Cosmetic Surgery Abroad

While “cosmetic surgery tourism” is a success for some people, there are a number of things that need to be considered when deciding if it is the right thing for you.

Our patient information guide for people considering cosmetic surgery abroad answers some of the common questions that potential patients may have

Am I more likely to have a complication if I travel abroad for my cosmetic surgery?

No procedure is free from risk and complications after cosmetic surgery can occur whether your surgery is carried out in the UK or abroad. However, if you choose to have a surgical cosmetic procedure in the UK, the consultant plastic surgeon who conducted the surgery will provide you with any necessary aftercare. If something does go wrong, either a complication arises or the outcome of the procedure is unfavourable, then the surgeon is on hand to discuss it with you and decide how the problem can best be resolved.

This reassurance cannot easily be provided when travelling abroad to have cosmetic surgery. Some clinics overseas will not have someone in the UK for you to turn to if problems arise and for many of those that do, it is a nurse or GP, not a plastic surgeon.  
Any potential cost savings that might arise from travelling abroad should be balanced against this, and other considerations, such as the need to take time off work and the cost of possibly returning to the overseas clinic for corrections, must be taken into account. At BAPRAS we believe that patients should be able to see the plastic surgeon who actually carried out the operation if there are any concerns.

Are there any special risks of travelling for cosmetic surgery abroad?

Both air travel and major surgery increase the risk of developing deep vein thrombosis or a pulmonary embolism. Flying soon before or after an operation abroad combines these risks, particularly if your flight is a long one.

Deep vein thrombosis (DVT) occurs when a blood clot forms in a vein, partially or completely blocking blood flow. It usually occurs in a deep leg vein and can cause immobility and long term problems with circulation. The symptoms usually entail; swelling, pain, warm skin, tenderness and redness. Your risk of getting DVT is also increased if you are obese, a smoker, over 40, have cancer or a heart condition, are taking HRT or the combined contraceptive pill or have a prolonged anaesthetic or period of immobility.

A pulmonary embolism occurs when a blood vessel supplying the lung becomes blocked by a clot. This may travel in the bloodstream from a vein in the pelvis, abdomen or leg. Symptoms of a pulmonary embolism include breathlessness, chest pain and potentially fatal collapse. You have an increased risk of a pulmonary embolism if you have a DVT, are elderly, obese, or have cancer or have a prolonged anaesthetic or period of immobility.

Therefore, before flying home, you should wait five to seven days after procedures such as breast surgery and liposuction, and seven to ten days after facial cosmetic procedures or tummy tucks.

Drinking plenty of water, avoiding alcohol and walking about during your flight can help the circulation, but this does not completely remove the risk of a blood clot, especially if you are having major surgery. Blood clots can start to form during your operation. You should ask your surgeon about this before deciding to travel abroad

How do I know that the surgeon is properly trained?

There are some very well-trained plastic surgeons outside the UK but it can be difficult to check. In the UK, plastic surgeons will be on the specialist register for plastic surgery that is held by the General Medical Council (GMC).

Other countries use different systems and because of differences in standards and qualifications it is not easy to find out if a surgeon overseas is a fully trained plastic surgeon. In the UK, full members of BAPRAS have all had full specialist training. You may find there are similar associations abroad where you can check to see if the surgeon is a member. You should always ask a surgeon what training and qualifications they have and what organisations they belong to. No respectable surgeon will mind this in the least!

How do I know if the clinic is clean and safe?

In the UK all private hospitals and clinics are regulated by the Healthcare Commission who ensure that standards of the facilities and care are high and inspected regularly. Other countries do not necessarily have a similar licensing and inspection regime. Patients report that some clinics abroad are clean and of very high standard whilst others are not.

You should ask about the regulation of the clinic, its record on infection rates and what back-up services are available on the main clinic site if something were to go wrong during your operation or stay.

What do I need to know about the consent process? 

Cultural differences in surgical consent can pose significant risks for patients seeking cosmetic surgery abroad.

While the UK has robust processes in place to ensure patients are fully informed about the risks, benefits, and alternatives of the procedure, other countries may have different cultural norms and legal requirements for informed consent.

Patients who travel abroad for cosmetic surgery should be aware of these potential differences and take steps to fully understand what they are consenting to. 

Why is surgery sometimes cheaper abroad than in the UK?

In the UK, cosmetic surgery is heavily regulated by the Healthcare Commission and the General Medical Council. Such regulation is quite expensive for the surgeons and clinic owners. In addition, plastic surgeons in the UK must have extensive malpractice indemnity in case something goes seriously wrong. This ensures that you are fully protected and receive the best possible care and treatment. Inevitably, the cost of this reassurance is reflected in the cost of your surgery. Cosmetic surgery is regulated differently in other countries and so standards of care may differ and the cost of regulation be less.

