The Cosmetic Surgery Crisis by Dr Andre Safvat

Late in November, the patients in Australia had a win as AHPRA finally decided to protect the title of “surgeon” for doctors who are actually properly trained Fellows of the Royal Australian College of Surgeons (FRACS). Dr André Safvat - Plastic & Reconstructive Surgery - Bowral, Concord & Miranda

This is still to be legislated but hopefully common sense prevails! This change follows the public outcry to the Four Corners TV programme on the ABC, and the 60 Minutes programme on Channel Nine about cosmetic surgeons.

On both the news features, cosmetic surgeons were exposed for their blasé attitude to patients’ care, and how they were risking patient safety for profit.

I personally found these programs infuriating, as I have had firsthand experience with unfortunate patients who have been victims of cosmetic surgeons. I remember a young lady who had a breast augmentation by a cosmetic surgeon who was trained as an oral surgeon, but decided it was more profitable to do cosmetic surgery instead!! She developed a post-operative haematoma, and to save money, and to put a lid on his complications, he tried to aspirate the haematoma in his rooms. Of course, this is against all the basic surgical principles available, and the poor lady ended up with an infected haematoma, and became septic and very sick.

The patient was admitted to a public hospital where I was working at the time. We had to remove her implants and put her on strong intravenous antibiotics. Fortunately, she recovered from the sepsis, but was not too happy about the price she had to pay, both from her health point of view, and the financial costs to the cosmetic surgeon.

Another time, another lady had breast reduction surgery overseas, and ended up losing her left areola completely. It required a few operations to reconstruct a new nipple for her.

Recently, I had another lady who had an abdominoplasty by a cosmetic surgeons in his own rooms (not an accredited hospital), and he took too much fat from under the skin, causing her skin to be stuck to the underlying muscle, quite a painful experience. She needed fat grafting to rectify the complications.

I guess in all these cases, cosmetic surgeons not only compromise the patient’s health and safety, but also do not look after their patients following the surgery, often forcing the patient to go to real surgeons to get the care they need.

The obvious question is: why do patients go to these so called cosmetic surgeons?  Part, if not all of the blame falls on AHPRA, who up to now maintained a lax attitude towards cosmetic surgeons, and allowed them to misguide patients with false advertising and promises.

Most patients comment afterwards “I thought he was a real surgeon”…

Fortunately, if the new legislation gets passed, this will stop untrained people calling themselves surgeons, and will offer more transparency for the patients; better protecting them in the long-term.


Patients should discuss with their GP and Plastic Surgeon as to whether surgery is a good option for them. All surgery comes with risks which will be discussed during consultation. Your final results can take up to 12 months or more to be seen. Before proceeding, it is recommended that you seek a second opinion from an appropriately qualified health practitioner.

Registered Medical Practitioner, Specialist Plastic Surgeon (specialist registration in Surgery – Plastic surgery).