Tropical scenes tempt patients overseas, where post-op care includes recovery in a luxury resort. This may cover immediate complications but delayed problems will arise some weeks later when support is then at a distance.

Those in the market for a nip and tuck are finding cosmetic tourism an attractive option. The promise of cheaper rates and recovery in a luxury Southeast Asian resort are drawing a growing number of patients overseas, but not everyone is convinced. There are accusations of poor-quality work and limited patient monitoring, and we could find no strong audit trail behind the surgeons’ or tour operators’ endorsements. Complication rates of a few percent can make a real difference and there is a natural reticence to return to the original operator if things go poorly and you are out-of-pocket and have no legal means of redress.

Ms Rebecca Degenaar

Nevertheless, business at one cosmetic tourism operator, Restored Beauty Getaways, is booming. In 2003, brother and sister team Rebecca and Robbie Degenaar established their first branch in WA and have since expanded to ten offices across Australia and New Zealand. Cheaper rates and the promise of recovery in four-star comfort has lured over 1800 patients since business began, now running at 45-50 customers every month.

They offer the full gamut of cosmetic procedures, including laser eye surgery and cosmetic dentistry. Rebecca said most customers choose packages that include surgery, travel and accommodation. Their agency has exclusivity arrangements with Bangkok Hospital Pattaya and Bangkok Hospital Phuket.

Patients are flown to Thailand for surgery and recover in a hotel close to the hospital where follow-up appointments are made.

How much cheaper?

Cosmetic tourism websites tempt customers with photos of tropical paradises and, as with Restored Beauty Getaways, boast “incredible savings”; bilateral breast enlargement – one of their most popular procedures – costs $3700, plus an extra $1800 for travel, accommodation and taxes.

Dr Mark Duncan-Smith

Even so, this falls far short of the $10-12,000 WA Society of Plastic Surgeons President Dr Mark Duncan-Smith said customers can expect to pay in Perth.

He suggested [the relative handful of] patients whose abdominoplasties or breast reductions may be covered by Australian Medicare could be more out of pocket if they took the cosmetic tourist option.

How safe is it?

Rebecca said the hospital they use in Thailand is accredited by the Joint Commission International, a private assessment company that certifies much of the US hospital system. They have used the same plastic and reconstructive surgeons in Thailand for eight years, who each have 15-30 years’ experience. All are listed on their website, including their credentials. Post-op care lasts the duration of the patient’s stay in Thailand (typically eight days) and Rebecca said they also monitor patients closely when they return home.

Mark agreed it is likely WA surgeons are losing business to overseas providers, and said it is worrying that patients are turning their backs on WA surgical expertise.

“We have world-class people here. If you’re going somewhere and you’re not willing to drink the water, then why would you go there for surgery? The most important time you’ll find out how good your surgeon is, is when something goes wrong. With cosmetic tourism, you’ve already buggered off by then.”

If the patient requires corrective surgery, Rebecca said they are returned to Thailand free of charge under the Thai hospital’s insurance but this has not happened in her experience. Mark is not convinced this promise means endorsement for the service.

“I heard one of these companies saying they offer a free return fare is something goes wrong, but they’ve never had to do it. It’s just ridiculous to suggest they’re not having any problems – it’s that patients aren’t going back to them with their problems,” he said.

Mark has noticed a “definite increase” in the number of corrective surgeries he is performing on patients who have returned from Asia, including breast augmentation, and he mentioned unconfirmed reports of “knock-off implants coming out of Asia” being used.

“I’ve even had a couple of patients who’ve had surgery in Southeast Asia who had silicon injected into their breast, rather than actual breast implants,” he said.

Rebecca is aware of these reports, but said all their breast enlargement patients receive a certificate verifying the authenticity of their implants.

These stories have done little to reduce the demand for overseas surgery. Rebecca said word of mouth and a strong Facebook following means there is no need for them to advertise. They regularly hold free information seminars, and appearances on Today Tonight and Women’s Day have also helped to get the company’s name heard.

“It’s flat out at the moment, we’re really busy,” Rebecca said.