Before and after photos AHPRA rules: what you can post in 2026

Before you post a before and after photo, ask two questions. Does the comparison meet AHPRA's rules for fair, consistent images? Does the result directly or indirectly advertise a prescription only injectable? If either answer is uncomfortable, keep the photo out of your clinic's marketing.

In short: Before and after photos are not banned outright in Australia. AHPRA says they can mislead unless the images are closely matched, while the TGA prohibits a photo that directly or indirectly refers to a Schedule 4 substance such as Botox or dermal filler. Consent and a disclaimer do not override either rule.

Can clinics post before and after photos in 2026?

Yes, sometimes. The clean answer is not "all before and after photos are banned", and it is not "patient consent makes them fine". Clinics need to apply two rule sets before publishing.

First, AHPRA treats before and after images as advertising content that can create a misleading impression. The image pair needs to present a fair comparison. Second, the Therapeutic Goods Administration restricts any advertising that directly or indirectly refers to a prescription only substance.

That means a clinic could have a carefully matched, unedited image with valid consent and still be unable to publish it because the result clearly promotes a Schedule 4 injectable. It also means a photo that has nothing to do with an injectable can still be a problem if lighting, framing or selection exaggerates the outcome.

The rules became tighter again when AHPRA's guidelines for higher risk non surgical cosmetic procedures took effect on 2 September 2025. Clinic owners reviewing older content should not assume a post is safe because it went live before that date. The broader AHPRA compliant marketing rules for 2026 apply across the whole account, not just the image folder.

What are AHPRA's conditions for before and after images?

AHPRA's cosmetic procedure advertising guidance says before and after images "have the potential to be misleading or deceptive". It says they are "less likely to be misleading if the images are as similar as possible in content, camera angle, background, framing and exposure".

That is the practical standard for every comparison:

* use the same camera angle * use the same background * keep the framing consistent * match the exposure and lighting * show comparable content in both images * do not alter the apparent result

The full AHPRA cosmetic procedure advertising guidance should be the clinic's reference point, not a competitor's Instagram feed.

Cherry picking also matters. If the account only shows unusually strong results, the overall impression can still be unrealistic even when each pair looks tidy. A "results may vary" caption does not correct a filtered image, a flattering angle or a deliberately darker before photo. The image itself needs to be fair.

These checks should sit inside the clinic's normal practice compliance process, with a named person responsible for approving advertising before it is posted.

Are before and after Botox photos illegal in Australia?

The phrase "before and after photos are illegal" misses the real rule. The TGA says advertisers are not prohibited from using before and after photos, but those photos must not directly or indirectly refer to prescription only substances used to deliver the service.

Botox and dermal fillers are Schedule 4 substances. Under section 42DL(1)(f) of the Therapeutic Goods Act, an advertisement cannot directly or indirectly refer to a prescription only substance. Removing the brand name from the caption does not solve the problem if the result itself makes the injectable obvious.

The TGA's cosmetic injections advertising FAQ confirms this distinction. The photo format is not automatically prohibited. The Schedule 4 reference is.

Sydney Health Law's May 2024 health law analysis puts the practical test plainly: "if it is clear to the consumer that the after photo is a result of a Scheduled Substance, this would be prohibited".

For a clinic team making the posting decision, the safe operational rule is simple. If an ordinary viewer can identify a prescription injectable as the reason for the result, do not use that before and after image in advertising.

Do clinics need separate patient consent?

Yes. A patient's consent to treatment is not consent to appear in an advertisement.

AHPRA's cosmetic surgery advertising reforms took effect on 1 July 2023. Those reforms require separate consent to use a patient's image in advertising, distinct from the consent obtained for surgery. Build the advertising consent as its own documented step. Do not bury it inside a treatment form or assume a verbal yes covers future social posts.

Consent is only one gate. A patient cannot consent to misleading advertising, and their permission cannot make a Schedule 4 reference lawful. The clinic still needs to check image consistency, the overall impression and the TGA restriction before publishing.

Consent also does not turn a patient endorsement into compliant advertising. Testimonials about regulated health services remain prohibited under section 133 of the National Law. Genuine patient reviews left on a third party platform such as Google are not caught in the same way, but the clinic must not use or solicit testimonials in its own advertising. Copying praise from a Google review into an Instagram caption or placing it beside a patient image changes how the clinic is using it.

Keep the consent record, the original images and the approved final post together. If the post is questioned later, the decision should not depend on someone remembering a conversation from months ago.

Can clinics edit or filter before and after photos?

Do not use an edit or filter that changes the apparent outcome. This includes smoothing skin, changing colour, hiding texture, reshaping an area or using exposure to make the after image look better.

AHPRA's stated comparison points are content, camera angle, background, framing and exposure. If those conditions change between images, the viewer is no longer comparing like with like. A ring light in the after photo and overhead fluorescent light in the before photo can create an apparent improvement before the treatment result is even considered.

The same applies to framing. Moving closer or cropping one image differently can overstate the change. A disclaimer at the bottom does not neutralise what the image communicates at a glance.

AHPRA says these images have the potential to be misleading or deceptive. Treat that as a production rule, not a caption warning. Set one photography process for the clinic, keep the original files and reject pairs that cannot be matched properly.

The issue is not whether the edit looks subtle. It is whether the advertising presents a fair impression. If the clinic's website contains older comparison galleries, an AHPRA website compliance check can identify images and claims that need a closer review.

What should a clinic check before posting?

Use this checklist for every before and after image:

• Separate advertising consent: Keep written permission to use the patient's image, separate from consent for the procedure.
• Original files: Keep the unedited source images with the clinic's approval record.
• Like for like conditions: Match content, camera angle, background, framing, lighting and exposure as closely as possible.
• No altered result: Do not filter, smooth, reshape or otherwise change the apparent outcome.
• Realistic selection: Do not cherry pick a result that gives an unrealistic overall impression.
• No Schedule 4 attribution: Do not publish an image that directly or indirectly points to a prescription only injectable.
• No testimonial: Do not pair the image with a patient endorsement about a regulated health service in the clinic's advertising.
• Final human check: Have the responsible person review the image, caption and surrounding page together before publishing.

The checklist combines AHPRA's warning that before and after images can mislead with the TGA's separate ban on direct or indirect references to Schedule 4 substances. Passing one check does not mean the post passes the other.

Run the same review across social posts, landing pages, practitioner profiles and archived galleries. A clinic website can hold years of content, including posts written under older internal processes. The guide to checking whether your clinic website is AHPRA compliant covers the wider page elements that sit around the photos.

What happens if AHPRA finds non compliant images?

The risk is not theoretical. AHPRA has run targeted audits of cosmetic procedure advertising since September 2022. The cosmetic surgery reforms that took effect on 1 July 2023 also increased the maximum penalties.

For an individual, the maximum rose from $5,000 to $60,000. For a body corporate, it rose from $10,000 to $120,000. Those figures make a quick pre publication check considerably cheaper than defending a post after it has been flagged.

Start with the live advertising that carries the clearest risk:

1. before and after images that obviously show injectable results
2. image pairs with different lighting, angle, framing or exposure
3. patient photos without separate advertising consent
4. patient endorsements copied into the clinic's own marketing
5. old posts that nobody has reviewed since the 2 September 2025 guidelines took effect

LUNA Systems provides marketing compliance support for clinics. It does not provide health services or legal advice, and the clinic remains responsible for its advertising decisions.

If your image library needs a proper check before the next post goes live, have a chat with LUNA Systems.