Cosmetic surgery abroad under the spotlight

Cosmetic surgery abroad is under the spotlight in the UK media, and its increasing popularity contributes to the poor image that medical tourism in general has in the UK.

I recall some time back attending a medical tourism conference in the USA. The organisers had included on their programme a UK plastic surgeon who was to speak on “Cosmetic Surgery Abroad”. Unfortunately, the conference organisers hadn’t done their speaker research too well. What they expected to be a plug for cosmetic surgery tourism turned out to be a 20 minute onslaught of graphic slides illustrating cases of cosmetic surgery gone wrong…. patients who had travelled from the UK to elsewhere for cosmetic surgery whom this surgeon had been asked to treat on their return….. what is becoming known in the UK as “Botched up Bodies”. (For non-native English speakers, “botched up” means …. ruined, destroyed, messed up.)
Cosmetic surgery is a significant sector of the medical tourism market. It represents a significant proportion of the outbound medical tourism market from countries with developed health systems such as the UK. In the UK, according to the Treatment Abroad Medical Tourism Survey, 42% of outbound medical tourists are seeking cosmetic surgery abroad. These consumers cannot afford the prices for cosmetic surgery within UK hospitals and clinics and are attracted by the cost savings available in other countries. Belgium, Czech Republic, Turkey and Poland are the favoured destinations for British women seeking a new look.

Botched up bodies on TV and in the press

Cosmetic surgery abroad is under the spotlight in the UK media, and its increasing popularity contributes to the poor image that medical tourism in general has in the UK. The medical professional (e.g. BAAPS and BAPRAS) hold strong, negative views on cosmetic surgery tourism and when the opportunity arises, such organisations will highlight the pitfalls of going abroad for cosmetic surgery:

  • Cosmetic tourism and the burden on the NHS
  • Patients warned against cosmetic surgery ‘tourism’

They have, of course, a vested interest. If UK patients travel abroad, it hits the pocket of UK plastic and cosmetic surgeons. But they are also on the receiving end of “botched up” cosmetic surgery that is undertaken abroad. When a patient returns from a foreign cosmetic surgery clinic with problems, it is the UK plastic surgeons who “inherit” the problem and often the UK’s National Health Service that bears the cost of further surgery.
The problem of “cosmetic surgery abroad gone wrong” has become such a topic in the UK that we now have a weekly national TV programme, entitled “Botched Up Bodies”. This Channel 5 programme tells the story of British men and women who have gone abroad for treatment and the surgeons who are fixing the problems that have arisen when they return home. Recent cases featured in the programme include:

  • “Claire Hawker’s breasts were left horrifically scarred after a cut-price boob job in Prague went drastically wrong.”
  • “Shenise Farrell wanted a permanent change of eye colour. As the procedure is not licensed in Europe, she took a risk and decided to have the surgery done in Panama, paying £8,000 for the privilege. Unfortunately, the procedure went horribly wrong.”
  • “Nicole Burnett, 30, was left with a raging infection after a botched boob job she had on a trip to Turkey.”
  • “After shelling out £7,500 for a nose job abroad, Barbara was left worse off than ever before after her Czech surgeon botched the job so badly, she is barely able to breathe.”
  • “Marcia decided to pay for surgery in Belgium to remove the unsightly bingo wings – and was left devastated when she discovered that not only had the bungling surgeon failed to remove any flab; he’d left her arms badly scarred to boot.”

These newspapers also feature regular stories of “cosmetic surgery gone wrong”:

  • The women who went abroad for cheap cosmetic surgery and ended up scarred for life
  • They promised luxury – but my cosmetic surgery ‘holiday’ was a nightmare: Polish practice reduced June’s breasts without asking and left a gaping hole in her stomach
  • How safe is cheap cosmetic surgery abroad?

View the latest research on medical tourism which explores the experiences of patients who have gone abroad for some form of surgery, medical or dental treatment:

  • The Treatment Abroad Medical Tourism Survey

Botched up bodies in social media

The image of cosmetic surgery abroad is also being tarnished in the forums and social media where prospective patients go to find out what’s good and what’s bad about cosmetic surgery in other countries.

  • The Facebook group ( a closed group) Victims of botched surgery” attracts past patients warning others of the perils of cosmetic surgery abroad.
  • The sofeminine web site has a dedicated discussion forum where patients relate their good and bad experiences of cosmetic surgery abroad

Can we fix the problem?

It’s not going to be easy. Let’s take a tummy tuck as an example: the percentage of patients who need a second operation (due to dissatisfaction with the first operation) after a tummy tuck is reported as ranging from 11% to 34.4% in the published clinical papers. If a patient is unhappy with the result or has a post-operative complication, this is much easier to sort out in their own country. When the surgery is done abroad, it is not that straightforward. The issue with cosmetic surgery abroad is what do you do if you need a second operation when the tummy tuck was done in Poland, Czech Republic, Belgium or Turkey? Let’s assume that surgeons in these countries are as competent as those in the UK. If one in ten people undergoing a tummy tuck (or possibly one in three) is unhappy with the result or has a post-operative complication who “owns the problem” and who is going to deal with it.
The root of the problem lies in:

  • Cosmetic surgery clinics and agencies that:
  • Fail to provide patients with comprehensive information on the risks of cosmetic surgery.
  • Wash their hands of the problem when a patient has complications.
  • Have no system in place for handling the problems that may occur when the patient returns home.
  • Deliver sub-standard surgery due to lack of expertise or poor care.

You could also argue that it is the fault of patients who:

  • Fail to investigate the credentials of overseas surgeons and clinics.
  • Ignore or are unaware of the risks of surgery and what can go wrong.
  • Don’t factor in the risk that may be associated with low cost.
  • Fail to take out complications insurance.

Hospitals, clinics and agencies offering cosmetic surgery to international patients need to accept that cosmetic surgery sometimes goes wrong and, however good their surgeons may be, there will be complications. They must make it very clear to cosmetic surgery tourists that there are associated risks and how any problems and complications will be handled. They need to take responsibility for the care of such patients and ensure that the appropriate follow up care and treatment is available when and where it is required. They need to make some form of complications insurance compulsory for all patients they treat.
Until the medical tourism industry cleans up its act, and is able to provide assurance to travelling patients, the stories of “botched up bodies abroad” will continue to abound in the media and restrict industry growth.

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Keith Pollard
As Editor in Chief of International Medical Travel Journal (IMTJ) and a Healthcare Consultant for LaingBuisson, Keith Pollard is one of Europe’s leading experts on private healthcare, medical tourism and cross border healthcare, providing consultancy and research services, and attending and contributing to major conferences across the world on the subject. He has been involved in private healthcare, medical travel and cross border healthcare since the 1990s. His career has embraced the management of private hospitals in the UK, research and feasibility studies for healthcare ventures, the marketing and business development aspects of healthcare and medical travel and publishing, research and consultancy on cross border healthcare.