The $1 billion industry will undergo significant reform after an independent review highlighted misconduct.

The Australian Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia have agreed to implement the recommended changes to strengthen industry regulations and improve patient safety.

The inquiry, led by former Queensland Health Ombudsman Andrew Brown, found unsafe practices, misleading advertising and substandard marketing across the cosmetic industry.

When it comes to cosmetic surgery, 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.

“In this environment, consumers are largely left on their own when it comes to selecting a practitioner to perform cosmetic surgery, having to sift through a plethora of advertising and marketing material and try to make sense of numerous qualifications, in an attempt to identify a qualified and competent practitioner,” Brown said.

The inquiry also noted under-reporting of safety issues by registered health practitioners and employers.

Additionally, the state-by-state variation in facility regulation potentially exposes patients to risk.

The review made 16 recommendations including 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 AHPRA and the medical board manage cosmetic surgery notifications, and implementing a targeted education campaign to stop the under-reporting of safety issues.

Concerns around misleading advertising could also be addressed by strengthening the advertising 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.

However the Australasian Society of Aesthetic Plastic Surgeons (ASAPS) said more needed to be done, and warned the new proposals would 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 review began in January after a series of alarming media reports highlighted patients who had been victims of disfigurements and other complications.

In October last year, a joint investigation by The Sydney Morning Herald, The Age and ABC’s Four Corners program into controversial medical practitioners dubbed “Cosmetic Cowboys” uncovered serious hygiene and safety breaches across popular 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.