The new question you have to ask before you get Botox.

In the forever-evolving world of cosmetic enhancements, anti-wrinkle injections have become almost as common as getting your hair done. But beneath the surface of this booming industry, a significant shift is taking place — one that's finally acknowledging the complex relationship between appearance and mental health.

Since mid-2023, cosmetic practitioners across Australia have been quietly implementing a new psychological screening process — and it's changing the way people have injectable treatments.

Because before any needle comes anywhere near your forehead, there's now an entirely different kind of question you need to be prepared for.

Watch: Speaking of beauty, here's a handy hack that'll get rid of dry feet for good. Post continues below.

In July 2023, the Australian Health Practitioner Regulation Agency (AHPRA) introduced updated guidelines that changed how patients are assessed before receiving non-surgical cosmetic treatments like anti-wrinkle injections.

Dr Nicole Chater from Concept Cosmetic Clinic told Mamamia that one of the key changes was "the requirement for practitioners to assess patients for underlying psychological conditions, such as Body Dysmorphic Disorder (BDD)".

Body Dysmorphic Disorder (BDD) is a condition where someone becomes obsessively preoccupied with perceived flaws in their appearance that are often minor or completely invisible to others.

What this means is that your cosmetic doctor isn't just looking at your face anymore — they're also considering your psychological well-being before proceeding with treatment.

Why is this psychological assessment now required?

Of course, the regulatory change didn't emerge out of nowhere. Rather, it represents a growing recognition that beauty treatments can sometimes mask deeper issues.

According to Dr Chater, it was "implemented in response to growing concerns about vulnerable individuals seeking cosmetic procedures as a way to manage extreme psychological distress".

The uncomfortable truth is that for some people, cosmetic treatments can become a temporary fix for deeper psychological issues.

"Unfortunately, cosmetic treatments in these circumstances lead to only temporary relief, akin to an addiction," Dr Chater explained.

Listen to The Quicky discuss the new Botox rules. Post continues below.

What exactly is being assessed?

While the requirement is clear, the implementation varies considerably. Interestingly, there's no standardised questionnaire that every clinic must use. Instead, Dr Chater said that "AHPRA has not mandated a specific psychological assessment tool for non-surgical cosmetic treatments."

Practitioners are expected to use their medical judgment to identify potential "red flags," which might include:

1. A history of frequent cosmetic treatments without satisfaction

2. Extreme distress about appearance

3. Avoiding social situations or mirrors

4. Unrealistic expectations of treatment outcomes

5. Seeking excessive reassurance about appearance.

With this in mind, some clinics have implemented what's called a "cosmetic readiness questionnaire," said Dr Chater, though its use for injectables (unlike for surgical procedures) remains at each provider's discretion.

How will you be assessed?

So what does this mean for your next appointment? Well, the assessment process varies between clinics. Dr Chater said it "can be conducted in person during the consultation or completed online via a questionnaire before the appointment."

So don't be surprised if your next booking confirmation comes with a pre-appointment questionnaire, or if your practitioner asks more in-depth questions about your motivations and expectations during your consultation.

What happens if there are concerns?

The question many potential patients are asking is: If your practitioner identifies psychological concerns, will you be turned away? Not necessarily. As Dr Chater explained, "the patient must be referred to a psychologist, psychiatrist, or GP for further evaluation".

However, she added that while "AHPRA does not provide specific guidelines on whether treatment should be refused... ethically, it stands to reason that these patients should not be treated until they have undergone psychological therapy."

However, Dr Chater said that because "many patients with BDD or similar conditions may not acknowledge their psychological struggles," they may "simply seek out another clinic willing to proceed" if they're refused treatment at one practice.

Do you need a GP referral now?

Amidst the changing regulations, a common misconception about the new guidelines is that they require GP referrals for all injectable treatments.

So, do you also need to see a doctor now before undergoing injectable treatments?

As Dr Chater clarified: "A GP referral is only required for cosmetic surgery, not for non-surgical treatments such as anti-wrinkle injections and dermal fillers".

What this change really means.

For many established clinics, the adjustment has been subtle, rather than revolutionary. For experienced practitioners, the formal requirement may not have dramatically changed their approach.

Dr Chater noted that in her practice, "very little has changed".

"As an experienced specialist GP with a strong background in mental health, it has always been my practice to assess patients' mental state."

However, she shared that this is "a great step in the right direction to help screen patients who are at risk," particularly for less experienced injectors.

Looking to the future, this may not be the end of regulatory changes in the cosmetic medicine space. Dr Chater shared that "further regulatory changes are likely in the future, as discussions continue around tightening guidelines even more to enhance patient safety in the cosmetic medicine industry".

So, next time you book in for anti-wrinkle injections, remember that the consultation isn't just about where to place the needle — it's also about making sure you're seeking treatment for the right reasons. And that's a change most experts agree is for the better.

What are your thoughts on the above changes? Share with us in the comment section below.

Feature image: