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Who can do Cosmetic Procedures?

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  • Published

    March 1, 2022

  • Written by

    Dr Garth Dicker

At the Collins Cosmetic Clinic, we are often asked about what training is needed to perform cosmetic treatments. Many patients are astounded when they find out about the lack of Government regulation of cosmetic procedures and how people with very little in the way of training or qualifications are allowed to perform cosmetic and beauty treatments.

THERAPISTS

Nearly every shopping centre has a beauty salon with therapists doing skin treatments. The level of training and expertise of the therapists working in these salons varies widely. In Australia there are 4 main levels of therapists. A Beautician does a 6-month course (Certificate 3 in Beauty Services), a Beauty Therapist a 12-month course (Diploma of Beauty Therapy), a Dermal Therapist a 2-year course (Associate degree in Applied Science) and a Dermal Clinician a 3-year University degree course (Bachelor Applied Health Science Clinical Aesthetics). Whilst the training, skillset and qualifications vary tremendously there is little monitoring and regulation of which skin procedures are done in a particular clinic. In some states of Australia such as Queensland and Western Australia, there are registration requirements for Lasers and other devices such as IPLs used in cosmetic procedures which helps regulate the qualifications of providers. On the other hand, in Victoria there is no requirement to register lasers and other devices used for cosmetic procedures. There are no regulations that control the quality of devices used or any minimum requirement of the training and qualifications to use these devices. Not only can less qualified beauticians do procedures like Laser and IPL treatments in Victoria but essentially anyone can use them. I always remember a patient telling me the person doing their laser tattoo removal used to an electrician but thought he could make more money in tattoo removal so did a weekend course and opened a Laser clinic in Melbourne!

NURSES

There are 3 levels of nurses: Enrolled Nurse, Registered Nurse and Nurse Practitioners and all can legally perform cosmetic injections under the supervision of a medical practitioner. The training of each nursing level is different: an Enrolled Nurse completes an 18-month Diploma of Nursing; a Registered Nurse completes a 3-year Bachelor of Nursing degree; and a Nurse Practitioner is an experienced Registered Nurse who completes a further postgraduate 2-year part time qualification in Master of Advanced Nursing Practice. However, in terms of cosmetic injectables, it is important to understand that there is no cosmetic training in any of these nursing courses and no recognized cosmetic nursing qualification. Nurse Practitioners in the Perioperative category are permitted to prescribe cosmetic injections despite there being no cosmetic training in their course. The Nursing Board even allows Nurse Practitioners to self-determine which cosmetic procedures they wish to perform without any assessment or proof of competence. Any nurse who works in the cosmetic medicine area can call themselves a ‘Cosmetic Nurse’ or ‘Nurse Injector’ irrespective of their expertise or experience, even after a weekend workshop! Whilst there are structured cosmetic injecting courses for nurses available after graduation there is no regulation or requirement for nurses to do such courses. Nurses can start cosmetic injecting without any formal assessment of competence. There is a legal requirement of medical supervision for nurse injectors in Victoria but this supervision does not have to be in person as authorities allow this ‘supervision’ to be via phone. A doctor can be on his phone on a beach in Queensland and ‘supervise’ nurses injecting prescription drugs to patients in shopping centres around Melbourne.

DOCTORS

Certain titles in medicine are protected titles, which means they are not able to be used without the correct qualifications and are protected under national law with significant penalties for transgression. The title ‘Doctor’ is not actually protected as there are many different types of doctors other than in medicine, such as dentists, chiropractors, and PhD graduates. The title ‘medical practitioner’ is protected by law and can only be used by someone who has graduated with a degree in medicine. In Australia when a medical practitioner completes their 6-year University degree they continue training in hospitals for several more years before treating patients outside of hospitals. Some medical practitioners develop a particular interest in Cosmetic Medicine, and do further training and concentrate on treating patients with these concerns. Doctors who primarily work in non-surgical cosmetic procedures are often referred to as ‘Cosmetic Physicians’ but this is not a specific qualification, or a protected title and any medical practitioner can use this title. Many doctors working in Cosmetic Medicine become members of organizations such as the Cosmetic Physicians College of Australasia (CPCA) that aim to provide ongoing medical education to doctors and maintain high standards in the practice of Cosmetic Medicine. The senior and most experienced doctors in organizations such as the CPCA are called Fellows which indicates their experience and the high regard they are held within that organization.

 

A ‘specialist’ in medicine is a medical doctor who has undertaken a specialist training program to become a specialist in a certain medical discipline. The title ‘medical specialist’ is protected and each recognized medical specialty such as ‘Plastic Surgeon’ and ‘Dermatologist’ are also protected. The title that causes the most confusion for the public is ‘Cosmetic Surgeon’. This is not a protected title, and any doctor can use this title irrespective of training and qualifications. What can confuse the public more is that there are specialists in other areas of medicine that perform cosmetic surgery and call themselves specialist cosmetic surgeons. For example, some Dermatologists perform cosmetic surgery and whilst they are specialists in skin disease, they do not have anywhere near the level of surgical training of Plastic surgeons. Plastic surgeons must do an additional 6 years of postgraduate surgical training in cosmetic and reconstructive procedures and must pass an extensive examination process whereas Dermatologists train as physicians with limited training in surgical procedures. A recent case in the news saw one senior Melbourne Dermatologist relinquish his medical registration after major concerns were raised on the ‘Four Corners’ TV show over his cosmetic surgery standards and complications.

 

The lack of Government regulation and the presence of many opportunistic practitioners is why it is so important that patients ask questions and do their research before having any cosmetic treatments. This applies to all procedures from simple skin treatments through to invasive cosmetic surgical procedures. At the Collins Cosmetic Clinic, we have a team of experienced medical practitioners, dermal clinicians and nurse injectors working together to provide the highest standard of care in our dedicated medical facility. Our practitioners not only have their university qualifications but undertake extensive postgraduate training as well as ongoing education in skin treatments and cosmetic procedures. We believe that best medical practice is to have medical doctors on site to supervise and maintain the highest standards of outcomes and safety. At the Collins Cosmetic Clinic our focus is on non-surgical cosmetic procedures but when we do refer patients for cosmetic surgery, we recommend Plastic surgeons.  If you have any further questions about cosmetic treatments and who is best qualified to perform them feel free to contact our clinic by phone 0396545720 or email contact@collinscosmeticclinic.com.au

 

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