcomes.
“In our clinic, we treat more than 200 people a week. We’ve seen tens of thousands of patients over the last decade with no adverse outcomes — and we’re not the exception. Most clinics are led by nurses who take patient safety seriously. If something goes wrong, it’s our livelihood at stake.”
She also calls out a double standard. “In regional hospitals, nurse-led care is essential — often assessing patients in critical condition without a doctor onsite. Yet in aesthetics, we’re not trusted to assess someone’s skin? It doesn’t make sense.”
Do These Changes Actually Help the Patient?
“The feedback I’m getting is that patients are more confused than ever. Many are frustrated. Meanwhile, the unsafe clinics don’t follow the rules anyway — so the regulations aren’t targeting the real risk” says Kelly.
Sherilee Knoop, President of the Cosmetic Nurse Association, agrees: “There’s a turf war between faculties that has nothing to do with patient safety. There’s a common feeling that if you disagree or ask too many questions, you may become the subject of the next investigation.”
She adds, “There’s no doubt we need stronger standards and mentorship — maybe even more specific licensing. But we also need balanced reporting and genuine engagement with those delivering safe, evidence-based care every single day.”
The Missing Data
Where is the data showing how many procedures are performed safely each year? Where is the patient satisfaction reporting?
In The Sydney Morning Herald piece, of the 16 practitioners who were reviewed — five of them were nurses. For an industry delivering thousands of appointments each week, that sample size raises questions about whether the conclusions being drawn are truly representative.
If patient safety is the priority, then we need real data, real consultation, and real understanding — not selective soundbites or policy shaped by pressure.
That’s why we’re proposing an independent survey to gain deeper insight into how these reforms are impacting both practitioners and patients — and to bring real context back to the conversation.
What are your thoughts? Let us know in the comments below and stay tuned for part 2.
Read our latest issue below:
There are 5 ways you can catch up with SPA+CLINIC
- Our quarterly print magazine, delivered to your door. Subscribe here.
- Our website, which is updated daily with its own completely unique content and breaking news.
- Our weekly newsletter – free to your inbox! Subscribe here.
- Our digital magazine – click here to view previous issues.
- Our social media – see daily updates on our Instagram, Facebook & Linkedin
