Cosmetic surgery not all prettty

CHOICE investigates the cosmetic surgery industry and uncovers some disturbingly unprofessional practices.
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03.What our shadow shoppers found

Breast augmentation

Breast augmentationBreast augmentation is one of the most popular cosmetic procedures, as well as one of the most emotive. Our shadow shopper visited 12 clinics and uncovered some appalling examples of unprofessional behaviour, including:

  • Being shown the breasts of one of the sales consultants as an example of the doctor’s work.
  • Being told by one doctor that she “needed” to have the surgery done.
  • Being offered a discount if she agreed to have “before” and “after” photos of her breasts published on the internet.
  • Even being told that if she had her breasts enlarged it would increase her chances of finding a partner!

All this aside, our ASPS experts rated overall explanation of the procedure’s potential risks as particularly bad. Our shadow shopper was not totally informed by the doctors about dangers such as haematoma, infection, leakage or scarring.
Some did not even ask why she was considering the treatment. Only seven checked her weight, while only two clinics provided evidence of accreditation when asked (another had a certificate in the waiting room).

In a few instances our shadow shopper also felt she was being pushed into making a decision, and three times was offered brochures about credit without asking (see Change now, pay later, below).


LiposuctionLiposuction is another popular procedure, but also one of the most dangerous. In February 2008, a young Adelaide woman died after having liposuction, as did a Melbourne woman in 2007. Liposuction usually involves pumping the “problem” area with liquid before sucking fat out of the body. It can be painful and requires a high level of post-operative care.

Our shadow shopper was rated by ASPS experts as a poor candidate for liposuction – they suggested she would need to lose weight first and that an abdominoplasty (tummy tuck) would probably be more suitable. She visited 14 cosmetic surgery clinics, and while our experts felt some of her consultations were reasonable, as some cosmetic surgeons suggested abdominoplasty by a plastic surgeon, most also suggested she consider having liposuction in other areas of her body.

One doctor suggested other cosmetic procedures to improve her appearance, such as removing fat from her chin and another doctor suggested removing some moles and skin tags, even though she didn’t request them.

While the general advice about liposuction was sound, not all the doctors said how many surgeries they had performed – and even when they did it was very vague. Very few doctors mentioned their actual qualifications and accreditations, hence placing the onus on the patient to do all the asking.


Botox doesn’t involve surgery and nowadays seems an everyday treatment, even on offer at so-called “Botox parties” held in private homes. Despite this image, it is still a risky procedure and not suitable for all candidates.

BotoxIt’s also critical that potential clients are questioned thoroughly before undertaking the treatment, particularly if there is a possibility the patient is pregnant – an Australian baby was born with severe defects possibly as a result of the mother using a virtually identical treatment to Botox in her first week of pregnancy.

Our ASPS experts didn’t consider the shadow shopper a suitable candidate for Botox and suggested other alternatives would work better for the deep line on her forehead. She visited 12 cosmetic clinics and received varying advice.

One doctor said Botox would not be suitable as she would be unable to use her eyebrows to express herself, instead recommending a filler, which our experts felt was reasonable advice. However, nine doctors recommended both a filler and Botox. Six recommended a brow lift (along with Botox or a filler), which the experts considered reasonable.

While most of the advice she received was acceptable, discussion of risks in all the consultations was minimal. The amount and location of the injections varied widely between consultations. Our experts assessed that one doctor would be injecting in the wrong area of the face, while another told the shadow shopper that Botox wouldn’t fix her problem, yet offered the service anyway.

Shadow shop results concerning

Overall, the results of our shadow shop are concerning. Without discussing risks, it’s extremely difficult for a potential patient to make an informed decision. There were also some important questions that some cosmetic surgeons did not ask the shadow shoppers, which are critical to ensure the patient’s safety.

Some of the shadow shoppers also said they felt rushed through their consultations, and that some practitioners lost interest quickly when it became clear they weren’t a suitable candidate for a procedure. One doctor even took phone calls to arrange a golf game during a consultation!

Change now, pay later

Cosmetic surgery can be very expensive, and is not covered by Medicare or many private health insurers if it is being undertaken for aesthetic reasons only.

A number of finance companies and brokers are targeting potential cosmetic surgery patients with expensive loan offers. So if you’re in a hurry to have a procedure done, perhaps you’re thinking a loan is the answer? Perhaps not. Cosmetic surgery loans can be far more expensive than a low-rate credit card. Mediplan charges an interest rate of 16.9% for members and 17.9% for non-members, including a 7% processing fee (up to a maximum of $295). For an operation costing $4000, the fee would be $280.

Both the Australian Society of Plastic Surgeons and Consumer Action Law Centre (CALC) are critical of these schemes. “If you buy a car on finance, if you can’t afford the repayments at least you might be able to give it back to help pay your debt,” says Carolyn Bond from the CALC. “But what do you do with a breast implant?”.


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