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by Staff GBAF Publications Ltd

UK surgeons have seen a marked decline in ‘botch jobs’ performed abroad over the past 18 months, both in the NHS and private sector

Caution is being issued for patients considering post-lockdown medical tourism deals and offers

UK surgeons have provided a checklist for those considering surgery abroad

With the further easing of travel restrictions coming into effect, UK surgeons are issuing caution to those considering cosmetic and medical procedures abroad. This comes after UK surgeons have seen a marked decline in the amount of revision surgery required from patients who have undergone surgery abroad over the past 18 months, both within the NHS and in private practice.

Dr Bessam Farjo, Hair Restoration Surgeon at the Farjo Hair Institute, is one of the surgeons who is particularly concerned about seeing vulnerable patients lured in with cheap offers now the travel industry is opening back up.

“Hair transplants when performed correctly by a doctor in a safe setting can be transformative for the patient. However, it’s no secret that certain destinations abroad have been at the heart of a growing market of cheap medical tourism targeting vulnerable hair loss patients” he says.

“At the Farjo Hair Institute we’ve seen a marked decrease in revision cases from hair transplants performed abroad this past year and I can only hope that we don’t see a rise again now travel restrictions are being eased.”

This issue seems to be across the board when it comes to cosmetic surgery.

“I have other surgeon colleagues who echo this concern. It’s absolutely paramount for anyone considering surgery abroad to thoroughly do their research before booking a flight/procedure.”

One such colleague is Plastic & Reconstructive Surgeon, Mr Naveen Cavale, who operates both within the NHS and at his private practice, Real Plastic Surgery.

“In the NHS, the reduction in ‘botch jobs’ from procedures carried out abroad since the pandemic started has been quite stark” he says. “I’m not looking forward to seeing poor patients who have had cheap plastic surgery abroad coming in with serious health complications again – all of which is a cost to the NHS – now that travel restrictions are starting to be lifted” he says.

“Something else to be aware of if you’re considering having cosmetic surgery abroad is that you won’t be able to seek legal representation for medical negligence from UK lawyers, as it’s outside of their jurisdiction” says Mr Cavale.

Dr Bessam Farjo agrees with this. “I think it’s important that people who are considering surgery abroad are fully informed. It’s often the case that patients who have come to us at Farjo for revision surgery haven’t received the level of treatment or care they were expecting when getting their procedure done abroad, so we want to arm people with the right knowledge to prevent this from happening. There are absolutely qualified and reputable surgeons based in medical tourism hotspots such as Turkey. I have colleagues based there who are just as upset by the situation and are actively lobbying the Turkish government to bring in stricter regulations to improve ethics and standards. Sadly, there are still a lot of cowboys so patients need to be extremely vigilant when choosing a clinic, whether that’s in the UK or beyond.”

The cost of cheap surgery abroad can be life-threatening too. “If there is a complication post-surgery once the patient is back home, it can have devastating effects” says Mr Cavale. “Take for example, if someone went abroad for a cheap breast augmentation, but once they’re back in the UK there’s an issue like a blood collection around the implant which may very well require urgent surgery and care. A surgeon in a different country isn’t necessarily going to be much help because of the distance, whereas if it was in the UK with an experienced surgeon, we would be able to get the patient back in quickly to remedy the situation. It’s situations like this where the NHS has to step in as a complication like this can be life-threatening” continues Mr Cavale.

Dr Bessam Farjo and Mr Naveen Cavale’s parting advice? Follow the below checklist of questions with any clinics (both UK and abroad) you are considering surgery with. If they can’t sufficiently answer the questions and you have doubts, it’s probably better to seek an alternative.

Checklist for potential patients to ask clinics offering hair transplant procedures:

Do you know who will be performing the treatment? It should be a highly experienced surgeon(s).
Who would be responsible for the surgical and critical parts of the procedure? Any crucial decision regarding design or action that involves cutting through skin should be done by a surgeon.
What qualifications does the practitioner have? They should be a doctor or surgeon licensed in that city or country. In the UK, they should be on the General Medical Council’s register.
Do the staff wear adequate PPE?
For hair surgery, From the photos and videos on the clinic’s website, do the staff use high powered magnification to perform the surgery?
Ask the clinic and surgeon how many treatments they perform ? For hair transplants, be wary of those where a doctor is responsible for more than 1-2 procedures a day.

Checklist for potential patients to ask clinics offering plastic surgery:

Ask how frequently the surgeon performs the procedure you intend to book in for? They should be performing it regularly and have many years of experience.
Check if the surgeon is properly qualified in the country they are operating in. They should be the equivalent of being board certified (US)/be on the GMC specialist register (UK).
What are the arrangements if there is a complication? Do they have facilities to take you back into the operating theatre to correct things even in the middle of the night?
What’s the procedure if you have a complication when you’re back in the UK? How easy is it in the following days/weeks/month to get things corrected? For example, if it’s a breast augmentation complication, all the NHS will offer is removal of the implant. You may find revision surgery costs a lot more.
Are they properly insured for complications?
In the UK we have care quality commission (CQC) regulated clinics. Is the facility where you will be having your operation the equivalent of CQC-certified?
Have they offered you an adequate cooling off period? Be wary of those pressuring you to book in immediately after a consultation.
Check to see if they are a member of associations that have a high level of standards e.g. ISAPS, BAAPPS, BAPRAS.