Trish

Hello, listeners. It’s Trish Hammond here from the Transforming Bodies podcast. And today, it’s been a year, but I’m at the NSS, and I’m joined again with Dr Tim Edwards. Now, Dr Edwards is the President of the Australasian Society of Aesthetic Plastic Surgeons. And we caught up last year, and there’s been so much happening in this last year, and we’re gonna get a bit of a rundown of what’s been going on. So welcome, Dr Edwards.

Dr Edwards

Thanks for having me again.

Trish

Thank you so much. So tell me, so much has happened in the last year. And let’s just start off with, like, what’s changed with regards to the regulations and what’s changed – the face of the industry has changed a lot. Can you give us a little bit of insight on that from your side?

Dr Edwards

Yes. So when we spoke last year, the government had completed its review into the cosmetic surgery industry. And had implemented a raft of reforms. And he’s really focussed on patient safety. Things such as psychological screening before surgery, things such as mandating two consultations, some cooling off periods, and toning down these sorts of social media that we’d seen surrounding some practitioners with outrageous claims over sexualised imagery and these sorts of things. And really dialling cosmetic surgery back from being a consumer based marketing exercise to a clinical, surgical procedure, which actually is. Now in the last 12 months, we’ve seen that the regulators don’t differentiate between cosmetic surgery and non surgical procedures. We see them as 2 separate industries even though we are intimately involved in both. But the government lumps them all into one basket. And so the sorts of reforms that we saw wash through aesthetic surgery are now starting to permeate into the non surgical space.
What that means is that there has been a second raft of enquiries with stakeholders being asked to submit their recommendations. And although the government hasn’t released its final report, it’s reasonably clear that we can expect that similar if not the same restrictions, controls, that were brought in for cosmetic surgery will be brought into the non surgical space. And so at this conference, we’ve been preparing our attendees for what is likely to come in the next 12 months.

Trish

And do you reckon though, like, because looking at it from a patient’s perspective and I speak to patients quite a lot because of a little Facebook group that patients jump onto it. It is a plastic surgery group, but they come on for non surgical information as well. Do you think when it’s quite so harsh, not harsh, I don’t know if that’s the right word, but when it’s quite so it’s gone, this is what we used to do. Now we can’t do any of that. And I’m actually finding a lot of patients are actually starting to look overseas. Do you think this is a good thing? Like, is there any way we can stop that from happening?

Dr Edwards

It is a difficult question. And I think what we’re seeing is that the entire industry body is being punished for the bad actors who formed a small proportion of that industry. The vast majority of practitioners are ethical, honest people who just want to do the best they can by their patients. But unfortunately, it was spoiled for the many by the actions of a few. Now you’re quite correct that by making it difficult for practitioners to disseminate responsible information with fairly blanket bands on terminology that can be used. People are starting to look for information that comes from elsewhere. And whilst we understand what has been done by the regulators and broadly support it. There are some things that we think have gone a little bit too far and maybe that’s something that we can discuss with them once the dust settles and they have time to reflect on the impact that had. But equally, organisations such as the NSS have a role to play.

So whereas in the past, a lot of information has been disseminated through social media channels. What we’ve started to do this year is introduce the NSS Academy, which is a vehicle for practitioners in this space to record their ongoing education program through what’s known as continuing professional development or CPD. And the NSS will then be able to provide those practitioners with an accreditation, which shows that they are committed to lifelong learning.

Now this is what patients will be looking for in the future. They won’t be looking for the most attractive TikTok video, they’ll be looking for the most qualified practitioner and being a member of the NSS Academy will be a guarantee of that.

Trish

Okay. And will that be just, I guess, it is non surgical. Isn’t it so it’s just been non surgical. It won’t be surgical at all? Or will that filter through to the surgical arena as well?

Dr Edwards

So the surgical arena has been addressed in a different way. So in the past, we had a number of people able to perform surgery who are not qualified surgeons. And they were able to even label themselves as the title surgeon. Even though they had no formal recognised qualification. So we had the system in place of registered specialist surgeons, but people were undermining it and circumventing it. That’s been stopped by the government by insisting on proper qualifications and also restricting the title of surgeon now that it can only be used by a specialist FRACS, Fellow of the Royal Australasian College of Surgeons, qualified Surgeon. And what that means is that that process has been reinforced, that process that was in place. In the broader nonsurgical space, because there are so many different practitioners who perform these procedures, and we support that. We strongly believe that surgery is for surgeons, but in the non surgical space, we have dermatologists. We have general practitioners, cosmetic physicians, registered nurses, dental practitioners. Lots of different people. And so there’s no one standard, which applies to this broad spectrum of practitioners. And so the NSS Academy is a way of bringing everyone together on the same playing field and saying, this is the minimum standard that is required.

