INTRODUCTION AND AIMS
Cosmetic tourism, driven by the promise of inexpensive operations abroad, is popular despite warnings from professional bodies regarding the associated risks. Increasing numbers of individuals have presented to our department requesting NHS treatment of complications from such surgery. We set out to characterize these patients and evaluate costs incurred through their assessment and management.
MATERIAL AND METHODS
An observational study was conducted from 2007 to 2009 on patients presenting to a tertiary referral Plastic Surgery practice with complications of cosmetic tourism surgery. Demographic characteristics, as well as those related to the operation, were recorded. Hospital patient flow pathways were constructed, cost analysis performed using Patient Level Costing, and expenditure and profitability calculated.
Most operations were performed in Europe or Asia, and were primarily breast augmentation procedures (n = 13). The principal complications were wound infection or dehiscence (wounds splitting open), and poor cosmetic results. Patients received NHS treatment, at a cost of £120,841. The mean cost for all patients’ management was £6360 (range: £114–£57,968), rising to £10,878 for those accepted for treatment.
The costs to the NHS of managing complications of cosmetic tourism are substantial, and underestimated by central funding agencies.
The cost to the Australian taxpayer is possibly higher than those stated above, and these costs were brought up with Dr Murray when he attended the federal budget dinner. Most insurers will not cover the cost of medical evacuation (approx $150,000AUD) and private repair of complications. A NSW study found over 40% of these overseas procedures needed repair.
Surgery is not time for a holiday and flying post-operatively greatly increases your risk of serious complications and even death. Additionally, many cosmetic surgery destinations are in third world countries that have a high rate of infection, HIV and Hepatitis C. Followup and prompt treatment of complications is more important than the surgery in many cases. Some complications do not show up for years afterward.
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