Australia’s booming medical aesthetics industry is under more scrutiny than ever before and continues to be thrust into a whirlwind of regulatory reform. The heightened focus on advertising compliance, increased public scrutiny and rising Ahpra notifications have left many practitioners feeling exposed and confused.
Compliance in medical aesthetics is no longer a box-ticking exercise. In today’s environment, regulatory literacy is as essential as clinical skill. Many practitioners feel increasingly expected to think like clinicians while being prepared to defend their actions like litigators.
This article unpacks the complaints-handling frameworks of both the Therapeutic Goods Administration (TGA) and Australian Health Practitioner Regulation Agency (Ahpra), the scope of their powers and recent reforms that are shaping the future of compliance in aesthetic medicine. By understanding where the key risks lie, clinics can protect their reputation, minimise exposure and focus on what matters most: patient care.
TGA and Ahpra: fragmented oversight
The TGA is responsible for regulating therapeutic goods. This includes medicines and devices commonly used in cosmetic procedures, such as botulinum toxin, dermal fillers, ultrasound-based devices and certain lasers. The TGA also oversees the advertising of these products to the public. Its authority is grounded in the Therapeutic Goods Act 1989 and the accompanying Therapeutic Goods Advertising Code, which sets strict rules around what can be said, shown and implied in promotional material for therapeutic goods.
Ahpra, on the other hand, is the national body responsible for regulating health practitioners and works alongside the Medical Board of Australia to uphold professional standards. It manages the registration of practitioners, investigates concerns about conduct, performance or impairment – and most recently it has introduced updated practice guidelines for non-surgical cosmetic procedures. When a complaint – referred to as a ‘notification’ – is lodged about a medical practitioner, it is Ahpra that assesses and manages the response.
In theory, the split is clear: the TGA regulates products and their promotion, while Ahpra regulates people and their practice. In reality, the regulatory boundaries often blur, especially in aesthetic medicine where treatments are elective, commercially driven and publicly visible. A single social media post might be scrutinised by both regulators – first for potentially unlawful advertising, then for alleged professional misconduct.
Inside the TGA: A structured, risk-based approach
Since July 2018, the TGA has been the sole authority responsible for handling complaints about the advertising of therapeutic goods to the public. It applies a tiered, risk-based model that categorises complaints as low, medium, high or critical priority, depending on the severity of the breach, the potential for consumer harm and the advertiser’s prior history.
Minor breaches, such as an isolated instance of ambiguous wording on a website, are typically addressed through education and regulatory obligation notices. Medium-priority cases involve ongoing non-compliance and usually require a formal response. High and critical cases are investigated swiftly and may involve prohibited representations, unlawful claims or risks to public safety. These can result in fines, public warning notices or criminal prosecution.
The TGA accepts anonymous complaints and publishes the outcomes of most enforcement actions on its website. It has also introduced key performance indicators to improve transparency, aiming to close 90 percent of low-priority complaints within 20 days and high-priority matters within 90 days.
Is Ahpra’s notifications system fit for purpose?
Ahpra, in partnership with the National Boards, is responsible for managing notifications about registered health practitioners. In theory, the system is designed to balance public safety with practitioner fairness. In practice, there is increasing scrutiny on whether it is delivering on that intent.
One of the main criticisms of Ahpra’s framework is its current triaging system. Unlike the TGA, which applies a clearly defined risk-based priority model (low, medium, high, critical), Ahpra’s notifications process does not consistently differentiate between low-risk, technical breaches and serious patient safety concerns at the point of initial screening. As a result, relatively minor breaches, such as advertising language errors or communication issues, can trigger full investigative processes.
Notifications triggered by anonymous or poorly substantiated sources may still result in formal interviews, documentation requests or prolonged uncertainty.
Further, the investigative burden often falls disproportionately on the practitioner, even when no regulatory action is ultimately taken.
This has led to growing calls from within the medical profession, and particularly the aesthetic sector, for Ahpra to implement a more structured and transparent triage model, similar to other regulatory bodies.
Notifications, once reserved for serious concerns about a practitioner’s conduct or capability, have ballooned in number and scope. From 2022 to 2023 alone, over 19,000 notifications were lodged. Many of these were never upheld, yet still triggered long and often opaque processes.
While patient safety must always come first, there is a growing sense that Ahpra’s approach too often defaults to prolonged investigation over proportionate triage. This raises a critical question: does the current system strike the right balance between public protection and practitioner fairness?