Trish

And how can someone who actually does run an aesthetic business? Look, because I’ve read the regulations and like, they are really hard to understand and you’re not sure, like, if you can’t say a particular word or if you can’t say the product that’s being used or you can’t actually say now because I think now they’ve changed it, so you can’t actually say the result, I guess. Like, you know, anti wrinkle, you can’t kind of say that sort of thing anymore. Do you think that’s detrimental to the industry though as well because, I mean, people are gonna travel elsewhere.

Dr Edwards

Well, they’re not gonna travel elsewhere in terms of travelling out around Australia, because the rules apply broad based across Australia. And whilst people do travel overseas for surgery, non surgical procedures, which tend to be smaller, less expensive and less invasive. I doubt that people are gonna travel overseas. So people are gonna need to find different ways of sourcing that information. And that’s what the NSS Academy is about. It’s about practitioners being able to stand on their record of education and expertise rather than relying on a social media profile to advertise their business.

Trish

So basically, the non surgical simple NSS is gonna kind of convert into like a bit of an educational academy that is that kind of what you mean?

Dr Edwards

Not quite because the NSS is already an educational academy. What it’s doing is providing a way that practitioners who use the NSS for their education can record that with the relevant CPD provider and have it acknowledged and then display their digital badge in their practice that confirms that they have met the requirements for the preceding 12 months.

Trish

Got it. So basically, like, you as a doctor, plastic surgeon physician. You have an AHPRA number like a nurse does. So this will be, not only will you have an AHPRA number, you will actually have an NSS digital badge to sort of say, hey, we know that this person is committed to continuous learning and safety requirements in aesthetic procedures.

Dr Edwards

That’s correct. And in the past, CPD has been part of our lives since we graduated. And it is for many of our colleagues. But what’s changed is that the CPD is now more specified for the procedures and the area in which you are working. So to give an example, in plastic surgery, a very broad specialty, we do everything from burns to craniofacial to hand surgery, microsurgery in many more fields. And there was no stipulation that as an aesthetic surgeon, I should be doing my CPD in that area, whereas that is now what’s going to change. And so this is a way of practitioners accessing the right education given by the relevant industry specialists. Recording it and then transparently showing it to their clients that they have completed this recommended process.

Trish

So basically, if I was a plastic surgeon, I’d probably be dangerous. But if I was a plastic surgeon, and I only did injectables. The extra training that I would need to have is just in that area. Like, that would be what I have to earn my CPD points in. Is that kind of what you’re saying?

Dr Edwards

Not only, but it’ll be a proportion of your CPD. Your CPD covers a broad range of things such as patient respect, cultural sensitivity, and everything right through to making sure you’re up to speed with your resuscitation techniques. But now a part of it will be specified close to the area in which you are practising.

Trish

So is the NSS kind of gonna be like a little mini society kind of thing? Is it or, like, how does that work legally, kind of thing?

Dr Edwards

So in formal societies such as the Fellow Royal Australasian College of Surgeons, it’s very prescribed how things work for all of the surgeons who belong to that organisation. With the Non-surgical because people come from so many different medical disciplines and dental disciplines, and therefore, the rules governing all of those different people are different. 

The NSS is if you like a way of bringing an umbrella over those people. So that they can come together as a family and teach each other, learn from each other, and also record that learning.

Trish 

Okay. I actually don’t think it’s a bad thing. What I’ve done, I just think it’s gonna take a while for people to get used to it. And I think sometimes people interpret things differently. Is there an easy way for someone who may not be in part of the Non Surgical Symposium because they might not be at like, they might just be started. I don’t know. They’ve just chosen not to, and might not even be aware of it. Is there any way for them to sort of make sure they’re adhering to the guidelines in a simple way? Because if you read them, they’re really hard to translate.

Dr Edwards

If they are difficult to translate. And I think when new things come in, it does take a while for everybody to understand it and also to just manage the collateral damage. Sometimes some decisions that are made that are well meaning, but they may actually cause some other problems. So this will take some time to wash through and for everyone to understand. Now in terms of others, if people aren’t part of the NSS Academy, I am absolutely sure that there will be other pathways for them to undertake their learning, but those have not come to fruition as yet. This is all very new.

Trish 

Yeah. So it’s almost a real visionary thing, really, that’s what the NSS is doing because and I guess it’s probably been lots of brainstorming about this, I reckon you had a brain.

