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Sun, Sea and Silicone

Cosmetic surgery tourism is a fast growing industry, but is it safe? Leah Hardy investigates the boom in nip/tuck holidays

Cosmetic surgery can be expensive and, with prices in places like Prague and Turkey around half of those in the UK, it is no wonder that more and more people are cutting costs by having cosmetic surgery abroad. A recent survey by Liberate Cosmetic Surgery found that 40 per cent of British women would consider cut-price 'sun and surgery' holiday packages and The British Association of Aesthetic Plastic Surgeons (BAAPS) estimates that around 20,000 people travel abroad for cosmetic surgery every year.

With plans to impose VAT on cosmetic procedures in the UK on the horizon, this is a trend that shows no sign of slowing down. But what is the real cost of cut-price surgery abroad? A 2009 BAAPS poll found that 26 per cent of surgeons had noted an increase in the number of patients who had complications stemming from cosmetic surgery holidays. In February this year, the issue hit the headlines when 20 year-old British dancer Claudia Aderotimi died after travelling to the US to have buttocks enhancement.

The case was extreme because the procedure was carried out in a hotel room by an unlicensed practitioner Miss Aderotimi met over the internet and an illegal, industrial silicone was used. But even when patients choose their clinic with great care, things can go wrong. Sue Wilson, 50, a teaching assistant from Sussex, had saved for years to afford a tummy tuck and breast implants. "When I found a website offering cosmetic surgery by highly trained doctors in Turkey at a price I could afford, I thought it looked wonderful", she said.

But a year later, Sue, who is still in severe pain, describes it as "the worst mistake of my life". According to reconstructive plastic surgeon Charles Nduka, Sue's choice nearly killed her. He says, "The surgery was performed incompetently. She had large scars on her breasts due to poor technique, and a massive skin infection meant I had to remove tissue the size of a paperback book from her stomach area."

So what are the main concerns about surgery tourism? Deaths are extremely rare and there are obviously many talented surgeons working abroad but, as consultant plastic surgeon Nigel Mercer points out, "it's unlikely you'd find them via a surgery tourism website run by salespeople." One of the main problems with cosmetic surgery tourism is that many patients do not meet their surgeon prior to flying out for their operation and, according to BAAPS, 55 per cent of cosmetic tourism companies only offer online or telephone consultations.

Surgeon John Pereira says, "Every week I see at least one unhappy patient who had surgery abroad and did not meet their surgeon prior to having their procedure. The results have been poor and when patients try to get anything done they suddenly seem unable to get a response - the initial efficiency has vanished, along with their money."

Some people also wrongly believe that they can combine their surgery with a holiday, but as Mr Nduka says, "Having surgery is nothing like going on holiday. You won't be able to swim or go sightseeing after your operation. Many women wouldn't dream of getting a haircut on holiday, but will allow a complete stranger to operate on them in a foreign country. Bad plastic surgery won't grow out."

Recovery from surgery also takes weeks so, unless you fork out to stay in a hotel within easy reach of your surgeon, you will be missing out on essential aftercare. "Most surgeons see patients at least three times after surgery", says Mr Nduka. "This is not possible when your surgeon is thousands of miles away." This is even more of a problem if something goes wrong, especially as the NHS won't always be there to pick up the pieces. "People believe the NHS will step in and that's not entirely true", says Mr Nduka. "The NHS will treat patients who have medical problems such as infections as a part of its duty of care but will not pay for operations to revise a bad cosmetic result. For example, if a breast implant bursts, the NHS will remove it, but not replace it. An NHS GP may even refuse to take out stitches if you've had cosmetic surgery abroad."

Some companies offer revision surgery to unhappy patients, but surgeon Peter Arnstein from McIndoe Surgical Centre points out, "If you run into major problems following the procedure it is unlikely that you will be in a fit condition to return abroad for follow up care anyway." And of course, flying after surgery carries its own risks. "Surgery raises the risk of DVT, which can kill, and flights longer than one hour raise this risk even further", adds Mr Nduka.

If you are still contemplating surgery abroad, ensure you check that your surgeon is appropriately qualified in their native country. The organisation www.treatmentabroad.net has a section on its website listing the local organisations that check surgeons' accreditation.

You should also look at the hospital or clinic's website and ask if they have facilities to deal with medical emergencies. Make sure you meet your surgeon before you pay anything and arrange to stay for at least a week after your surgery. You should take out specialist insurance, but remember that, even if you do have the right insurance, there is no guarantee that your surgeon will be covered.

Mr Nduka says, "One of the reasons surgery in the UK tends to cost more is because surgeons are legally obliged to be fully insured, with liability running into millions of pounds. This does not apply to surgeons in the EU, for whom insurance may be voluntary or capped at a low level. But even if they are

insured, the cost of legal fees, flights and language difficulties mean it is practically impossible to sue a doctor in a foreign country."

Finally you should ensure you have enough money to fly back if you have any problems and factor extra flights and accommodation into your budget. All things considered cosmetic surgery in the UK may not seem so expensive after all.

This article originally featured in a special report on "Cosmetic Procedures" in Dec 2011 - published by Raconteur Media and distributed with The Times (UK).