Priority categories: what triggers a red flag?
| Priority | Example scenarios | TGA action |
| Low | First-time or minor breach (eg. vague claim about skin benefits) | Guidance email, no formal response required |
| Medium | Repeat offender, no consumer harm | Warning letter + 14-day response period |
| High | Use of restricted representations or prescription-only substances | Immediate warning, possible enforcement |
| Critical | Public health risk, misleading vulnerable populations | Fast-track enforcement, possible legal action |
Overview of proposed complaints handling model once a breach is established
A system that feels punitive by design
Doctors who have been through the notifications process often describe it in terms typically reserved for legal proceedings: ‘under investigation’, ‘presenting evidence’ and ‘awaiting judgement’. The emotional toll of this language – and the lengthy, uncertain timelines that follow – can be profound.
Once a notification is lodged, the practitioner is often treated as though they are guilty until proven innocent. Even when a notification is ultimately dismissed, the reputational and emotional damage can be lasting.
The system is open to vexatious misuse. Competitors, disgruntled clients or online trolls can file complaints that trigger months-long investigations without sufficient cause. For many doctors, a single unfounded notification can derail their livelihood, and anxiety, depression and burnout are common.
The issue isn’t that regulation exists. It’s that the tone and structure of the process suggest suspicion before support, guilt before enquiry. While Ahpra has made efforts to improve transparency, it remains common for practitioners to experience prolonged periods of uncertainty about the nature of a complaint. This can undermine practitioner confidence and fuel anxiety.
Tension between intent and outcome
The duplication of oversight (with Ahpra and TGA operating in parallel but rarely in coordination) often leaves practitioners unsure of who governs what. A single Instagram post promoting wrinkle relaxers or showcasing a patient testimonial might breach TGA advertising rules, but if a patient lodges a complaint, it can escalate to Ahpra-level scrutiny – even if the issue is primarily regulatory, not clinical.
The lack of clear triage in these instances is a problem. Not all notifications are equal, but the system frequently appears to treat them as such.
To its credit, Ahpra has taken steps to improve its handling of notifications. Recent reforms include: a target to complete 60 percent of initial assessments within 60 days; a greater focus on practitioner wellbeing, including better communication; and educational content to help health professionals understand the process.
These are important changes, but for frontline practitioners, especially in aesthetic practice, the core issues remain:
- A lack of proportionality in how notifications are triaged and investigated
- A system open to vexatious or misinformed complaints
- Emotional strain and reputational damage even when no fault is found
- Limited transparency about how and why decisions are made.
‘THE RESULT IS A REGULATORY ENVIRONMENT WHERE PRACTITIONERS FEEL INCREASINGLY CAUTIOUS ABOUT TREATING PATIENTS, EVEN WHEN THEY ARE ACTING WITHIN LEGAL AND ETHICAL BOUNDARIES.’
Fear, fairness & the new practise of aesthetic medicine
Increased public scrutiny and visibility makes the industry particularly vulnerable to complaints – some valid, others opportunistic or misinformed.
The result is a regulatory environment where practitioners feel increasingly cautious about treating and communicating with patients, even when they are acting within legal and ethical boundaries.
If the objective of regulation is to support safe, ethical practice while maintaining public trust, then the system must be designed to respond proportionately. It should be able to filter out low-risk cases quickly, reserve its most serious responses for actual harms and provide clarity to both regulators and practitioners.
That means clear guidance, a consistent approach and systems that filter out low-risk complaints early, rather than dragging them through full investigative procedures.
Calls have also been made for greater medical expertise at the decision-making table, particularly in aesthetics, where the regulatory nuances are vastly different from general medicine.
In the end, public protection is not served by burning out good practitioners. What is needed now is not just stronger enforcement, but smarter enforcement grounded in risk, proportion and an understanding of how medical practice operates in the real world.
The Australian aesthetic medicine industry will continue to grow. With that growth comes responsibility – not just for practitioners to act ethically and safely, but for regulators to ensure that the systems they manage are fair and effective for all involved. AMP
Notifications: the numbers
- According to 2023-24 data, 19,522 notifications were made about 15,078 practitioners nationally.
- 11,200 notifications were managed directly by Ahpra and the National Boards.
