Cosmetic Surgery Guidelines

June 2008

`Cosmetic surgery' is defined in the guideline as operations and other procedures that revise or change the appearance, colour, texture, structure or position of normal bodily features with the sole intention of improving the patient's appearance or self esteem.[1]

Standard 1.1 of the NSW Medical Board's Code of Professional Conduct: Good Medical Practice states that:

`Good clinical care includes an adequate assessment of the patient's condition, based on the history and clinical signs and appropriate examination.'

The following guidelines supplement Standard 1.1 and apply to persons seeking cosmetic surgery.

1. Assessment should include:

1.1 an exploration of why the surgery/procedure is requested. Both external reasons (eg, a perceived need to please others) and internal reasons (eg, strong feelings about appearance) should be explored.

1.2 an exploration of the person's expectations of the requested surgery/procedure.

2. If there are indications that the person has self esteem or mental health problems, the person should be referred to a clinical psychologist or psychiatrist for review.
3. In relation to persons under 18 years of age:

3.1 if the requested surgery/procedure has no medical justification[2] there must be a `cooling off' period of 3 months, followed by a further consultation during which the request is further explored. The requested surgery/procedure should not be scheduled at the initial consultation.

3.2 the person should be encouraged to discuss their desire for cosmetic surgery and any concerns with their general practitioner during the cooling off period.

4. At the initial consultation, the person must be provided with written information in easily understood language about:

a) what the surgery/procedure involves

b) the range of possible outcomes of the surgery/procedure

c) the risks associated with the surgery/procedure

d) recovery times and specific requirements during the recovery period

e) total cost

f) other options for addressing the person's concerns.

[1] Medical Council of New Zealand, Statement on Cosmetic Procedures, October 2007

[2] Surgery or a procedure may be medically justified if it involves the restoration, correction or improvement in the shape and appearance of the body structures that are defective or damaged at birth or by injury, disease, growth or development for either functional or psychological reasons.