By Dr Naveen Somia, PhD., FRACS, Specialist Plastic Surgeon
Thinking of having cosmetic surgery overseas? Know your risks.
Cosmetic surgery overseas is a part of the burgeoning global medical tourism industry. Medical tourism that was heavily restricted during the pandemic will get a boost with the borders opening and restrictions on travel easing.
All surgery carries risk whether it is performed at a state of the art centre here in Australia or overseas. However, there are additional risks that you need to be aware of when you choose to have cosmetic surgery, or any surgical procedure, overseas.
The Australasian Society of Aesthetic Plastic Surgeons (ASAPS) is a member based, professional organisation made up of over 300 registered specialists in the recognised medical specialty of Plastic Surgery, and who specialise in Cosmetic Surgery. All ASAPS members use the title, Specialist Plastic Surgeon.
ASAPS members practice across Australia and New Zealand and through this large 300+ nationwide member network, ASAPS is aware of numerous examples of patient harm following cosmetic surgery over the years. This has enabled ASAPS to put together a list of things to consider for patients who are considering cosmetic surgery overseas.
Prior to undergoing overseas surgery, ASAPS recommend:
1. Air Travel increases risk of blood clots
If you are travelling on a long flight for your cosmetic surgery overseas and then flying back to Australia, you need to be aware of the risks of air travel post surgery.
During a flight, you are at risk of developing Deep Venous Thrombosis (blood clot in the legs) and Pulmonary Embolism (blood clots travelling to the lungs) as a result of air travel.
Cosmetic surgery operations like tummy tucks, body lifts or large volume liposuction, where your mobility after the operation is limited or restricted, further increases your risk of clots.
Combining air travel with surgery can significantly increase your risk of clot formation. While Deep Venous Thrombosis is usually not fatal if treated in time, a pulmonary embolism can be a medical emergency, with a risk of fatality.
2. Overseas surgery locations may not have the same stringent, quality controls as Australia
All hospitals in Australia have to be accredited for safety and hygiene on a regular basis. In addition to this, all facilities that perform cosmetic surgery must be licensed for cosmetic surgery. There are government mandated safety guidelines regarding cosmetic surgery in Australia, including accreditation of staff, nursing ratios and discharge planning and after care.
The overseas facility may not have the same stringent controls that you see in Australia that may potentially impact your overall quality of care and your outcomes following cosmetic surgery.
3. Overseas surgeon’s do not have the same accreditation process as Australia
In some countries, the training, accreditation and registration requirements to become a Surgeon may be different overseas than in Australia. This can mean that the recommended criteria and standards that a Surgeon has to fulfil to maintain their registration and licence to practise overseas, may vary.
4. Risk of infections could be higher due to antibiotic resistant bacteria overseas.
All medical procedures have a risk of complications, but surgery specifically carries an increased risk of wound infections and sepsis. If you are in a tropical country, the bacteria and viruses that inhabit that environment will be different to those present in the Australian hospital environment. Since you may not have been exposed to these bacteria during your lifetime, your body may not have had the opportunity to develop natural immunity or antibodies, which puts you at a disadvantage compared to someone who has developed natural immunity from that country. Certain overseas countries have a higher incidence of blood borne diseases such as hepatitis B, hepatitis C and HIV.
Antibiotic resistance is a major problem caused by the indiscriminate use of Antibiotics. You are more likely to encounter antibiotic resistant bacterial infections overseas, and if you do so, the normal antibiotics will not be effective against the infection. Foreign infections often require mega doses of strong antibiotics to get the infection under control. There is a small risk of the infection not responding necessitating escalation and in some cases, admission to intensive care.
5. Language barriers and communication issues can impact surgery outcomes
There is a potential for misunderstanding and miscommunication due to language issues. In a cosmetic surgery setting this could lead to problems. Most places would have made arrangements for English speaking staff, but it will be different to what you expect here in Australia.
When planning a surgical procedure, it is of utmost importance that the patient and practitioner are completely aligned on the patient’s wants and needs, to prevent an unsatisfactory outcome.
6. Overseas surgeries are harder, and often expensive to fix should they go wrong.
All cosmetic surgical procedures carry risks. These include both anaesthetic complications and surgical ones such as wound infections, bleeding, sepsis and even death due to complications.
Follow up and timely interventions can minimise the risk of complications. But circumstances beyond your control may not make this possible when you are overseas. Sometimes complications manifest a few weeks later, once the patient has returned to Australia, which can make finding specialist care more complex.
Treating complications is expensive. If you require hospital or intensive care admission following your surgery, you are at risk of increased costs. Prior to your travel, patients should ensure that all travel insurance policies cover emergency medical care, and medical retrieval back to Australia. Be sure to check the terms of your travel insurance in fine detail, if the trip is for a surgical procedure.
7. Overseas patients are at great risk of “surgery ghosting” and “ghost surgeons”.
Surgery ghosting is when a surgery is performed by a surgeon different to the one who has consulted you, prior to the operation. This can happen when the surgeon decides to swap with another practitioner, once the patient is under general anaesthesia, without the patient’s consent, also known as: “Ghosting victim”, “ghost doctor,” or ‘ghost surgery’.
There are a number of reasons why a practitioner may choose to do this, for example, one surgery may be overbooked, or may wish to use a less experienced (and less expensive) surgeon to perform the procedure. This betrayal and violation of the trust is not just unethical, it is illegal and undermines the relationship of trust between the doctor and patient.
Dr Naveen Somia, PhD., FRACS, Specialist Plastic Surgeon, is a specialist plastic surgeon and an ASAPS Member with extensive training and experience in his field. If you have any questions about any of the topics discussed in the blog, you are welcome to contact Dr. Naveen Somia.
Excerpts from News.com pertaining to what Dr Naveen Somia, PhD., FRACS, Specialist Plastic Surgeon has said for the interview have been republished here with permission. Read the full article here.