- Matters involving 180 practitioners (relating to 305 notifications) were decided by a tribunal.
- ~2% of cases resulted in deregistration or disqualification
- The average time to close a matter is over 90 days.
Ahpra’s notification process
- Lodging a notification
- Who can notify: Anyone, including patients, relatives, health practitioners, employers or other concerned individuals, can raise a notification about a registered health practitioner.
- Types of notifications:
- Voluntary notifications: Concerns raised without a legal obligation.
- Mandatory notifications: Certain individuals, like health practitioners and employers, are legally required to report specific issues, such as impairment, intoxication or significant departure from accepted professional standards.
- Initial assessment
- Timeframe: Ahpra aims to complete the assessment process within 60 days.
- Process: During this period, Ahpra gathers relevant information from the notifier and may contact the practitioner for their input.
- Investigation
- If the initial assessment indicates potential risk to public safety, a formal investigation may be initiated.
- Investigations delve deeper into the practitioner’s conduct, performance or health to determine if regulatory action is necessary.
- Outcome determination:
- Possible outcomes:
- No further action: If the practitioner poses no risk to public safety.
- Caution or reprimand: Formal warning regarding the practitioner’s conduct.
- Conditions imposed: Restrictions or requirements placed on the practitioner’s registration.
- Suspension or cancellation: Temporary or permanent removal of the practitioner’s registration.
- Review and appeals
- Practitioners have the right to request a review or appeal decisions through appropriate legal channels.
Top 5 compliance risks for aesthetic clinics in 2025
As regulatory scrutiny intensifies in the Australian medical aesthetics sector, clinics must be more vigilant than ever about how they promote, perform and document treatments. While many practitioners focus on delivering excellent patient outcomes, it’s easy to overlook the finer points of compliance – until a complaint lands at your door.
- Advertising Sch 4 medicines (directly or indirectly)
Risk area: TGA Advertising Code compliance
One of the most common breaches investigated by the TGA involves advertising of Schedule 4 prescription-only medicines, such as botulinum toxins and dermal fillers. It is illegal to mention these products by name in any public-facing promotional material, including websites, Instagram captions, hashtags or videos. But indirect references can also land you in hot water. Phrases like ‘anti-wrinkle injections’, ’frown line relaxers’, or even emojis can be interpreted as therapeutic claims.
- Before-and-after photos and patient testimonials
Risk area: Both TGA and Ahpra regulations
The TGA prohibits the use of before-and- after images that imply a therapeutic benefit of a product, while Ahpra bans patient testimonials entirely under the National Law. This includes reviews, video reactions and social media reposts—even if the patient volunteered the content.
Many clinics unknowingly breach these rules by sharing tagged posts, Google reviews or client selfies in their stories. Even using ‘client transformations’ in Reels can trigger a compliance complaint.
- Unclear or inadequate informed consent processes
Risk area: Ahpra – professional conduct and performance
Consent isn’t just about getting a signature on a form—it’s about ensuring the patient fully understands the risks, alternatives and likely outcomes. In aesthetic medicine, where expectations can be influenced by social media, Ahpra frequently receives notifications about inadequate consent, particularly for off- label or novel treatments.
Practitioners must ensure they document verbal consent discussions and provide ample opportunity for patient questions. Failure to do so can be seen as a breach of professional standards, even when no harm has occurred.
- Misleading claims about results, safety or innovation
Risk area: TGA – misleading advertising; Ahpra – professional misconduct
Using terms like ‘non-surgical facelift’, ‘permanent fat removal’, or ‘risk-free’ are red flags. These statements breach the TGA Advertising Code by creating unrealistic expectations, and could also be cited by Ahpra in cases involving patient dissatisfaction or misunderstanding.
New devices or treatments can be particularly risky if they haven’t been adequately reviewed by the TGA or lack published clinical data to back up claims.
- Vexatious or trivial complaints escalating to formal investigations.
Risk area: Ahpra notifications process
Even when a clinic is compliant, it’s still possible to face a notification. Vexatious complaints whether from a disgruntled client, competitor or ex-partner can trigger months of investigation. While Ahpra has begun implementing safeguards against vexatious complaints, the process remains time-consuming, emotionally taxing and reputationally risky.
Practitioners are often surprised to learn that even minor issues (like a vague Facebook post) can lead to formal scrutiny not only by Ahpra but sometimes also by the TGA if advertising is involved.
