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WHY COSMETIC DOCTORS MUST PAUSE DURING RESTRICTIONS | OP-ED 

I am writing to thank you for your support and patience during this difficult year. In February 2020, after the possibility of a SARS-CoV-2 pandemic became likely, Grace and I had made a plan to periodically pause Kiora’s services if coronavirus came to Australia. We know this plan is at odds with many of our colleagues in the cosmetic specialty and we believe we owe you a full explanation.

For over 16 years I have dedicated myself to my chosen specialty of Cosmetic Medicine. Kiora has been uncompromising on patient safety. We maintain a near perfect record, with no severe adverse outcomes. I do not intend to break our perfect record by transmitting COVID-19! This is the reason why Kiora has pre-empted every government mandated shutdown and acted early to protect our patients, our staff, our community and our hospital colleagues from unnecessary transmission of the SARS-CoV-2 Virus.

As a specialist cosmetic doctor I am vulnerable to spreading this terrible virus. To get the best possible cosmetic outcome, treatments cannot be rushed. As such my patients and I are in close- proximity for a prolonged time. A small risk of aerosol transmission continues to exist even with our upgraded ventilation, cleaning procedures, masks and PPE. The close-range work, combined with my high patient workload, makes contact tracing a potential nightmare. If even a single COVID-19 contact were to come into Kiora I would have to contact trace well over 150 patients. I believe this risk is unacceptable to the community. For this reason, we made the decision to pause Kiora’s services early and pause them as often as needed.

Doctors are entrusted by the authorities to self-classify our medical procedures as essential or non-essential. I believe we have a moral obligation to play this straight and true. As doctors we must act swiftly and voluntarily to stop all non-essential services. Unfortunately, many in Cosmetic Medicine do not share this opinion and have self-classified their cosmetic services as essential.

This is one of the few situations where business or job viability concerns are secondary to public health concerns and I am determined to do the right thing. Whilst others in cosmetic medicine have been legally (and incongruously in my opinion) allowed to remain open, Grace and myself have consciously chosen to hold ourselves to a stricter safety standard. This decision to periodically pause our services has come at considerable personal cost to myself, my staff and our families. It is not driven by refusal to accept ANY risk. In a previous life, with no responsibilities, I managed to survive my youth doing cave diving and I was fully cognizant of my 1 in 2000 chance of dying every time I stepped through the ropes on my way to becoming the Australian University Boxing Champion. But this pandemic is terrible. I am no longer responsible just for myself - I am responsible for the health and safety of my staff, my family, and the community. The risk equation for continuing to offer non-essential medical services during times of high community transmission is poor. I would argue to continue to operate amounts to negligence.

The SARS-CoV-2 virus has only been studied for several months and we learn more about its pathophysiology every day. Everyone knows the headline fact that mortality is 1-1.5%. This can climb to almost 10% if the hospital system is overwhelmed. Many experts are coming to the realisation the long-term health effects of SARS-CoV-2 infection will be significantly worse than the headline grabbing 1% mortality rate. The virus seems to attack the endothelial cells of a patient’s (both young and old) vascular system to cause both heart damage and a vasculitis, posing concerning long term implications.

Grace and I prepared and budgeted Kiora for periodic shutdowns as soon as SARS-CoV-2 outbreaks were reported in Iran and Italy in February. Kiora will continue to voluntarily shut down if community transmission numbers grow. Our waiting list is now extremely long. However, none of our patients will have to wait longer than 4 weeks when we reopen. Grace and I plan to schedule triple shifts till 8pm every evening, once Stage 4 restrictions are lifted. We believe by working harder and longer during the times of low community transmission we can see our patients safely whilst protecting our community. Grace and I have been at this for 15 years and we intend to be here for at least another 20.

We sincerely thank you for trusting our clinical judgment. At a time when everyone is under immense hardship, your patience and understanding when your appointments are repeatedly moved, has been deeply appreciated by our entire team.

This has been the toughest year of my life, and as many of you know I have unfortunately been touched by personal tragedy. However, I have always believed adversity brings out the true character of a person and I will not fail this test. Grace and I are determined to get the job done. We are determined to get it done safely. And we are determined to do it with the same honesty and scrupulousness we have always applied to every aspect of our lives both personal and professional.

Stay safe and well!

We will be back.



Yours Faithfully,


Dr Neville LEE SEE LLB MBBS Bsc

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