Creating a Safer Industry

Dr Andrew Clark is the Treasurer of the Australasian College of Aesthetic Medicine (ACAM) which is an organisation of doctors and nurses that is dedicated to advancing the clinical, educational and professional standards of Aesthetic Medicine being practised in Australia. To this end, Dr Clark volunteers his time to:

• Train General Practitioners and emergency department doctors to be able to recognise, diagnose, look after and appropriately refer patients who have suffered complications from cosmetic medical treatments
• Provide ongoing education and professional development for healthcare practitioners who undertake cosmetic medical treatments to improve the quality of care that they are able to deliver
• Advise state and federal government health departments and regulators so that they have a better understanding of the cosmetic medicine industry in order that they can improve the safety of the industry through better regulation
• Provide resources and support to Aesthetic doctors to improve the ethics and governance of the businesses that provide cosmetic treatments to the public

In his previous role for ACAM, Dr Clark was head of its education committee and helped to rewrite and restructure its education offerings to members. Each year Dr Clark helps ACAM to run its annual workshop where participants are taught the skills to improve the safety of their clinics and the treatments they provide.

Dr Clark also volunteers as an advisor on the scientific committee for the Australasian Society of Plastic Surgeons Non-Surgical Symposium Conference with the task of ensuring that the education provided at the conference meets the high standards of evidence and objectivity needed to ensure that the education provided at the conference free from corporate bias and remains as the pre-eminent cosmetic medical conference in Australia.

If anyone is going to do treatments on the face, including cosmetic injections, it is vital that they have a deep understanding of facial anatomy. In Australia, many injectors are taught how to inject by copying an injection pattern and no effort is made to teach them the underlying anatomy and the reasons for adapting injection patterns to suit certain individuals.

To help improve the standard of cosmetic injecting that takes place in Australia, Dr Andrew volunteers once per year to teach at the “Anatomy for Injectors” workshop, where conscientious injectors who wish to become safer and more capable learn about facial anatomy and how a to inject more safely and more effectively.

It’s simply not possible to learn how to do cosmetic medicine treatments in a weekend. Sadly, some health professionals think that after gaining a “certificate of attendance” at an injectables course they are then qualified to start performing unsupervised treatments on unsuspecting members of the public.

Currently, there is only one requirement for someone to start cosmetic injecting in Australia: They need to be a registered healthcare practitioner operating “within their scope of practice”.

Fortunately, serious side-effects from cosmetic medical treatments are very rare, and one of the first steps in further reducing the risks of side effects is for the person doing your treatment to have a thorough knowledge of facial anatomy1.

Unsurprisingly the training of Nurses, Dentists and Doctors during their publicly subsidised university degrees in Australia provides zero training on cosmetic injectables or on cosmetic skin and laser treatments. There is no requirement for injectors to have completed any particular course in injecting, laser treatments or anatomy before working in a cosmetic clinic. There are no exams they need to pass that tests their understanding of the procedures they plan to provide or the medicines they will administer.

Healthcare practitioners who inject just need to be able to put their hand on their heart and say “I think I know how to do this”.

ACAM has been working hard to improve the safety of the Australian public by asking for better regulation that would require practitioners performing cosmetic injections to at the very least have a relevant Post Graduate qualification in the field. Unfortunately, the regulators are still allowing practitioners to self assess themselves to have “sufficient training and experience” to perform these treatments.

Far beyond the minimum government requirements, the practitioners working at MIRA Clinic have all been hand-picked by Dr Andrew only after they have already been working extensively in the cosmetic medicine or skin health industries for one or more years and demonstrated a passion for learning and growing their skillset.

This is so important because we know that complications are also less likely to occur when advanced techniques are used instead of simpler techniques that are generally taught at beginner injector workshops2.

In Australia, we are fortunate to have a robust regulatory framework around the medicines that are allowed to be used in Australia and how healthcare professionals should practice their professions. But the relevant laws were written in 1989 and 2010 (The Therapeutic Goods Act and the Health Practitioner Regulation National Law), and they just didn’t predict the rise in popularity of non-surgical cosmetic treatments and therefore the regulations just have been unable to close the loopholes to ensure that the cosmetic medicine being performed in Australia is of a high enough standard.

At MIRA Clinic we strive to set the standard in practising ethical cosmetic medicine as safely as possible.

We are pioneers in the use of ultrasound in aesthetic medicine, which not only helps us to diagnose and treat complications from aesthetic treatments, it helps us to improve our anatomical knowledge and to improve our understanding of how the face reacts to cosmetic medicine treatments.

1. Jones DH, Fitzgerald R, Cox SE, Butterwick K, Murad MH, Humphrey S, Carruthers J, Dayan SH, Donofrio L, Solish N, Yee GJ, Alam M. Preventing and Treating Adverse Events of Injectable Fillers: Evidence-Based Recommendations From the American Society for Dermatologic Surgery Multidisciplinary Task Force. Dermatol Surg. 2021 Feb 1;47(2):214-226.

2. Alam M, Kakar R, Dover JS, Harikumar V, Kang BY, Wan HT, Poon E, Jones DH. Rates of Vascular Occlusion Associated With Using Needles vs Cannulas for Filler Injection. JAMA Dermatol. 2021 Feb 1;157(2):174-180.