A plastic surgeon is a doctor who has trained to perform cosmetic procedures for approximately 10-12 years.
The term 'cosmetic surgeon' can be used by anyone who has completed a basic medical degree in university, with no specific surgical training.
It's a disparity that is not only costing lives, but causing unnecessary pain and suffering across the country.
Associate Professor Gazi Hussain is the Vice President of the AustralianSociety of Plastic Surgeons has been trying to do something about this crisis for the past 20 years.
"It’s very sad and it’s very frustrating. We’ve been trying to get people’s attention about this issue for 20 years and as the number of surgeries increases, so do the complications," he told 9Honey.
Samantha Humm had been dreaming of having a breast augmentation since she was 19. Then in 2015 at the age of 27, she was finally ready.
"I didn’t want it for other people, just for myself," the 30-year-old told 9Honey.
She saw a Facebook ad for affordable breast augmentation and assumed because it was an Australian doctor, it was a safe choice.
"I never wanted to get them done overseas because I’d heard they could be dodgy," she said. "I thought because this doctor was in Australia it would be safe because there would be more regulations."
The mother-of-four says she attended the consultation, choose the breast size she wanted, signed the paperwork and booked in the procedure.
“I just wanted them done," she said. I was in such a rush. I didn’t investigate anything. I just trusted the system."
The procedure took place in June of 2015 and at first, Humm says everything seemed fine.
"They were healing really well. I wasn’t in much pain and they looked really good."
About two weeks into her recovery, however, Humm started to feel pain in her left breast.
"It became red and I thought it was part of the healing process," she told 9Honey. "Then I was drying myself after having a shower on a Friday night and I felt something dripping down my stomach.
"I looked down and I had fluid coming out of my left breast. It had swelled up and the wound itself was weeping."
Humm phoned her cosmetic surgeon however because it was a Friday, he said he wouldn't be able to see her until the following Monday.
"I wasn’t worried at this stage. He seemed pretty confident it would be fine which made me feel confident that these things do happened."
On the Monday, her doctor took a swab and once again assured Humm it was a normal part of the healing process. The 30-year-old says she wasn't too concerned. That is until her left breast kept of developing redness, pain and continued to leak fluid.
She was told she was taking a little longer than usual to heal.
"I had to always wear pads in my bra, in case it did leak, and I had to be careful what I was doing," she said.
By the time she developed a black wound in her left breast that was leaking, Humm says she knew something was terribly wrong.
Later that day, she felt something strange in the crop top she had been wearing since the breast augmentation surgery.
"It was silicone," she said. "I was actually pulling it out with my fingers out of my breast.
"I was freaking out."
Her doctor told her it was 'impossible' for silicone to be coming out, so she sent him a photo. At that stage, Humm says her doctor began freaking out too.
"He told me to come and see him next week, but I couldn’t wait, so I went to my local hospital. They’d never seen anything like it."
Doctors at the hospital told her she'd been 'butchered' and that her doctor had done 'a horrible job'.
They recommended she go back to her original doctor to have the left implant taken out, which she did for an additional cost of $2,000.
Her left breast developed yet another infection.
"Eventually it calmed down and my doctor told me to come back in a few months and pay another $2,000 to have another one put in. I decided not to. There was no way I was going back to him," she said.
Humm only had one implant in for months.
"I had a saggy breast with nothing in it and one with an implant in it that was a horrible job."
The mother-of-four had the right implant removed three weeks ago, after two years of living with mismatched, lopsided breasts.
It wasn't until she made contact with other victims of the same doctor on Facebook that she discovered there has been multiple complaints made against him.
Information that would have come in handy before her disastrous procedure.
Nicole Montgomery is a registered nurse who works at Trusted Surgeons, a non-profit organisation that helps Australians find a qualified doctor to perform invasive, medical procedures.
Nicole Montgomery, 38, used to work at the Cosmetic Institute, the subject of a class action lawsuit since September 2017.
TurnerFreeman Lawyers states on their website that staff at the Cosmetic Institute "lacked the capacity to access urgent medical assistance and the clinics did not have adequate infection control."
The legal firm is still receiving complaints from patients from New South Wales and Queensland reporting a range from major intra-operative and post-operative complications following breast augmentation surgery including seizure activity, punctured lungs as well as pain and deformity.
The 38-year-old nurse says it was her time at the Cosmetic Institute that made her aware of how many unqualified doctors are performing invasive, cosmetic procedures.
"If you’re a specialist plastic surgeon, you’ve been through the RoyalAustralasian College of Surgeons," she told 9Honey. "If you’re a cosmetic surgeon, you may or may not have had any formal training at all."
Nicole Montgomery says the industry needs urgent regulation.
"It’s quite sad, because you do have incredible cosmetic surgeons devoted to patient care, but then you’ve got other people who aren’t."
The registered nurse says there needs to be a formal benchmark for cosmetic surgeons and an organisation - like the Royal Australasian College of Surgeons - before you can call yourself one."
