Medical tourism and extreme makeovers - April 2016

Written by Dr Jill Tomlinson on .

The sad news of Melbourne man Leigh Aiple's death following an overseas plastic surgery extreme makeover highlights the dangers of medical tourism but also needs to be considered in the context of the difficulty of accessing such surgery in Australia. 

News reports state that Leigh underwent extensive surgeries in Malaysia, including a full body lift, extensive liposuction, a thigh lift, an upper eye lift, a chin tuck, lip filler and chest sculpting. One of his surgeries took 11 hours and he had significant medical complications while in Malaysia but was cleared to return home. Tragically, the 31 year old man died of a pulmonary embolism less than 24 hours after he returned to Australia. 

Many medical organisations have highlighted the risks of medical tourism and the unexpected issues that may arise when plastic or cosmetic surgery is performed overseas. If your surgery is performed cheaply in another country it is more likely that the surgeon's qualifications and the operating theatre (including sterilising services) and hospital facilities will not meet the standards required in Australia. If you suffer a complication during or after surgery you may not have access to life saving intensive care units and specialist medical care. Even if such services are available, who will pay the costs?

Since January 1 this year body contouring surgeries in Australia have become much more expensive for many people, as the eligibility requirements for Medicare services for abdominoplasties, thigh lifts, arm reductions, body lifts and buttock lifts have tightened. To qualify for body contouring surgery with a Medicare benefit it is now necessary for individuals to have

  • a skin condition that risks skin integrity, and has not responded to treatment over three months
  • excess skin and fat that interferes with activities of daily living
  • lost weight of at least 5 Body Mass Index (BMI) units
  • maintained a stable weight for 6 months following the weight loss

Although listed in the Medicare Benefits Scheme, body contouring surgeries are not available through many public hospitals and even individuals who meet the Medicare requirements report that they are unable to find hospitals who will treat them. Individuals who do not meet the eligibility requirements for Medicare services will not receive rebates from Medicare or from their private health insurers for such surgery. Body contouring surgeries are therefore largely only available in Australia to people who are able to fork out the relatively high out of pocket costs for surgery, anaesthesia and hospitals, and the cost of managing any post operative complications that may occur.

This is a difficult situation for individuals who are seeking body contouring surgeries. Research demonstrates that this surgery can produce significant improvements in an individual's satisfaction with their body, their sex life, their self-esteem and their physical symptoms. Individuals who cannot fund such surgery in Australia, but can fund it overseas, will continue to participate in medical tourism. We can't stop this, and nor should we try. But we need be aware of the reasons why people seek this surgery overseas, and the risks they face - whether knowingly or unknowingly. 

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The Australian Society of Plastic Surgeons has a "Cosmetic Tourism Checklist" for individuals who are considering overseas plastic or cosmetic surgery. 

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