In the wake of the TGA regulations around cosmetic medicine, there continues to be a lot of fear around what this will mean. Most injectors to date have relied heavily on being able to show before/ after photos, often of a single treatment area, “before” and “after” treatment with an S4 (prescription) medication. For example? A before photo of someone frowning hard and an after photo of that person no longer able to frown. No guesses as to which class of drug is responsible for this; there is only one. 🤫 A before photo of someone with thin lips at rest (ie not smiling) and an after photo of that person with plump, juicy swollen lips. Again, no guesses as to which class of drug is responsible for this. 🫤 Many pages on social media are full of these images, and these injectors’ selling point, is that they treat with the drug in question for those who want similar results. The problem with this from the TGA’s point of view? it’s seen as incentivising it’s advertising a prescription medication stating prices, specials and packages often gets people to act on impulse and walk in to “buy” the treatment on sale as if it is an order for a burger. these advertisements often trivialise the fact that these are medical procedures, risks may be low but not zero and not everyone is suitable for it. these adverts may lure vulnerable people in who may have body dysmorphic disorder, unrealistic expectations and encourage injector hopping. advertising typically acts on people’s emotions and desire to act now to avoid missing out, and advertisers will typically put forward their best results, rather than average results and minimise poor results. So what is the solution now Before/ After photos are no longer permitted? With this easy means to generate revenue curtailed the TGA is likely hoping to return to a more medical model for medical procedures, often by very inexperienced people. More and more people are studying nursing who have no interest in nursing except to inject. Similarly many doctors post the mandatory year of internship, are opting to bypass speciality training to set up as aesthetic injectors. These people have the bare minimum knowledge of what it means to be a doctor or a nurse, much less to begin to know the ethics of medicine, and thus are at risk of falling into the retail model of providing medical services which goes against every code of medical conduct. In the absence of photos, how are you  to choose a provider? When we put the medicine back into medical aesthetics, we go back to basics, which should have been in place already. How do you choose a plastic surgeon, most of whom don’t advertise their work online through before/ after photos? How do you choose an orthodontist, most of whom don’t advertise their results? Or any type of doctor, dentist or provider? We do it through some means: word of mouth referral by friends and family who’ve seen that provider understanding someone who’s right for them may not be right for you. reviews on third party sites such as Google (though may providers incentivise these eg “leave us a 5 ⭐️ review and go into the draw for X worth $300”) stalk their social media pages for a while (usually months) ; observe how they work; observe their ethos, and their own face to get an idea of whether their outlook aligns with your own aesthetics and goals. Then….make an appointment. Go in with an open mind. Spend the time in consultation deciding: do you feel comfortable with them? do you feel safe with them? do you feel they get you, understand your concerns? do you feel confident they can help you? do you feel you can develop a longterm relationship with them? are you a fit for what they need from you, in terms of the timeframe, cost and appointments needed? we are still able to show before/ after photos of results in consultation with you; do the results appeal to you, and is each result optimised to the person being treated? Ie do they still look like themselves, or does everyone look the same after treatment? If you’re an ethnic person, it’s important to look also for representation of your ethnicity, or other ethnic types in the work, so you can see that the person who’ll be treating you, understands how to treat different faces and isn’t simply following trends and fads. Ok…I’ve attended the consultation and am ready to start. Now what? At Skin Essentials, our Full Face Aesthetics appointments are moving to an “expression of interest” form format for those who are keen to explore this. Why is this? it’s a significant investment of time and money. we have limited appointment slots for those who are ready to begin so spots are prioritised for those who are ready to begin on the day if appropriate. having an EOI form is an extra step for those who are ready and serious; Dr Joshi vets them prior to taking payment for the consultation. We don’t want to waste your money or our time together if you’re not ready. once we have your filled out EOI form, we’ll be in touch to advise on next steps including the ballpark time and monetary commitment and to offer you an appointment and take payment so we can begin the process. Still keen? Get in touch with us to get the ball rolling! We look forward to meeting you soon!  

As of March 7th 2024, the Therapeutic Goods Administration (TGA) of Australia implemented widespread changes that will limit most discussion about medical aesthetics on social media and most settings outside of a consultation with your doctor or healthcare professional (HCP). The ability to simply order treatment with prescription medications on demand over the last few years, often via barely qualified HCPs is resulting in the commoditisation of medicine and prescription medications, which carry far more side effects than over-the-counter (OTC) medications, with higher risks. This has led to increased risk and poor outcomes on occasion, in untrained hands. As such, long after it was due, the TGA is aiming to return this aspect of medical care back where it belongs, between a patient and their HCP, but I anticipate we will get a lot of pushback. So why is a consultation necessary for medical aesthetics, if you know what you want? Like any other concern, all consultations begin with a comprehensive consultation between you and your doctor to determine what your concern is. Even if you’ve googled the issue and believe you know what is wrong, your doctor has an obligation to exclude any other possibilities that may be the cause of your condition and to satisfy themselves that the treatment you request is not only the best option for you, but also something they can safely provide for you. Equally, they need to be certain that there are no reasons you should NOT have that particular drug/ medication. All this takes time and is far more than the cursory 30 second consultations often taking place up until now, whereby we exclude pregnancy, ensure you are 18 and make sure you have no significant medical illness. It’s also more than the 20 second video call with a doctor you’ll never see again, who nods and signs off on the drugs another HCP administers if you choose that model of care. By law, what is required, as stated above, is a list: your concerns if your doctor can help you with those how much they bother you and whether you’ve had any treatment for them to date any vulnerability you may have if you have any reason you may not be a suitable candidate for medical aesthetics eg a history of being underage, pregnant but also having anxiety, or a history of going from injector to injector and still being dissatisfied with the results or being overfilled. If you and your doctor determine you are a good candidate, there is still more to cover: what is possible given your concerns, your genetics, age and budget the timeframe if it is a time sensitive concern eg aging whether you have the budget for it without too much hardship whether you are able to stick to the treatment plan as agreed to between you and your doctor if you feel safe and comfortable with your doctor All the steps above take time, well above a half hour, and cannot be rushed. At Skin Essentials, if we cannot tick all of those boxes, I tend to suggest a patient goes away to think, and mull her options and to return if/ when that changes and she feels ready to proceed. Medical aesthetics is entirely optional and a want, even if it can feel like a need. It is still medical procedures that are entirely optional and as such, the stakes are much higher to get the results you want, or to wait until you are ready and able to commit. All of this requires clear, upfront communication about costs, timeframe and expectations - for you of your doctor and for your doctor of you. This is what the TGA is hoping for to limit the tide of poor work and vulnerable people being taken advantage of at present. In no other area of medicine would you be able to simply show up to an appointment and order a treatment with a bare minimum of consult or relationship with your doctor. So it is with medical aesthetics, a specialty in its own right with rare but real risks.