A WA woman speaks out about the dangers of medical tourism.

More patients seek help for dodgy overseas cosmetic surgery

Headshot of Peta Rasdien
Peta RasdienPerthNow

THE number of people seeking help to fix complications from overseas cosmetic surgery is on the rise, with local doctors warning people hoping to save money by going overseas that they could be putting their lives and health at risk.

They could also become a burden on the Australian taxpayers. A Monash University review found women travelling overseas for budget boob jobs cost the Australian health system an average $12,600 to fix complications when the surgery goes wrong.

Hard statistics on how many people fly out of the country every year in pursuit of cosmetic surgery are not available, however it is estimated to be around 15,000. Putting a number on the amount of people who fly back home with complications is also difficult, but it is thought to be increasing about 10 per cent each year.

Lured overseas by low prices — sometimes one third to half the price of what it would cost in Australia — and the promise of a holiday, it is believed only a fraction of the cases that go wrong come to light, because patients are too embarrassed to come forward and seek help.

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People who have a good result, though, happily boast about it on social media.

WA woman Sharon, who did not want her surname published, chose to speak publicly about her disastrous liposuction ordeal because she did not want others to experience anything similar.

She woke from surgery struggling to breathe after a reaction to the anaesthetic, developed aspiration pneumonia and has been left scarred and out-of-pocket after a procedure in Thailand 18 months ago.

“I’m probably more embarrassed now than I was prior to liposuction of what my legs look like” she said.

In December, Victorian coroner Caitlin English warned people to be aware of the risks if travelling overseas for medical treatment.

She investigated the tragic death of 31-year-old Leigh Aiple who paid more than $35,000 for a plastic surgery package in Malaysia in 2014 - about one third of what it would have cost to have performed in Australia.

He had a 360 degree tummy tuck, extensive liposuction, an upper eye lift, a chin tuck, a thigh lift, chest sculpting and lip filler, over two marathon surgeries within five days. Despite feeling short of breath, with a rapid heartbeat and fainting spells he was cleared to fly home five days later. He died a day after arriving home.

Leigh Aiple, 31, died after two major cosmetic surgery operations in Malaysia.
Camera IconLeigh Aiple, 31, died after two major cosmetic surgery operations in Malaysia.

Ms English found the care and treatment Mr Aiple received at the Beverly Wilshire Clinic in Kuala Lumpur, fell well below Australian standards.

Breast augmentation is the surgery most sought after by medical tourists, with Thailand and Malaysia popular destinations. It is also the most common type of surgery requiring correction, doctors say.

Language barriers, under-qualified clinicians, lack of post-operative follow-up and holiday packages which encourage patients to go shopping rather than rest after major surgery, all contributed to the problems.

Mark Lee, a Perth-based plastic surgeon and former head of department at Sir Charles Gairdner Hospital, said patients would regularly return from overseas operations with infected breast implants. One patient, a number of years ago, came back with tuberculosis.

“I have seen some very strange bacteria, multi-resistant bacteria, fungal infections...and that can make it difficult to treat these patients. We usually have to remove the implants, treat the infections and then they can have implants put back in if they want later (in the private system).”

“In my private practice ... I have had to use breast cancer reconstruction techniques (usually used in cancer patients) to fix up some of the botched stuff that has come in which is a lot more extensive surgery.”

Dr Lee, an Australian Society of Plastic Surgeons spokesperson, said even when corrective procedures were done in the private system, those patients were still claiming a rebate from Medicare.

Sharon nearly didn’t survive her liposuction procedure in Bangkok 18 months ago.

After seeing a couple of doctors and getting some quotes locally, Sharon decided to look overseas because she liked the idea of combining the surgery with a holiday.

“Looking back now there wasn’t much of a difference in price, but I thought for the same price I was going somewhere,” she said.

Sharon, who did not want her surname published, regrets her decision to have liposuction in Thailand.
Camera IconSharon, who did not want her surname published, regrets her decision to have liposuction in Thailand. Credit: TheWest
Sharon now faces revision surgery.
Camera IconSharon now faces revision surgery. Credit: TheWest

Booked through a cosmetic surgery holiday agency, Sharon said she travelled alone to have the surgery done and planned to meet up with her partner the following week.

But when she arrived, Sharon discovered the doctor wasn’t the same as the one featured on the agency’s website and he could not speak English.

The only person who could speak English during the ordeal was the agent she booked the cosmetic holiday through and she only saw her at the initial consultation when she translated for the doctor and after she had been discharged from the hotel.”

