01Article · Before cosmetic surgery
Two consultations —
and seven days.
Australia has a defined sequence a patient must go through before cosmetic surgery: a referral, two consultations, a psychological screening, written costs, and a cooling-off period of at least seven days. None of it is optional, and none of it belongs to any one practice. This page sets out what each step is, when the clock starts, and what you should have in your hand at the end of it.
02In short
Before cosmetic surgery in Australia you must have an independent referral, two pre-operative consultations with at least one held in person with the practitioner who will operate, a psychological screening using a validated tool, and written information covering the procedure, the risks and the full cost. A cooling-off period of at least seven days then runs from the point both consultations are complete and you have given signed informed consent, and surgery cannot be booked inside that window. For patients under 18 the cooling-off period is three months and an independent psychological evaluation is mandatory. These requirements come from the Medical Board of Australia and took effect on 1 July 2023.
03Why this page exists
The process —
is the protection.
Patients often arrive at a first consultation having read a great deal about a procedure and almost nothing about the process that surrounds it. That is understandable. The process is less interesting than the operation. It is also, in our view, the part that does the most work.
Every requirement below exists because it slows a decision down and puts information in front of you before money changes hands. A referral means an independent doctor has looked at your general health. Two consultations mean you meet the practitioner twice rather than deciding in one visit. The cooling-off period means the decision and the booking happen on different days, deliberately.
We would rather a patient knew these rules and held us to them. If any practice, including ours, appears to be skipping a step, that is a reasonable thing to ask about directly.
— Dr Kishen Nara, RevAesthetic Melbourne.
04The required sequence
Six steps —
in this order.
These apply to cosmetic surgery anywhere in Australia, at any practice, regardless of the procedure or the price.
- 01A referral, preferably from your usual GP. The referring practitioner must work independently of the practice performing the surgery.
- 02A first consultation with the practitioner who will perform the operation, or with a registered health practitioner working with them. Not a patient advisor, agent or salesperson.
- 03A psychological screening using a validated tool, looking for body dysmorphic disorder and other underlying concerns. The result is documented in your file.
- 04A second consultation. At least one of the two consultations must be in person with the practitioner who will operate; the other may be by video.
- 05Written information about the procedure, the risks, the recovery and the total cost, given to you before you sign anything.
- 06A cooling-off period of at least seven days, running from the point you have had both consultations and given signed informed consent.
05Step one
The referral —
and why it is independent.
Since 1 July 2023, a referral has been required before a cosmetic surgery consultation. It should come from your usual GP where possible, because that is the doctor who knows your history. Where that is not possible, it may come from another GP or from a specialist medical practitioner.
The word doing the work in the guideline is independent. The referring practitioner cannot be someone who performs cosmetic surgery or non-surgical cosmetic procedures. A referral generated inside the practice that will operate on you does not satisfy the requirement, because the point of it is a second set of eyes with nothing at stake.
A referral is not a recommendation that you proceed. It is a clinical letter confirming your general health has been reviewed and outlining anything relevant. Your GP may also raise concerns in it, which is exactly what the process is for. What we ask referring doctors to include is set out on our information for referrers page.
06Steps two and four
Two consultations —
at least one in the room.
A minimum of two pre-operative consultations is required. The first must be with the practitioner who will perform the operation, or with a registered health practitioner working with them. It may not be with a patient advisor, a coordinator or an agent, which is a direct response to a model where the first person a patient met was effectively selling.
At least one of the two consultations must happen in person with the practitioner who will operate. The other may be by video, which matters for patients travelling from Tasmania or South Australia to our Melbourne rooms.
What happens in the room varies with the procedure, but generally includes a history, an examination, a discussion of what the operation can and cannot do for your particular anatomy, the alternatives including doing nothing, and the risks. Our longer note on how a first conversation unfolds is on the enquiries, assessments and consultations page.
Questions worth asking while you are in the room. None of these should be difficult for a practice to answer.
- 01What is your registration type, and does your entry on the AHPRA register carry any conditions?
- 02How many of this particular operation do you perform in a year?
- 03What are your rates of complication and revision surgery for this operation?
- 04Who administers the anaesthetic, and what are their qualifications?
- 05Where will the operation take place, and is that facility accredited?
- 06Who sees me if something goes wrong at two in the morning, three days afterwards?
- 07What happens to my deposit if I decide during the cooling-off period not to proceed?
The first of those questions is the one patients most often skip. Anyone can look up any registered practitioner in Australia before they book, and we have written a separate guide on how to check a cosmetic doctor's registration.
07Step three
Psychological screening —
for everyone, not for you.