"They’ve called for submissions from medical professionals asking what sort of involvement they should have in the industry and whether or not they should be policing it."
Grace-Montgomery claims cosmetic surgeons argue there is no need for regulation, alleging plastic surgeons are trying to push them out of the industry.
Many plastic surgeons, however, say there should be no such thing as a cosmetic surgeon.
"You've either completed 12 years of medical training and practice, or you haven't," she says.
The 38-year-old has been made aware, through her work at Trusted Surgeons, of cosmetic surgeons performing multiple invasive procedures for which they are not trained.
"They are doing breast augmentations, breast lifts, tummy tucks, autoplasty, facelifts.
"We see some quite horrific photos, not just from overseas. And that’s what’s really sad.
"Obviously cosmetic tourism is a real concern, however when you see some people who have undergone procedures in Australia, you think they’d have been better off going overseas."
Grace-Montgomery says she felt quite powerless during her time at the Cosmetic Institute and is speaking out now out of "frustration" at the continued lack of regulation.
"My heart breaks for these women," she told 9Honey.
"There is one woman at the moment I’ve been speaking to. She’s currently paying $50,000 out of her super to have reconstructive surgery for her breasts. The surgeon she originally chose, she was under the impression he was a qualified surgeon, and he’s recently be disbarred in NSW."
"Women are being left disfigured and suffering psychologically as well," she said.
"Also, it’s costing the country money when women go into the public system to have breast implants removed. It costs the tax-payer money."
Dr Donna Burgess is a general practitioner and cosmetic physician who wouldn't dream of performing invasive procedures, despite having worked as a surgical assistant and then assisting plastic surgeons for the past 20 years.
She is aware of cosmetic surgeons practicing without adequate qualifications.
"I do think it is going on, although I wouldn’t be able to point fingers," she told 9Honey. "Most of the people in our area are doing it properly and leaving such procedures in the hands of plastic surgeons."
Associate Professor Gazi Hussain is the Vice President of the Australian Society of Plastic Surgeons and also works at Macquarie University Private Hospital and Concord Hospital in Sydney. He has been practicing for almost 20 years and trained for a decade to become a plastic surgeon, specialising in facial nerve surgery.
"We’ve really seen this increasing number of practitioners who are not trained in surgery, let alone in plastic surgery who are undertaking procedures, and it is primarily because the area is unregulated," he said.
"Everything else in medicine is regulated.
"If you wanted to get a hip replacement, you wouldn’t dream of going to anyone except for an orthopaedic surgeon.
"To get breast implants put it in, it seems you can go to anyone. Any doctor can call themselves a cosmetic surgeon, because there’s no true title of cosmetic surgeon. It doesn’t actually mean anything. So, anyone can call themselves a cosmetic surgeon."
Dr Hussain says anyone who has a basic medical degree can call themselves a cosmetic surgeon with no training, or as little training as an online course.
He's not surprised that people are dying as a result of botched cosmetic procedures.
In September 2017, a woman died after a botched cosmetic procedure at a Chippendale salon in NSW.
35-year-oldJean Huang died after she was allegedly administered a local anaesthetic and breast fillers by Chinese tourist Jie Shao, 33, at the salon at which they worked. Shao was charged with manslaughter.
In 2007, 26-year-old Melbourne woman Lauren James (left) died after complications from liposuction on her legs and buttocks.
In 2008, 28-year-old Lauren Edgar (right) from Adelaide died from a bacterial infection resulting from a liposuction procedure.
Dr Hussain told 9Honey he doesn’t know why it’s taking so long for the industry to be regulated.
"The problem is, as cosmetic surgery becomes more acceptable, there are more people offering cut-price procedures and obviously things they can’t deliver."
Part of the reason there is a delay in regulating the industry is the fact regulations differ across each state and territory.
"We would like to see regulation be taken away from the states and be uniform," he said.
"Last year we saw the NSW government tighten regulations, however doctors who can’t practice in NSW as a result moved to QLD or VIC and would see patients who live in NSW in their new locations."
"That's why there needs to be a uniform change in legislation."
When it comes to finding a qualified surgeon to perform cosmetic procedures, Dr Hussain recommends checking their qualifications.
"See if they are a member of the Australian Society of Plastic Surgeons. But having said that, there are other trained surgeons who aren’t necessarily trained plastic surgeons but at a minimum they should have had what’s called a Fellowship from the Royal Australasian College of Surgeons."
He also advises prospective patients ensure invasive procedures are performed in private hospitals, with an anaesthesiologist in attendance.
"Some cosmetic surgeons offer discounts by doing the anaesthetic themselves or instructing a nurse to do it."
His final advice is to think carefully before agreeing to a procedure.
"Remember that if things are so badly done, it’s not always fixable," he said.
Original story by: Jo Abi from Nine Honey
You can share your story by contacting Jo Abi at firstname.lastname@example.org.