The global aesthetic industry is booming, but the level of regulation protecting patients – and defining who can legally perform cosmetic procedures – differs dramatically from one country to the next. While some governments enforce strict medical frameworks for injectables, lasers and cosmetic surgery, others rely on loose or inconsistent systems that have allowed a proliferation of unlicensed operators.
This disparity raises important questions not just about safety and training, but about both patient and practitioner rights, international standards and what constitutes ethical practice in a rapidly expanding industry.
Australia: among the most regulated
Australia is regarded as one of the most tightly regulated aesthetic markets in the world, with oversight shared between federal and state-level authorities. Registered medical practitioners must comply with standards set by the Medical Board of Australia (MBA), enforced by the Australian Health Practitioner Regulation Agency (Ahpra).
In June 2025, Ahpra released revised Guidelines for registered health practitioners who perform non-surgical cosmetic procedures, coming into effect on 2 September 2025. Key changes include:
- A requirement that nurses must have completed at least 12 months of general practice experience before they can begin training in cosmetic injectables.
- Prescribers must conduct real-time consultations (in person or via video) prior to prescribing Schedule 4 medicines such as botulinum toxin or dermal fillers. Asynchronous prescribing, such as through text, email or online forms, is now prohibited.
- Practitioners must provide a comprehensive informed consent process, including a clear discussion of risks, alternatives, post-procedure care and financial costs. A mandatory seven-day cooling-off period applies to patients under the age of 18.
- Post-procedure care responsibilities have been clarified, with the prescriber or supervising doctor remaining accountable even when the procedure is delegated.
Advertising rules have also been further tightened. The new Guidelines for advertising higher risk non-surgical cosmetic procedures include a ban on influencer testimonials, targeted ads to under‑18s (which must now be classified as adult content on social media), and require advertisements to include practitioner registration details. They emphasise removal of promotional inducements and language or imagery that trivialises cosmetic procedures.
In parallel, the TGA continues to regulate medicines and devices used in aesthetic practice, enforcing restrictions on advertising that prohibit patient testimonials, inducements and misleading before-and-after imagery.
Germany: tightly controlled
Under national medical licensing laws enforced by the German Medical Association (Bundesärztekammer), cosmetic procedures, whether surgical or injectable, must be performed by fully licensed medical doctors. There are no legal routes for non-medical practitioners to perform injectables.
Marketing of cosmetic services is highly restricted under the Heilmittelwerbegesetz (HWG), or the German Medical Products Advertising Act, which prohibits before-and-after images, patient testimonials and misleading claims. Device and product regulation is enforced through the Federal Institute for Drugs and Medical Devices (BfArM).
South Korea: high demand, tight laws
South Korea is a global leader in cosmetic procedures and has progressively tightened its regulatory framework. Oversight is provided by the Ministry of Health and Welfare (MOHW). All cosmetic surgery and injectable treatments must be performed by licensed physicians.
The country passed a groundbreaking law in 2021 mandating CCTV cameras in all operating rooms, following multiple cases of ‘ghost surgeries’ performed by unlicensed staff. Advertising is also tightly regulated, with medical providers required to clearly display their credentials and avoid unsubstantiated claims.
United Kingdom: reform in progress
The UK is undergoing a shift from a patchwork system to a more formal licensing regime. While cosmetic surgery must be performed by doctors registered with the General Medical Council (GMC), non-surgical procedures like Botox and dermal fillers have been historically under-regulated, often administered by beauticians with no formal medical training.
However, under powers granted by the Health and Care Act 2022, the Department of Health and Social Care (DHSC) is developing a national licensing scheme for all providers of aesthetic injectables.
United States: fragmented oversight
In the US, the Food and Drug Administration (FDA) regulates aesthetic products like dermal fillers and lasers. But regulation of who can administer cosmetic treatments is handled at the state level, resulting in inconsistent standards.
Some states allow registered nurses or physician assistants to perform injectables under physician supervision; others permit more autonomous practice. The rise of medspas – sometimes owned by non-physicians – has further complicated oversight. While many medspas are physician-supervised, others operate in legal grey areas with limited accountability.
Advertising and patient protection laws also vary by state, with enforcement largely left to individual state medical boards and the Federal Trade Commission (FTC).
Brazil: high volume, uneven enforcement
Brazil ranks among the highest globally in cosmetic procedures per capita. The field is governed by the Federal Council of Medicine (CFM), which sets professional standards for physicians. The Federal Council of Dentistry (CFO) allows trained dentists to perform certain aesthetic procedures, such as lip fillers and facial harmonisation.
While the framework is established, enforcement is a known challenge. The National Health Surveillance Agency (ANVISA) oversees product regulation but has limited reach into informal or illegal aesthetic clinics.
Turkey: cosmetic tourism hotspot with regulatory gaps
Turkey has built a multi-billion-dollar cosmetic tourism sector, particularly in hair transplants, rhinoplasty, and dental aesthetics. Clinics must be licensed by the Ministry of Health, and medical procedures should only be performed by qualified doctors.
However, international medical bodies, including the International Society of Hair Restoration Surgery (ISHRS), have warned of a booming “black market” for cosmetic procedures in Turkey, specifically foscuing on hair transplants, with cases of unlicensed providers, unsanitary conditions and poor aftercare. The ISHRS launched a campaign called ‘Fight the FIGHT’ (Fraudulent, Illicit & Global Hair Transplants) to raise awareness of the risks of medical tourism for hair transplants and combat these black market practices.
As aesthetic medicine continues its global expansion, regulatory frameworks around the world are being pushed to strengthen rules and tighten oversight in response to rising demand, commercial pressures and patient safety concerns. More robust regulation in many jurisdictions is increasingly essential—not just to safeguard patients, but to uphold the integrity and professionalism of the aesthetics industry worldwide.
