Surgeons call for compulsory insurance as cosmetic complications soar

[THE British Association of Aesthetic Plastic Surgeons (BAAPS) is calling for action to be taken to address the issues associated with botched cosmetic surgery carried out abroad. They are calling for travel insurance to be made compulsory in order to protect patients and reduce the burden on the NHS, as complications from cosmetic surgery abroad rise by 44%.

An audit published by the association revealed that complications from patients having surgery abroad rose during the COVID pandemic as people sought out cheaper deals outside the UK. The audit showed that 324 patients required further surgery after returning to the UK in the past four years. The annual number rose by a staggering 44% in 2021 compared to the previous year – a period when people were being advised against elective surgery and unnecessary travel.

In 2021, 75 women and seven men were treated for complications, which included some with life-threatening problems such as the need for emergency surgical removal of dead skin tissue – known as debridement – and admission to intensive care for life support following systemic infection. Those complications, despite treatment, would still leave permanent life-changing physical deformities along with the psychological effects of the injuries.

A survey of BAAPS council members showed that all of the complications came from Turkey and that abdominoplasty accounted for 75% of them, followed by breast surgery procedures.

Travelling for cosmetic surgery is not a new phenomenon. A BAAPS survey in 2009 highlighted the extent to which the NHS manages the complications of cosmetic tourism. However, patients travelling abroad during the COVID-19 pandemic for aesthetic surgery is especially alarming.

The lack of individual responsibility is being highlighted by BAAPS: many of the patients suffering complications are treated on an already strained NHS. One study presented to BAAPS in 2017 suggested the average cost to the NHS per patient was a staggering £13,500, a figure which is now estimated to be closer to £15,000. Many also need private treatment, wiping out any saving they may have made by going abroad in the first place.

Mary O’Brien, president of BAAPS, commented: “When patients go abroad for cosmetic surgery, they usually have no knowledge of the competence and experience of the surgeon; and there is very little prospect of follow-up care and advice. Best practice is compromised by the fact that patients are only meeting their surgeon immediately before a procedure – at which point generally they are committed to and have paid for the surgery. Patients then return to the UK without adequate medical records, if any. Follow-up is difficult. Complications do occur and are usually left to the British system to pick up. The surgeons involved in these schemes do not have a work permit nor are registered in the UK, and it is unlikely there will be any possibility of seeking revisional surgery.”

Consultant plastic surgeon and BAAPS council member Caroline Payne explained the factors that led to the increases in cases: “BAAPS members were very cautious in recommending surgery during the pandemic. Additionally, many private hospitals were assisting the NHS with their facilities to help with emergency and urgent medical need, as were many of the BAAPS surgeons themselves. Unfortunately, COVID does not seem to have deterred patients from seeking low-cost options abroad and some UK clinics are paid to refer patients to Turkey. “Cheaper can sometimes prove to be more be expensive – if patients need things put right or are worried and need a follow up consultation they may have to fly back. That additional cost can wipe out the original saving. Alternatively, they may have to pay a surgeon in the UK to correct the procedure or the NHS may end up shouldering the responsibility.” As restrictions ease, an increasing burden of patients with complications from cosmetic tourism needs to be avoided at all costs. That is why BAAPS is calling for cosmetic surgery travel insurance to be made compulsory to help tackle the situation.

Mary O’Brien explained: “Patients travel abroad mainly for cost saving. As such they gloss over expertise, and the higher complication rates associated with lesser expertise puts the patients and NHS at a burden on their return. This could be addressed with compulsory travel insurance. Furthermore, increasing the overall cost for patients travelling abroad for cosmetic surgery would perhaps make them think twice about a decision that could have serious, if not lethal, consequences.” q