01Public health update · NSW Health
A reminder from NSW Health —
about who administers your injection.
NSW Health has confirmed three hospital admissions for suspected botulism after anti-wrinkle injections received from a residential premises. The Department's executive director for health protection has reminded the community to receive cosmetic injections only from authorised practitioners.
02What happened
Three hospital admissions —
a public health reminder.
Three people were admitted to hospital with suspected botulism, with one case confirmed. All three had received unregulated anti-wrinkle injections at a residential premises in New South Wales. Investigations are continuing in conjunction with the Health Care Complaints Commission and police.
The reminder from NSW Health is a simple one. Cosmetic injections — including botulinum toxin and dermal filler — are medicines. They should be administered only by appropriately trained, registered practitioners working in registered clinical settings.
More on the potential risks of cosmetic procedures is available on our risks page.
— Dr Kishen Nara, RevAesthetic Melbourne.
03What botulism is
Why this is taken —
seriously.
Botulism is caused by neurotoxins released by the bacterium Clostridium botulinum. The illness is rare. It can be serious, with a constellation of symptoms relating to the nervous system that, in advanced cases, can affect the muscles used for breathing.
Early symptoms typically begin around the face — the muscles affected first by the toxin — and may progress to weakness elsewhere in the body. Anyone who has received cosmetic injections from an unregistered source and develops any of the symptoms below should seek medical care promptly.
04What to know
The symptoms —
and the questions.
The two lists below are from public health guidance — early symptoms of botulism to be aware of, and the questions worth asking before any cosmetic injection.
Early symptoms to watch for
- Blurred vision or double vision.
- Dryness of the mouth, or trouble swallowing.
- Drooping eyelids, or facial weakness.
- Nausea, with or without vomiting.
- In more advanced cases, weakness in the chest or limbs.
Ask before any injection
- Is the practitioner registered with AHPRA, and have they trained in cosmetic medicine?
- Where is the procedure being performed — a registered clinic or a residential premise?
- What product is being used, and is it Therapeutic Goods Administration approved?
- What does aftercare look like, and who do you contact if something feels wrong?
05Why training matters
Cosmetic medicine —
has its own training.
A common assumption is that all doctors are trained in cosmetic medicine. They are not. Cosmetic medicine and surgery are not part of public hospital training curricula in Australia, because Medicare does not cover elective cosmetic procedures. Cosmetic-specific training is delivered through dedicated colleges — for example the Australasian College of Cosmetic Surgery and Medicine — whose training rotations are based in private cosmetic clinics and day surgeries.
That distinction matters because it shapes how a practitioner thinks about consent, risk, product handling, aftercare and complication management. The ACCSM website lists practitioners who have completed that pathway.
For an overview of our non-surgical service, the non-surgical procedures page covers what to expect at consultation.
06About 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.
All assessments are conducted in line with Medical Board of Australia guidelines. A second medical opinion is encouraged at any stage.
- 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
07Enquire
Begin a
conversation.
Consultations are conducted personally by Dr Nara across Melbourne, Tasmania and Adelaide. We respond within one business day. There is a written reflection period before any decision, and a second medical opinion is encouraged at any stage.
08Continue 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 Cosmetic Injectables — Beauty Treatment Update
Cosmetic injectables regulation in Australia and what patients should know. - 2024 TGA Update on Vaginal Rejuvenation Treatments
TGA findings on energy-based devices for vaginal rejuvenation.
Disclaimer: This article is a plain-language summary of public health information. NSW Health remains the authoritative source for clinical guidance. If you have received an unregulated cosmetic injection and are unwell, contact your general practitioner or call HealthDirect on 1800 022 222. In an emergency call 000.