22 Jun All Tied Up
It sounds wonderful. Travel to an exotic Asian location. Have cosmetic surgery at a dirt cheap price. Then enjoy the rest of your time there doing the tourist thing whilst you recover.
It all sounds too good to be true. And like most things that sound like that…
The reality is somewhat different. For starters, you are going ahead with a significant surgical procedure performed by someone you’ve never met and whose reputation you are totally unaware of. You usually don’t know his name and you probably would have difficulty spelling it or even pronouncing it correctly. You don’t know what his formal qualifications are and you don’t know the process by which to check them. The qualifications can mean different things in different parts of the world so even for an expert it all becomes quite confusing.
And of course who is giving you the anaesthetic? In Australia, this would be given by a specialist anaesthetist who is every bit as well trained as his Plastic Surgery colleague. In different parts of the world, anaesthetics are given by technicians or nurses or persons of lesser qualification. Do you really want your life in their hands?
Then there’re the simple mundane things. What if you get sick from the food or the water? And will you really feel like bouncing around in a tour bus the day after an operation? Chances are you’ll probably end up in your hotel room and wouldn’t you really be more comfortable in your own bed or at least in a hotel room where there wasn’t a significant language barrier.
Bona fide Australian Plastic Surgeons are trained to a very high standard with stringent entry and exit examinations for their qualifications. Plus there are extensive ongoing continual medical education demands and recertifications. By the time an Australian Plastic Surgeon starts private practice he usually has about 8 years of surgical experience behind him and he or she builds on this experience with national and international meetings with the best guest speakers.
Recently Australian Plastic Surgeons have had to extend their clinical experience by learning to deal with the aftermath of the increase in Asian cosmetic tourism.
Breast augmentation is a commonly performed procedure both here and abroad. But one of the key elements to success is excellent communication between patient and surgeon. Selection of an appropriate implant, location of surgical incision and technique would be impossible without it. Regrettably many Australian Plastic Surgeons are seeing examples returning from overseas where even these basic principles have been ignored. The patients are very disappointed and often disfigured and are now faced with the cost of reparative surgery and sometimes replacement implants which may exceed the sum they would have paid if the surgery had been performed locally. Ten days ago I saw a girl who was very disappointed with her breast surgery. The scars were poor and inappropriate for the procedure and she had remarkable breast size asymmetry. She told me she’d always had different sized breasts but the same sized implant had been used on each side. I have no explanation for this approach. I would use implants of different sizes in probably 30% of my patients as breast asymmetry is extremely common.
And speaking of implants, how do you know what sort of implants you are receiving? Medical devices such as implants in Australia have to pass the stringent standards of the TGA. Other countries may not necessarily have such bodies or such standards. And in particular, in the context of countries where labour costs are much less the cost of the implant may seem exorbitantly high and there is a natural tendency to gravitate towards less expensive and possibly less reliable brands.
Then there was the lady who had had her nose done in Asia. Now you couldn’t pick an operation which is more different in the different racial groups than rhinoplasty. The original techniques of rhinoplasty evolved in central Europe as a method of assimilation for the Jewish community who were subject to prejudice and wanted to blend in with their new countrymen. As such it was mostly an operation that involved reducing the bony and cartilage structures of the nose – getting rid of the hump or the hook.
On the Gold Coast and in Australia, in general, the modern rhinoplasty is commonly a combination of subtraction and addition. Bone or cartilage may be removed to give a straight bridge line but cartilage may be added elsewhere to highlight the shape of the tip for example.
The Asian rhinoplasty is diametrically different to this. It usually involved adding structure to the nose which may be in the form of a prosthesis which is much better tolerated in the Asian face than in the Caucasian. Thus the surgeon’s perspective and techniques and experience would be inappropriate to the Caucasian.
Facial rejuvenation is again another commonly performed procedure both here and abroad. It is a very sensitive procedure as scars have to be very carefully placed as no one wants to look obviously operated on. I have seen several examples coming back from overseas where the facelift scars rather than being hidden in their usual location tucked tight around the contours of the ear were well out onto the cheek and below the ear and very visible.
There are excellent Plastic Surgeons both here and abroad. For my own further training in Asian cosmetic surgery, I spent time in Hawaii, Japan and Malaysia. Their expertise with shaping the upper lid and their techniques for nose reshaping in the broad flat nose have contributed enormously to our overall skill base.
When you choose a specialist here at home you talk to your General Practitioner, you talk to your friends and you try to find the person with the best reputation. For cosmetic tourism to Asia, all you have is the word of an intermediary whose business is to get as many people as possible to sign on for these trips. Scarcely an unbiased party.
So let the buyer beware. Tour the wonderful locations in Asia when you can best enjoy them, but plan anything as serious as a significant cosmetic procedure very carefully. You’ve grown up accustomed to the Australian healthcare system and you intrinsically expect a certain standard. Standards, however, vary from country to country and safe guidance may not always be there.