Every cosmetic surgery patient must be screened using a validated psychological screening tool, and the result must be documented. The tool is looking primarily for body dysmorphic disorder, a recognised condition in which distress about a feature is out of proportion to what other people observe. It is relevant here because surgery generally does not relieve that distress, and may deepen it.
Patients occasionally find the screening confronting, as though they are being assessed for suitability as a person. That is not what it is. It applies to every patient, in every practice, for every cosmetic operation. If the screening raises something, the response is a referral for proper assessment before any decision, not a refusal.
A patient under 18 must additionally be referred to an independent psychologist, psychiatrist or general practitioner for evaluation. Dr Nara does not perform cosmetic surgery on patients under 18.
08Step six
The cooling-off period —
where the clock starts.
This is the step most often described loosely, so it is worth being exact. For an adult, there must be a cooling-off period of at least seven days after you have had two consultations and given informed consent by signing the consent forms. Only then can the surgery be booked.
Three things follow from that wording. The clock does not start at your enquiry. It does not start at the first consultation. And seven days is a floor rather than a target, so taking three weeks or three months is entirely your prerogative.
For a patient under 18, the period is at least three months between giving informed consent and the surgery being performed.
A cooling-off period is not a sales technique and it is not a formality to be signed around. If a practice offers to bring a date forward inside that window, that tells you something useful about the practice. If you are not sure where you sit in the sequence, ask for the date they are counting from in writing.
09What you take home
The written quote —
eight things it must contain.
You are entitled to written information about costs before you commit to anything. A complete quote covers all eight of the following. If any of them are only mentioned verbally, ask for them on paper.
- 01The total cost, stated as a figure rather than a range.
- 02The cost of any implant or device used.
- 03Fees charged separately by other practitioners, including the anaesthetist and any surgical assistant.
- 04Facility costs, covering theatre, day surgery or hospital admission.
- 05The deposit required, the payment dates and the refund policy that applies if you change your mind.
- 06The cost of post-operative care and reviews.
- 07The likely cost of revision surgery, should it be needed.
- 08A statement that cosmetic surgery is not covered by Medicare.
The last point catches people out. Cosmetic surgery is not covered by Medicare, and private health insurance does not contribute to an elective cosmetic procedure. Narrow Medicare item numbers exist for specific clinical presentations, and whether you meet them is a question for your GP rather than for us.
The refund policy matters more than it appears to. Read what happens to a deposit if you decide during the cooling-off period not to proceed, because that is the precise circumstance the cooling-off period exists to allow.
10Informed consent
Consent is a conversation —
not a form to sign.
Signing a consent form is the last act of informed consent, not the whole of it. Before you sign, you should have been told what the procedure involves, what the recovery period restricts and for how long, what the recognised risks and possible complications are, what happens if a complication occurs, what revision surgery would cost, and how to make a complaint.
All cosmetic surgery carries risk. The general risks include bleeding, infection, poor wound healing, scarring, sensation changes that are sometimes permanent, asymmetry, reaction to anaesthesia, the possibility of further surgery, and dissatisfaction with the result. Procedure-specific risks are discussed at consultation and set out on our risks of surgery page, which we suggest reading before the second consultation rather than after it.
Results vary significantly from patient to patient, as each case is unique with its intrinsic risks and expectations. We encourage every patient to seek a second medical opinion before committing to anything.
11Frequently asked questions
Questions patients —
actually ask.
Do I really need a GP referral, or is it optional?
It is required. Since 1 July 2023, every patient seeking cosmetic surgery in Australia must have a referral before the first consultation. It should preferably come from your usual GP, and where that is not possible, from another GP or a specialist medical practitioner. The referring practitioner has to be independent, meaning they cannot be someone who performs cosmetic surgery or non-surgical cosmetic procedures themselves. The point of the rule is that somebody who does not stand to gain from the decision has looked at your general health first. Our information for referring GPs sets out what we ask for.
Exactly when does the seven days start?
The cooling-off period runs from the point at which you have completed both consultations and given signed informed consent. It is not measured from your first enquiry, and it is not measured from the first consultation. Surgery cannot be booked, and a deposit should not be taken, until those seven days have passed. If you are unsure where you sit in that sequence, ask the practice to tell you in writing which date they are counting from.
Can the cooling-off period be waived if I am in a hurry?
No. It is a minimum, not a default, and there is no mechanism to shorten it for elective cosmetic surgery. A practice offering to bring a date forward inside that window is not following the guidelines. You are, of course, free to take considerably longer than seven days, and many patients do.
