As the popularity of medical tourism soars what are the risks of cosmetic surgery abroad and what's the key advice to consider

What is medical tourism? 

The term medical tourism refers to travellers who have chosen to have medical, surgical, dental or cosmetic treatment abroad. Private companies, many of which advertise online, usually refer tourists to hospitals and clinics. Flights and accommodation often included as part of a package deal which also includes a surgeon pre-selected by the company in question.

UK medical tourism trends  

In an article published on Laing Buisson, it's noted that there's no official source of data on outbound UK medical tourism but that the Office of National Statistics (ONS) has estimated that 248,000 UK residents travelled abroad for treatment in 2019. This compared to 120,000 in 2015. 

The article makes clear that these figures came from a small sample size and must be treated with caution. It's also not clear how many of this number travelled for core elective medical care, or cosmetic surgery. 

UK medical tourism has historically been dominated by people travelling to other countries seeking cosmetic surgery and dental work. There's now, according to the article, an increased demand for core, elective medical care, such as hip and knee replacements, with NHS waiting lists at the heart of the increase.

Foreign Commonwealth and Development Office advice

Following the deaths of 17 British medical tourists since 2019, the Government issued an advisory warning last year to anyone considering travelling to Turkey for a cosmetic procedure. It's updated this advice recently after this figure increased to 22.

The Foreign Commonwealth Office website advises that the "standard of medical facilities and available treatment vary widely around the world. As such, British nationals considering undertaking medical treatment in Turkey should carry out their own research. It is unwise to rely upon private companies that have a financial interest in arranging your medical treatment abroad."

It advises people travelling to Turkey to visit the Health Turkiye website which includes medical providers approved by the country's Ministry of Health.

The FCO adds that those considering travelling for treatment should discuss their plans carefully with their UK doctor, dentist and/or hospital specialist before committing to any procedure abroad. Further advice and information is available on medical tourism from the National Travel Health Network and Centre website. 

The advice provided by the FCDO also includes some general warnings relating to travel abroad for any medical procedure or cosmetic treatment. This includes::

• Medical advice from a travel agent or administrator is unacceptable.
• A patient travelling abroad is likely to be at increased risk of complications, including expose to infections and viruses. 
• The British Association of Aesthetic Plastic Surgeons advises against travelling abroad for any surgery.
• Antibiotic resistance is a global problem and resistant bacteria may be more common in some regions. 
• Communication issues
• Poor quality medication
• Dangers of air travel post-surgery.

Cosmetic surgery in Turkey 

From what we see in our work, Turkey is a very popular destination for cosmetic surgery with travellers from the United Kingdom. I represent clients who have travelled there for a variety of procedures, including weight loss surgery. 

I've seen that treatment can be booked at most clinics very quickly via WhatsApp, and clinics fully utilise Facebook, Instagram and Twitter to advertise, and present what appears to be a safe and low-risk experience. 

A lot of the patients me and my colleagues speak to have made bookings for surgery in Turkey via WhatsApp or on Microsoft Teams, with limited opportunity to really understand the local health care system, or to see if the facility in which they will undergo their treatment is as it is presented in the promotional material provided by the clinics.

In 2016, Turkey was the fourth most common destination for UK outward medical tourists.There are little or no statistics available for 2019 and 2020. According to the ISAPS Global Survey 2020, the number of surgical and non-surgical cosmetic procedures undertaken in Turkey in 2020 increased by 25% from 754,392 to 945,477.  

Of this figure, the, five most common surgical procedures in 2020 were rhinoplasty (commonly called a nose job), 66,950; liposuction, 57,551; breast augmentation, (39,442); while 35,009 people underwent eyelid surgery and 27,131 underwent fat grafting.

A study by the British Association of Aesthetic Plastic Surgeons (BAAPS), reported in the Harley Street Journal in April 2022, revealed a staggering 44% rise in complications from cosmetic surgery abroad. It  led to the organisation calling for compulsory insurance to ease the burden on the NHS when returning patients need further treatment and corrective surgery. 

The study conducted by BAAPS showed that in the four years to April 2022, 324 patients have sought correctional treatment after returning to the UK, a number that has, according to BAAPS, risen sharply. The report confirms that in 2021 following a cosmetic procedure abroad 75 women and seven men were treated in the UK for complications, including life-threatening conditions, and admission to intensive care for life support following systemic infections. 

These complications have left permanent, life-changing injuries and psychological conditions for those patients to deal with. A survey of BAAPS council members showed that 100% of the most serious complications came from Turkey and that abdominoplasty accounted for the highest percentage of these, closely followed by breast surgery.

BBC investigation

A BBC investigation this week found of the 22 patients that had died in Turkey since 2019, seven of them had travelled for weight loss surgery. 

The stories featured by the BBC article very much reflect the experiences our clients have – of being told there's nothing to worry about, and that whatever post-surgical symptoms that they're suffering from are “normal”. 

The BBC spoke to medics treating patients who had returned from Turkey and quote one medic who says he sees at least one very unwell patient a week, arriving straight at the hospital from the airport. Other medics said that they have treated patients who had undergone an entirely different surgery to the one they understood they were having. 

The BBC highlight the story of Joe, a 25-year-old who died in Turkey in 2021 following bariatric surgery. The brief facts set out in this article and experience of his family are so very similar to other fatal cases which Irwin Mitchell has been involved in.

Price remains a motivation

The most common reason given by my clients for choosing to travel to Turkey is that surgery is far cheaper than it is in UK therefore they can undergo cosmetic treatment which might otherwise be out of their reach in the UK.  

Price remains the main motivation, but more recently this has changed in respect of some procedures. The BBC's research suggests that some patients, particularly those who want bariatric - weight loss - procedures, now opt for surgery abroad because of waiting times for this type of surgery on the NHS.  Other cosmetic procedures are rarely funded on the NHS in the UK. 

The BBC learned that the number of weight loss surgeries performed in England has fallen from 6,818 procedures three years ago to 4,409 in 2022, and while that trend continues, and while prices remain cheaper in countries like Turkey, it seems people will seek alternative solutions.  

Conclusion

While on the face of it such trips look appealing and websites and social media accounts look professional, there can often be a complex system behind such bookings and who may be responsible if something does go wrong.

There are always risks to consider in any type of surgical treatment, but there are particular risks involved in having a surgical procedure in a different country. I'd encourage people to thoroughly research various options before committing to any procedure.

It's also vital people understand what redress they have if something goes wrong and that they know the details of insurers in place.

Find out more about Irwin Mitchell's expertise in supporting people concerned about cosmetic procedure abroad at our dedicated medical negligence abroad section.