Dr Edwards

Well, the fortunate thing is that we’ve actually been talking about this for a number of years. And we’ve explored with our partners different modalities as to how this would happen. Did this bring it on a little quicker than perhaps it might have? Maybe. Yes. But it has been in planning for quite some time. It’s a bit like in the surgical sense where there was a sudden requirement for body dysmorphia and psychological vulnerability screening. And we introduced that very quickly and people said, oh my gosh, how did you have that. And the reason was that the Australian Foundation for Plastic Surgery, which is a charitable research group that we are part of, had been doing research into this for over 5 years. So these things are often in place and people who’ve already thought about them. It’s not like it was a light bulb moment. 

Trish 

Yeah. It’s almost like things are in process to fix things and then something happens, but there’s already something in process that was actually visionary to seeing that happening, so they’re trying to counteract it, I guess.

Dr Edwards

Visionary in retrospect. Doesn’t that mean that it was something we’re always trying to improve and it was something that people had already looked into and we’re already working on.

Trish 

So in an ideal 12 months time, what would you look like? How would that look? How would that look for a practitioner who’s got a clinic in Brisbane, who’s a doctor, maybe working as a cosmetic doctor, not a specialist, but a cosmetic doctor. And working with maybe one office person and outsourcing everything else like, how do you think that might look from their perspective?

Dr Edwards

Well, if they’re in Brisbane, it would be a very short drive down to the Gold Coast to attend the NSS meeting. And attend the NSS meeting and accumulate their learning for that period of time. And then also the NSS provides podcast learning and online learning throughout the year as well. So there are many avenues in which people can access what we do. And hopefully, that will see them commit to lifelong learning.
We talk about the 35-5 rule in surgery. You train for 5 years as a specialist plastic surgeon, but you’ve got 35 years of practice ahead of you. Now you’re acquiring your surgical skill during those 5 years. But what about maintaining it for the next 35 years? And it’s no different for our nonsurgical colleagues.

Trish 

Yeah. And it’s so interesting and, like, just what you’re saying to me is so interesting because, like, the talks that because I’ve been to this nonsurgical symposium, I didn’t know when it started, but I think from the first couple of years or something. 

Dr Edwards

This is the fourteenth symposium. Okay. Yeah. So it’s our most successful. We’ve had 1200 people attend.

Trish 

Wow. Yeah. Well, I’ve been coming for media for 11 years. And I just know every year that, I guess, it’s not the calibre of the talks because everybody has amazing talks, but the whole context of what the talks are kind of shifts and evolves over time and even I did a podcast with Anita and even just that discussion with her, it’s not even around just, like, how I’m gonna look better on some of that. Actually, it’s more holistic for the person’s when I think this is like another way of making it a bit more holistic. If I’ve even been saying it the right way, would you agree with that?

Dr Edwards

Yeah. You have to evolve the conference. You can’t have it stale and repeat itself. And we’ve developed different streams in the conference. So we have not just your facial aesthetics, but we have skin care. We have business development. We have the academy program. So we have a number of streams going on at the same time. We proceed to the meeting with the anatomy for injectors program, which is a very intensive course run by plastic surgeons to perform live, real dissection of tissue and show injectors and teach the anatomy. But this year, we added in ultrasound techniques and also had injectors buddying up with the plastic surgeons so that they could give a perspective of what they’re trying to achieve and then look at the anatomy of it in real time. So always evolving the education that we provide.

Trish 

And I guess for me to stand out it has been coming for it’s been evolving of this, but the inclusivity aspect of it is a standout for me, the fact that, like you said, a plastic surgeon is buddying up with, like, a dermal clinician, whereas it’s like such different like, years ago, it would have been so different to what it is now, whereas, like, you plastic surgeons have got so much respect for a dental clinician who is a specialist in the field of actual skin. Can you tell us a little bit about that? Because I love that. That’s my favourite thing.

Dr Edwards

It’s been a focus of ours who make this a very diverse and inclusive conference. And we may have seen that today when we had our 13 international speakers as guests on a panel.

From all over the world, all different backgrounds and all different specialties and training.

And we’ve provided a wonderful opportunity to learn and hear their individual perspectives on similar problems. And in fact, they were all asked the same question and went along the panel answering it. And so it was just fascinating to hear what they had to say and also very humorous when the Hong Kong plastic surgeon on the end of the panel said I really shouldn’t have sat in the last seat. Should I?

Trish 

Excellent. And oh, look. That made me laugh and made me forget the last question because I was gonna ask one last question. What was that? Let me think. Let me think. I kinda think. I kind of think I’m gonna kick myself afterwards, but I did have one really good question at the end. But anyway, I’ve got to say thank you so much for joining me today. It’s been absolutely fantastic.

Dr Edwards

My pleasure. Thank you. 

Trish 

Lovely. Awesome. And guys, yeah, you got to check out the ASAPS website. So it’s aestheticplasticsurgeons.org.au. I’m so glad I got that right.
Thank you so much for joining me.

Dr Edwards

Have a nice day.