Holidays with complications

GOING under the knife in a foreign country could be saving you dollars plus in most cases you get an exotic holiday out of it while you recover. However, cosmetic surgery is no holiday, warn health care professionals.

The Australian Society of Plastic Surgeons is strongly advising us to think twice before travelling overseas for cosmetic surgery as results from a recent survey highlight the number of Australians experiencing complications is on the rise.

“Cosmetic surgery packages sold as holidays downplay the importance of post-operative period,” ASPS president associate professor Rodney Cooter warned. “Any kind of surgery, cosmetic or otherwise requires a high level of post-operative care.”

“That means rest and healing time to reduce the risk of complications. It’s not about sunbathing, drinking cocktails, swimming and snorkelling before jetting home.”

Destinations we commonly jet-set to for cosmetic surgery include Thailand, Malaysia and South America. “Some of the surgeons operating in these countries are highly skilled professionals. It is important to make that point,” he said.

“We are not saying that anyone who travels to another country for a procedure is making a mistake. What we are saying is that post-operative care and monitoring is an important part of surgery. Ask yourself what follow-up care will I get back in Australia after my operation? Who will help me if something goes wrong?”

The most common kind of surgery being conducted overseas requiring corrective treatment was breast surgery, the ASPS said, representing 68% of all revision procedures. It was closely followed by facial surgery (15%), abdomen revision (8%), body contouring (5%) and ear revision (0.5%).

The survey highlighted various dangers associated with cosmetic tourism. Individuals with surgical complications that could not be completely corrected have been seen by 72% of surgeons in Australia who had to carry out revisions. Meanwhile, almost half of the surgeons said they had cases that would have been life threatening without corrective treatments. A total of 62% of surgeons on the other hand have had cases which involved permanent disfiguration despite their best efforts, while a similar number of Australian surgeons have seen patients who were severely psychologically impacted by the whole experience.

“Our plastic surgeons see the damage that can result when post-operative care has not been adequate,” Cooter said. “Infections are the most common complication including unsightly scars, hematomas and unsatisfactory results.”

“For example, one of our surgeons recently treated a facelift patient who was left permanently disfigured after a procedure in Bangkok, through skin loss following a complication.”

Patients often tell Cooter the cost was the main reason they venture overseas for a procedure, but he said people needed to realise that the cost blow out from complication is far worse.

The average cost of cosmetic surgery revision to a patient is an additional $5754. On top of the extra money we would have to fork out, the average recovery time was two weeks more than normal – meaning more time off work and potential loss of earnings.

The increasing number of patients requiring revision surgery is also placing a burden on our public health system, with 31% of all cosmetic tourism revisions in the last 12 months being conducted in public hospitals.

Australian Medical Association president Doctor Steve Hambleton said there were also dangers associated with enhancement procedures like wrinkle fillers and Botox. “Botox is a neurotoxin, which means it paralyses the muscle. It is quite dangerous.”

Hambleton said there have been deaths associated with Botox.

If someone is adamant about overseas surgery, Cooter recommends checking if the surgeon is a member of the International Society of Aesthetic Plastic Surgery. Check if you have the right information, have had enough time to give informed consent and have a plan for any post-operative issues. Question if the medical standards of care and quality control requirements at least as good as those in Australia. And do you know if devices and products used in the overseas hospital meet Australian standards of safety and effectiveness?

In addition, check out the person prompting the surgery – are they medically trained? Do they accept liability or provide any help if problems arise or are they simply a travel agent?

Hambleton said Australian’s didn’t just travel overseas for cosmetic enhancements, some individuals look to getting orthopaedic implants, knee reconstructions or even heart surgery. “These are procedures that require follow-ups. It’s not as simple as getting the surgery and everything is ay-okay.”

We only have one body, so think about how much it is worth to you, and then decide.

“You have to look at the big picture, you can’t just look at the price. Glossy pictures in brochures of someone who might or might not have been operated on is meaningless information to you,” Hambleton said. “It’s not going to tell you how you are going to come out [after the surgery].”

Who is a surgeon?

Surgeons are Fellows of the Royal Australasian College of Surgeons or equivalent, and have undergone intensive training to perform invasive surgical procedures. Plastic surgeons who are FRACS members will have studied and trained in Plastic and Reconstructive Surgery for a minimum of five years after medical school. FRACS is the standard qualification required in Australia to perform surgery in private and public hospitals.

Doctors with only a MBBS (bachelor of medicine and bachelor of surgery) degree are not surgeons. They are not trained for invasive surgical procedures. However in Australia, surgically unqualified doctors are also allowed to perform cosmetic surgery. To ensure your surgeon is fully qualified and has extensive surgical training, patients should make sure their surgeon is a FRACS. All ASPS members are FRACS and uphold the highest standard in plastic surgery.