Sharon attended a single pre-surgery appointment to discuss what work she would have done and was taken to have the procedure that same day.

“The information they gave me was similar to what I got from doctors in Perth but the experience was absolutely nothing like what the agent told me it was going to be,” she said.

She woke from the surgery with breathing trouble after an apparent allergic reaction to the anaesthetic and had to stay in post-operative care longer than originally planned.

When she was moved to her hospital room she was still having trouble breathing but couldn’t communicate with the nurses.

“I started losing my breath again and had to call a nurse in to get an oxygen mask, neither of those nurses at the hospital could speak English either,” she said.

Eventually, though, she was able to able to get the message across and got the much needed oxygen.

When she was discharged back to the hotel, Sharon said she was still in excruciating pain.

“I couldn’t even get onto the bed, I was in that much pain,” she said.

To make matters worse, she developed a continuous cough diagnosed as aspiration pneumonia weeks after she returned to Perth, possibly the result of breathing in vomit or saliva after her surgery.

And, the results of the surgery have been terrible.

“When I wear things like leggings or anything that is close to the skin you can see dents and that more so than ever, I’d have my orange peel back any day,” she said.

Sharon said in the long run she would probably have to pay about double what she would have if she had had the surgery in Perth.

Australasian College of Cosmetic Surgery spokeswoman Argie Xaftellis has seen numerous patients permanently scarred by poor standard cosmetic work done overseas.
Camera IconAustralasian College of Cosmetic Surgery spokeswoman Argie Xaftellis has seen numerous patients permanently scarred by poor standard cosmetic work done overseas.

Australasian College of Cosmetic Surgery spokeswoman Argie Xaftellis, who Sharon consulted for corrective work, said she had seen numerous patients permanently scarred by poor standard work — about 15-20 people a year who required correction.

“In Sharon’s case it is just a quick slap job and the patient has been left with divots and dents and scars and things that are really hard to correct,” she said.

“(In other patients) I have seen some terrible facial work where there are scars upon scars. Where (the surgeons) do their cuts sometimes don’t even make sense. Sometimes they are old fashioned (techniques) and I have to refer the patients back to my colleagues to see what they can do.”

Dr Xaftellis, who owns Argera Centre, said there was no follow-up care when you chose to have cosmetic surgery overseas.

“They do the job and walk away and take your money, but no responsibility. And, (the doctors are not seeing the results) of the work, so how do they know when they have made a mistake. They are not getting any (feedback) that inspires them to improve or learn.”

In Australia, patients must give informed consent for every surgical procedure carried out. However, when surgeries occur overseas that fundamental principal can be compromised.

Dr Lee said patients can feel pressured to follow through with a surgery if they’ve already paid for it and flown to another country to have it done.

“You don’t have a proper consultation if it is just over the phone or on Skype,” he said.

“(Afterwards), patients are put on a plane and sent back to their home countries who are obligated to pick up the pieces if something goes wrong.

Dr Lee said there were qualified plastic surgeons overseas, but there was also a big fringe of under-qualified practitioners doing a lot of the work in clinics that were not accredited and not safe.

“The hospitals people go to there might have a lovely marble foyer and look like a five star hotel but it’s the oxygen supply and the water supply and the sterility practices that are the most important things when you are having an operation, not a flash cosy room that looks like a five star hotel.

“Surgery can be dangerous, so trying to treat it like a retail decision and save money by going overseas can end up in disaster. This is your life and your health and nothing else is more important, so cut-price bargains and trying to combine it with a holiday is really a bad idea.”

John Flynn, former president of the Australasian College of Cosmetic Surgery, said usually third party agencies received a commission for sending someone to a particular clinics overseas, a practice that was not a good basis for a referral.

“I don’t think you can let off the referral agencies lightly here,” Dr Flynn said.

“They generally don’t have health training, they are making arrangements based on making a profit out of their travel and the referral.

“Now in Australia you are not allowed to accept a referral in exchange for a reward — I can’t pay somebody to refer me a patient, but that’s exactly what is happening with these patients.”

Dr Flynn estimated complications, both acute and long term, were increasing at a rate of about 10 per cent a year.

“Now that’s a pretty big increase in any language,” he said.

“I often say to patients if you are wanting to have surgery, why would you go to a country where it is not safe to drink the water?”

Dr Xaftellis’ advice?

“Use common sense, do your due diligence, look around, read around, go see a couple of doctors and never go with the cheapest quote because in the end you usually get what you pay for.”