Cosmetic Surgery

Cosmetic Surgery and private health insurance

What is Cosmetic Surgery?

Cosmetic Surgery is surgery that is designed to improve a person’s appearance by reshaping a bodily feature.

In other words, Cosmetic Surgery is not performed for a medical reason.

What is the difference between Cosmetic Surgery and Plastic Surgery?

Plastic Surgery is a broad field of medicine that includes Reconstructive Surgery and Cosmetic Surgery.

Reconstructive Surgery aims to restore body parts that are abnormal due to injury, cancer or a birth defect, including:

• breast reduction
• burns

• congenital abnormalities 
• skin cancer.

In contrast, Cosmetic Surgery is designed to reshape a person’s body to improve its aesthetic appearance.

Who can perform Cosmetic Surgery?

Specialist Plastic Surgeons and Cosmetic Surgeons can perform Cosmetic Surgery.

What is the difference between a specialist Plastic Surgeon and a Cosmetic Surgeon?

The difference between a specialist Plastic Surgeon and a Cosmetic Surgeon is their qualifications for performing Plastic Surgery.

What is a specialist Plastic Surgeon?

A specialist Plastic Surgeon must qualify as a doctor and then spend at least 5 years training in plastic and reconstructive surgery through the Royal Australasian College of Surgeons (RACS). They receive a specialist qualification that is recognised by the Australian Government. 

Many specialist Plastic Surgeons are members of the Australian Society of Plastic Surgeons (ASPS).

What is a Cosmetic Surgeon?

A Cosmetic Surgeon is not a specialist in plastic surgery. 

Any doctor can call themselves a Cosmetic Surgeon without further training or any specialist qualification. It is legal for Cosmetic Surgeons to perform a wide range of cosmetic procedures. 

A Cosmetic Surgeon cannot join RACS or ASPS because they lack the required qualifications.

Why is it important to understand the difference between a Plastic Surgeon and Cosmetic Surgeon?

It is important to understand the difference between a Cosmetic Surgeon and a Plastic Surgeon and how the industry is regulated before you have any type of Cosmetic Surgery. You need to be sure the doctor can perform the procedure safely and with adequate skill.

Does private health insurance cover Cosmetic Surgery?

No. Private health insurance does not cover Cosmetic Surgery.

However, private health insurance does cover these procedures under Silver and Gold Hospital Cover:

• Breast Surgery (medically necessary) such as:
  • investigation and treatment of breast disorders and associated lymph nodes
  • reconstruction and/or reduction following breast surgery
  • preventive mastectomy.
• Plastic and Reconstructive Surgery (medically necessary) such as investigation and treatment of any deformity whether congenital or acquired as a result of illness or an accident.
  

To claim under your private health insurance policy, these treatments must be performed by a specialist Plastic Surgeon not a Cosmetic Surgeon.

Weight Loss Surgery to reduce a person’s weight, remove excess or reverse a bariatric procedure is covered under Gold Hospital Cover.

Does Medicare cover Cosmetic Surgery?

No. Medicare does not cover Cosmetic Surgery.

Medicare will cover only procedures that are classified as clinically or medically necessary, such as:

• mastectomy (total removal of breasts)
• breast reconstruction following a mastectomy or removal/replacement of an implant
• facial reconstructive surgery after an accident or trauma
• hernia repair
• plastic surgery following skin cancer removal
• rhinoplasty to rectify an obstructed nasal passage
• certain types of weight loss surgery.