Health

Australians are heading overseas for cheap cosmetic surgery in booming numbers, despite the death of a Gold Coast woman undergoing surgery in Mexico and repeated warnings about the risks involved. By Megan Howe.

Overseas cosmetic surgery on the rise

Lauren (left) and Jackie Hall soon after they arrived in Phuket, Thailand, for cosmetic procedures.
Credit: COURTESY LAUREN HALL

When Lauren Hall’s mother discovered she had booked a trip to Thailand to have cosmetic surgery, she wasn’t pleased. “My mum didn’t know. Somehow she found out and she was not happy at all, but she knew nothing was going to stop me,” says Lauren, 28, from the Gold Coast.

Her mum’s concern was understandable. Earlier this year, 29-year-old Gold Coast woman Evita Sarmonikas died from complications resulting from a procedure known as a “Brazilian butt lift” in another destination popular with the growing number of medical tourists – Mexico.

But Lauren was confident in her choice to go overseas for surgery. “I’ve heard more things go wrong in Australia than overseas,” she says.

It was the second time she had chosen a cheaper, Thai option for medical treatment. Two years ago, she had dental work done in Phuket, and this time she was returning for breast implants costing $4500, compared with up to $10,000 in Australia. Her Melbourne-based sister Jackie, 26, joined her, undergoing her own dental treatment, as well as caring for Lauren after her surgery.

Lauren says she chose a surgeon and hospital based on a friend’s recommendation and checked online to ensure no bad reviews were lurking there. She booked the travel and surgery herself, rather than using a medical tourism agent.

Travelling in search of medical care is not a new phenomenon. Since antiquity people who could afford it have travelled to wealthier countries in search of medical expertise, technologies and environments for healing and recuperation. But as an American study points out, the difference today is that the flow has been reversed – the tourists are travelling from wealthy countries to developing countries, motivated largely by lower costs.

The study found the average price of breast implants in the United States in 2011 was $US6000, compared with $2200 in India, $2600 in Thailand, $3308 in Malaysia, $1248 in Cuba and $3871 in Hungary.

One of the most comprehensive studies into the phenomenon, entitled Sun, Sea, Sand and Silicone (SSSS), revealed two “typical” types of travellers, says Australian researcher and study co-author Dr Meredith Jones.

There are those who have made up their mind to have surgery – from rhinoplasty to abdominoplasty – and are determined to have it done either by saving, borrowing at home or by travelling.

The second type is a woman under 30 who travels with others in order to have breast augmentation, who perhaps would not have chosen to have the operation at home. “It was the whole package that they were buying, that is, new breasts, a great holiday, travelling with like-minded people,” Jones says.

She estimated that 15,000 Australians travelled overseas for cosmetic surgery each year – a figure that has, she says, likely increased slightly since the report was released two years ago.

Jones, a cultural sociologist now based at Brunel University London, said the study found medical tourists board the plane with their eyes open to potential risks, viewing it as a “considered gamble”.

“Most people are very well researched,” she says. “Many of them feel safer going overseas as they know the aftercare will be of a higher standard than in Australia.”

One in six of the 103 patients interviewed for the SSSS study experienced complications from their surgery and about 9 per cent received further treatment back home. But 97 per cent were happy with the outcome and would recommend their surgeon to a friend.

Lauren Hall saw her surgeon for the first time on the day of her operation. She discussed options, decided on the size of her breast implants, had preoperative tests and then was wheeled into surgery. She was back in her hotel a day later.

The recovery was painful, and she was very grateful her sister was there to look after her, but there were no complications. She saw the surgeon nine days later, before flying home. “I’m happy. It healed well and everything is perfect,” she says.

Sister Jackie was also happy with her dental work, including root canals and crowns, which cost her $2000 compared with an estimated $5000 in Australia. “I would definitely go back and I’ve recommended it to a friend and she is going,” she says.

But not all the stories are so rosy.

While the SSSS study only encountered one patient who developed life-threatening complications
as a result of their surgery, two deaths of cosmetic surgery tourists were reported to the researchers during their inquiries.

