Peak medical bodies say flagged reforms to Australia's cosmetic surgery industry still endanger patients after a damning report uncovered serious breaches across popular clinics.
An independent report released on Thursday found unsafe practices, misleading advertising and substandard marketing across the cosmetic surgery industry.
It also highlighted universal minimum standards for education, training and qualifications are non-existent in Australia.
Any medical practitioner can perform invasive cosmetic surgery without appropriate training or having amassed sufficient supervised experience to reach an acceptable level of competency.
The inquiry, led by former Queensland Health Ombudsman Andrew Brown, makes 16 recommendations that the Australian Health Practitioner Regulation Agency (AHPRA) and Medical Board of Australia have agreed to implement.
This includes a new accreditation process.
There is no set timeline for fulfilling all recommendations, however new accreditation guidelines would not take effect for up to three years.
The Australasian Society of Aesthetic Plastic Surgeons (ASAPS) said the changes could lead to worse patient outcomes.
"AHPRA has chosen to protect those who call themselves cosmetic surgeons, instead of protecting patients," ASAPS president Dr Robert Sheen said.
"It is reckless, and irresponsible. The government must step in to tighten the law so a practitioner who is cutting a patient's body has completed Australian Medical Council accredited surgical training."
The Australian Medical Association called on the federal government to intervene.
"Importantly, at their meeting on Friday, health ministers could make a decision to protect patients by restricting the title 'surgeon' to those medical practitioners who have undertaken a significant, accredited surgical training program," AMA President Professor Steve Robson said.
Royal Australasian College of Surgeons President Dr Sally Langley called for tighter regulations around surgical training.
"We still strongly recommend that anyone undertaking cosmetic surgery should be a fully trained surgeons who is trained by an AMC (Australian Medical Council) accredited surgical training program," she said.
The recommendations agreed on by AHPRA and the medical board include introducing an "endorsement" process under national law to establish expectations about minimum qualifications for medical practitioners wishing to perform cosmetic surgery.
Other recommendations include improving the way cosmetic surgery notifications are handled and implementing a targeted education campaign to stop the under-reporting of safety issues.
Concerns around misleading advertising could also be addressed by strengthening guidelines and taking stronger enforcement action against practitioners who breach the regulations, including on social media.
AHPRA welcomed all 16 recommendations and vowed to establish a Cosmetic Surgery Enforcement Unit to take action alongside the medical board, which is backed by a $4.5 million investment for extra resources.
Health Minister Mark Butler said tightening regulations was on the agenda for Friday's health ministers meeting.
"I want to see action that gives Australians confidence that if they're undertaking treatments, that the treatments are being performed by people with appropriate qualifications in appropriately licensed hygiene facilities," he said.
The review began in January after a series of alarming media reports highlighted patients who had been victims of disfigurements and other complications.
In October 2021, a joint investigation by The Sydney Morning Herald, The Age and the ABC's Four Corners program into controversial medical practitioners dubbed "Cosmetic Cowboys" uncovered serious hygiene and safety breaches across various clinics.
This resulted in the Medical Board of Australia taking action against several practitioners.
Celebrity dermatologist Daniel Lanzer is no longer registered to practise while prominent surgeons Reza Ahmadi and Daniel Aronov can no longer perform cosmetic procedures.
Doctor Ryan Wells was suspended altogether and can no longer practise medicine.
Last year, AHPRA said it received 313 notifications of cosmetic surgeries that had a complication or injury in the three years to June 2021.
Complaints were made against 183 surgeons following procedures ranging from tummy tucks, breast augmentation, face lifts, liposuction and eyelid surgery to non-invasive treatments like dermal fillers and anti-ageing injections.