Is one of my two consultations allowed to be by video?
Yes, one of them may be. At least one consultation must be in person with the practitioner who will actually perform the operation. The other may be conducted by video. What is not permitted is having your first consultation with a patient advisor, coordinator or salesperson rather than a registered health practitioner.
Why am I being screened for body dysmorphic disorder?
Because the guidelines require it for every cosmetic surgery patient, not because of anything specific about you. Practitioners must use a validated screening tool and document the result. Body dysmorphic disorder is a recognised condition in which distress about appearance is out of proportion to what others observe, and surgery generally does not relieve it. If screening raises a concern, you would be referred for assessment before any decision is made. That is a protective step, not a refusal.
What if I am under 18?
The requirements are stricter. A patient under 18 must be referred to an independent psychologist, psychiatrist or general practitioner for evaluation before surgery is considered, and the cooling-off period is at least three months between giving informed consent and the operation. Dr Nara does not perform cosmetic surgery on patients under 18.
Does any of this apply to non-surgical procedures?
A separate set of guidelines covers non-surgical cosmetic procedures, and the Medical Board strengthened them for higher-risk non-surgical treatments. The referral and seven-day cooling-off requirements described on this page apply to cosmetic surgery. We have written separately about the Medical Board update on higher-risk non-surgical procedures.
What should I do if a practice is not following these steps?
Ask them directly, in writing, which step they are up to and where their cooling-off period is being counted from. If you remain concerned, anyone may raise a concern about a registered practitioner with AHPRA, and you do not need to be a patient of that practice to do so. Our own complaints process is published, and raising a concern with us does not affect your care.
12Read the rules yourself
Primary sources —
all publicly available.
Nothing on this page is our interpretation of a private document. Every requirement above comes from published material you can read in full:
- Guidelines for registered medical practitioners who perform cosmetic surgery and procedures, Medical Board of Australia, effective 1 July 2023. The source for the referral, consultation, screening, cooling-off and cost requirements.
- Thinking about having cosmetic surgery?, AHPRA cosmetic surgery hub. Written for patients rather than practitioners, and worth reading first.
- Cosmetic surgery reforms, Australian Government Department of Health, Disability and Ageing. Background on why the requirements were introduced.
- Register of practitioners, AHPRA. Look up any registered practitioner in Australia before your first consultation.
13At RevAesthetic
How the sequence —
runs here.
An enquiry reaches the rooms and is answered by our team, not by an automated funnel. We ask for a referral from your usual GP before the first consultation. Dr Nara sees you in person in Melbourne, or by video where that is your second consultation rather than your only one. Screening is completed and documented. The written, itemised quote is prepared by Cate, our practice manager, and given to you rather than quoted at you.
Nothing is booked until the cooling-off period has run. There is no same-day figure, no deadline attached to a price, and no discount for deciding quickly. Consultations are held in Chadstone in Melbourne, in Cooee in Tasmania, and in Stepney in South Australia, with surgery itself performed at our accredited Melbourne theatre.
You can begin a confidential enquiry whenever you are ready, and there is no obligation attached to it.
14About the practitioner
Dr Kishen
Nara.
Dr Kishen Nara is a registered medical practitioner. He sees patients across Melbourne, Tasmania and Adelaide. The team at RevAesthetic includes practice manager Cate, Patient Liaison Jenny, and registered nurses, all involved in supporting your enquiry.
- MBBSBachelor of Medicine, Bachelor of Surgery (Monash University)
- FACCSM(Surg)Surgical Fellow, Australasian College of Cosmetic Surgery and Medicine
- AHPRARegistered medical practitioner, General Registration MED0001201549
15Continue reading
More from
the journal.
- 2025 Medical Board: Higher-Risk Cosmetic Guidelines
What the Medical Board of Australia's advanced guidelines for higher-risk non-surgical procedures mean for patients. - 2025 NSW Health: Suspected Unregulated Anti-Wrinkles
NSW Health update on suspected botulism cases linked to unregulated anti-wrinkle injections. - 2025 Cosmetic Injections — Medicines in Beauty
How cosmetic injections are regulated in Australia, and what patients should know.
Disclaimer: All cosmetic procedures have inherent potential risks and complications. We encourage you to seek a second opinion from a qualified medical professional before any procedure. Material on this page is educational in nature and is not generalisable — outcomes vary significantly between patients depending on genetic composition, medical history and individual circumstances. This page summarises publicly available regulatory guidance and is not legal advice. Dr Kishen Nara — MBBS, FACCSM(Surg), AHPRA Registration MED0001201549. General Registration.