“We remain unable to compare the risks of surgery abroad with the risks of surgery at home because no data on risks at home exists and there is no reliable information on the number of patients travelling abroad for cosmetic surgery,” it stated.

A recent British study found that people embarked on medical tourism with insufficient information and advice, with consequences ranging from troublesome to catastrophic.

Last year, a young British woman Joy Williams died after travelling to Thailand for surgery to increase the size of her buttocks. She reportedly developed an infection after the initial surgery, and died after corrective surgery a few days later. The surgeon, accused of carrying out surgery at night without a licence, has been charged with causing her death by negligence.

It’s cases such as this that strike home for Perth woman Tabatha Barrett.

Tabatha went to Thailand to have much-anticipated breast implants and liposuction to her waist and thighs in 2010.

After seven hours in surgery, she awoke to learn the surgeon had not gone ahead with the breast implants because there had been complications and she had needed two blood transfusions. She remained ill in hospital for four days, requiring another four blood transfusions. After she refused the hospital’s push to
go ahead with her breast implants, she flew home.

Tabatha says three litres of fat had been removed from her stomach and four litres from each leg –
a total of 11 litres and more than double the five-litre maximum that is recommended in one procedure in Australia.

Back home, she developed an infection as well as potentially deadly blood clots and was left in pain for months – and with disfigured legs.

In 2011, the company she’d booked the trip through agreed to pay half the costs for her to have corrective surgery in Australia. She is saving up for further corrective surgery. “I let myself believe that having cosmetic surgery overseas was the same as having it in Australia, only cheaper, with a bonus holiday. Instead, I found recovering from surgery was certainly no holiday, it was certainly not cheaper (due to the cost of repairing the poor job) and most importantly, it almost cost me my life,” she says in a blog on the website of Absolute Cosmetic Medicine, where she underwent the corrective surgery.

Dr Glenn Murray, the Perth surgeon who did her reparative surgery, is blunt about the risks of travelling overseas for medical procedures. “The Third World is called the Third World for a reason,” he says. “If you can’t drink the water, why would you risk your life there?”

He says the clinic has done corrective surgery on “hundreds” of patients following botched overseas procedures.

The Australian Society of Plastic Surgeons has warned consumers against going overseas for cosmetic surgery – a stance president Dr Hugh Bartholomeusz says is about the welfare of patients, not about protecting local surgeons’ interests. “It is one of our greatest concerns, for the patient sake, not for our sake, “ he says.

The society has a checklist on its website detailing what patients should consider before having surgery overseas. “Sitting by the pool, drinking cocktails and snorkelling does not qualify as postoperative care,”
it warns.

While he agrees complications can arise after surgery conducted anywhere, Bartholomeusz says when it is done overseas, the surgeon is usually not around to deal with any postoperative problems.

In response to the surge in cosmetic tourism, some Australian companies have sprung up offering cut-price breast augmentation services locally. Others, such as health insurer NIB, have moved to cash in on the overseas market.

Last year, it launched a new business (separate to its health insurance products) selling packages for cosmetic surgery and dental services in Thailand and Australia. It has since dropped the Australian option and is focusing on the “burgeoning market” of medical tourism, says spokesman Matthew Neat.

The company’s selling point is that it can assure travellers of the credentials of overseas hospitals and surgeons, as well as ensuring after-care in Australia if needed, he says. They’ve received a lot of inquiries, but he admits sales have not met initial expectations and the company is now redefining its business model.

While NIB hasn’t hit the jackpot yet, the US study found cosmetic tourism was a growth industry.

“More countries are building hospitals and courting patients, more physicians are moving to destinations of tourists and, each year, more patients are travelling,” it concluded. “The rapid globalisation of the industry also marks a fundamental shift in the world’s perception of elective procedures: patients are becoming consumers and these medical services are being viewed as commodities.”

But Tabatha Barrett’s message to others considering an overseas makeover is to think again: “My advice is to stay in Australia, have surgery done and utilise overseas countries for that holiday where you can show off your new assets.”

This article was first published in the print edition of The Saturday Paper on Jul 18, 2015 as "Want op, will travel". Subscribe here.

Megan Howe
is a Sydney-based medical writer.

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