BAPRAS members will provide full aftercare for you following your operation: both during your stay in hospital and afterwards – this includes follow-up consultations and any further treatment that may be required to resolve any problems. While this aftercare is factored in to the cost of the surgery in the UK, most clinics overseas provide only limited or no aftercare once you are back in the UK, which allows them to reduce the cost of surgery. In addition to this, the cost of living is often less than in the UK and therefore services such as staff costs and medical supplies are generally much cheaper.

Is cosmetic surgery always better value abroad?

Cosmetic surgery abroad is often cheaper than in some parts of the UK, however should there be complications following the initial surgery, returning to see the surgeon could add hundreds of pounds as well as involve significant time away from work. The cost of getting home if medical complications occur could be significant as holiday travel insurance doesn’t usually cover this. The NHS will treat life-threatening complications, but any other problems may have to be covered by you, either by going back to the clinic where you had treatment, or paying for private treatment in the UK.
Seeing a UK surgeon allows you the benefit of time and added consultations to build confidence in your surgeon and the procedure before making your decision. If you are travelling abroad for surgery, you will often not see your surgeon or discuss treatment in much detail beforehand. This should be considered when deciding on whether going abroad is actually better value for money.

How well can cosmetic surgery be combined with a holiday?

Cosmetic surgery abroad is often labelled as a holiday package. We think this is very misleading and creates the wrong impression. Firstly cosmetic surgery is a serious and major undertaking and should not be considered as a “holiday”. Planning to have a holiday after your surgery is unwise since it is unlikely that you will be able to carry out regular holiday activities. 

To properly heal and reduce the risk of complications, you shouldn’t sunbathe, drink alcohol, swim or do any water sports. After most surgery you would be advised to rest and just take gentle light exercise until your wound has healed and stitches have been removed. If you are keen to see the place you are travelling to, you should take the holiday before you have the operation and plan several days of rest afterwards.

Will my trip be covered by my normal holiday insurance?

Different policies vary but in general it is unusual for a holiday policy to cover you in the event of something going wrong during or after planned elective surgery for which purpose you had travelled. We would strongly recommend that you make sure that you do have full insurance cover, since the cost of prolonged medical care abroad or of medical evacuation back to the UK in the event of something going wrong could be extremely expensive.

Can I change my mind if I do not like the look of the place when I get to the clinic?

This is something that you must establish before you enter a contract with the company arranging the surgery abroad.

At BAPRAS we believe that patients should never feel compelled for financial reasons to go ahead with cosmetic surgery if they change their mind. There are real risks of feeling unable to back out if you have travelled a long way and are in a foreign country using an unfamiliar language.

If something goes wrong, can I go to the NHS for it to be sorted out?

The NHS will always look after you in the event of a life threatening emergency, such as bleeding or blood poisoning, however NHS Trusts and commissioners will usually refuse treatment for less serious complications or bad outcomes following cosmetic surgery in the UK or abroad. At BAPRAS we have noticed an increasing number of patients turning to the NHS with problems following cosmetic surgery abroad: this is not fair on patients who need NHS care and often ends up with the patient being treated as a “private” patient by the hospital and receiving a bill.

If you have a problem following surgery then the people who carried out should be there to help you resolve it: the NHS is not there to underwrite cut price surgery abroad.

Cosmetic surgery abroad checklist

If you are considering going abroad to have cosmetic surgery, make sure you do your research and find out the answer to these questions:

About your surgeon and your treatment

•  What is the surgeons experience in cosmetic surgery?
•  How many years has he or she been practising?
•  How many procedures of the kind you are interested in have they undertaken
•  Are they properly qualified and to what professional organisations do they belong to?
•  Can you have at least one consultation with the person who will actually be caring out the procedure, in the UK, before you commit to surgery?
•  Does your prospective surgeon speak English well enough to communicate issues related to your surgery?

About the clinic
•  What are the clinics credentials?
•  Ask if you can speak to patients they’ve treated before.
•  Ask to view before and after photographs of other patients’ surgeries.
•  What facilities do they have and what back up do they have if something goes wrong?
•  Is there always a doctor in the clinic and is there a high dependency or intensive care unit?

About the procedure
•  What complications or risks are there associated with the surgery you wish to have?
•  What are the complication rates for this procedure?
•  Who is part of the surgical team?

After surgery
•  Once you have had your surgery what are the arrangements for follow-up care with the surgeon?
•  Who will sort out any complications that may arise once you have returned to the UK? Would you have to pay to return to the clinic for further advice or treatment?

Regulation and insurance
•  Is there a body that regulates the clinic or practice to ensure that it meets minimum standards of care and treatment?
•  Will you be covered by travel insurance for such a trip which includes an operation?
•  What medical insurance arrangements are there if an error occurs?

And finally, always check the fine print to be clear about what you are paying for as there could be hidden costs. 
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