The Murky, Unscrupulous World of Plastic Surgery Tourism

Ever considered going on holiday – and getting a little nip, tuck while you’re at it? You are definitely not alone. From boob job breaks in Eastern Europe right through to luxury getaways offering five star treatment in some of the world’s most sought after destinations, medical tourism is increasingly popular. And if you’ve got cash to burn and an appetite for self-inflicted pain, there are worse ways you could go to enhance your aesthetics.

Take one of Bali’s world-renowned medical spas for example. A typical day might involve waking up, riding an elephant, hiking through a forest and having botox injections – all before lunch.

But perhaps you’d rather go to South Korea for facial surgery. The East Asian country now has the highest rate of plastic surgery per capita rate in the world, thanks to the hugely popular "aeygo" aesthetic; that is, a wide-eyed baby face and cute, SnapChat filter-esque features. Surgery there is cheap and efficient and people traveling from overseas make a significant contributor to the country’s GDP.

Meanwhile in Thailand companies like Gorgeous Getaways offer the whole package. For tens of thousands of dollars you can check in for as long as you want, enjoy first class hospitality, and get a whole new look while you’re sunning it up in total privacy.

From Asia we go to Africa, where Cape Town is increasingly putting itself on the map as a medical tourism destination. You can now book yourself in for a "scalpel safari." Travel itinerary: week one, face lift. Week two, see the big five. Or maybe you’d want to do that the other way round, so as not to frighten off the wildlife.

Of course if it is a better bum you’re after, you must go to Brazil. In 2012 the government made plastic surgery tax-deductible and experienced surgeons are both accessible and affordable. If it’s something further north you want to work on – your nose, perhaps – Iran is your best bet, where rhinoplasty is the specialty.

A tragic spate of international headlines have brought this booming industry to light – deaths in Turkey and Rio de Janeiro have both made the news in the last few weeks. Both of these involved bum improvements.

Around the world women—and it is almost exclusively women—are putting their lives at risk in the hands of doctors to "improve" their bodies. Or in many cases, to come closer to an increasingly homogenized idea of what a woman should look like. Let’s not all blame Kim Kardashian at once. Or should we? As Jameela Jamil recently pointed out; they’re starting to look a lot like double agents of the patriarchy.

This is no exaggeration – as a quick look at the maths reveals. According to research from the International Society of Aesthetic Plastic Surgery, in 2016 alone women accounted for 86.2 percent – or 20,362,655 – cosmetic procedures worldwide.

Watch: Brazilian Plastic Surgery: Beauty On a Budget

The five most popular procedures are Breast Augmentation (Silicone Implants), Liposuction, Eyelid Surgery, Abdominoplasty and Breast Lifts. In the same year men accounted for just 13.8 percent of cosmetic patients with 3,264,254 procedures performed worldwide.

Labiaplasty (designer vaginas to you and me) showed the largest increase in number of procedures from 2015, with a 45 percent rise. And guess what the least popular cosmetic surgery was in that very same year? Penile enlargement. The number of procedures also dropped by 28 percent.

“There are very few healthy messages out there” says Dr. Gerard Lambe, a Consultant Plastic and Reconstructive Breast Surgeon based in Manchester. “Designer vaginas are on the rise and I’ve seen that and I do that. It’s definitely a trend, and there are quite a few young woman who are wanting them.”

Going abroad for health reasons – or to engage in surgical or non-surgical personal improvement – is nothing new. There are Switzerland’s Mayr clinics, which promise to reset your gut and your life after a grueling week of existing on little but soda bread, water and colonic irrigation (let’s face it, you’re not really interested in gut health, you just want to lose weight and get better skin).

Then there are the countless yoga retreats, boot camps and detoxes where you can pay a small fortune for someone else to take control of your health for seven days straight. Even rehab centres are destinations now—why go to the Priory in drizzly, grey London when you can afford to splash out on Crossroads in Antigua?

But the huge and very important difference between surgical treatment centers and expensive rehab clinics are that the latter have trained medical staff who will speak English to you and crucially, run programs that ensure their patients safety and continued road to recovery long after they leave their facilities. The same cannot be said for many of the renegade plastic surgeons offering cheap fixes from their practices in the questionable zip codes of foreign cities.

Dr Lambe is adamant that the key to successful treatment is to meet a patient at least twice before agreeing to operate. “If I have any doubts, I put them through a screening questionnaire. It’s 14 to 15 questions which can be answered very quickly and it gives you an idea of how close they are to having body dysmorphia.” The idea behind the minimum two meetings is that the doctor can assess you properly, but also it gives you a chance to change your mind.

However, if you’ve just splashed out a fortune to travel halfway across the world, you’re probably not going to do that. So what if you’re confronted with some dodgy facilities and get cold feet? You’ve gone too far to back out now.

“It’s horrendous, if you go to Korea, you don’t understand the language, not everyone is going to speak first class English to you,” says Lambe, who during his 20 year career has become increasingly concerned with the global medical tourism industry’s lack of regulation. “That makes you feel isolated, that makes you feel vulnerable. If you go all the way to South Korea, you’re going to do it. They’re not going to talk you out of it, even if you are a bad prospect.”

It’s not the eye-wateringly expensive clinics that the tragic headlines emerge from. They come from the companies that dupe people with clever marketing scams and unbelievably small price tags. If you book a cheap-o holiday to Turkey for a butt lift and pay less than a grand the chances are you aren’t going to get a good service.

You also won’t ever see the same doctor again, and if complications do arise back at home you’re faced with having to find a surgeon with experience in the type of surgery you’ve undergone. If you do find someone in time? They won’t have any of your treatment notes or know what kind of operation you’ve had. In short: you’re pretty screwed.

“What people don’t see is that the complications rates can be as high as 30 percent at even reputable centers – and there are many of them abroad,” says Dr Jim Frame, a professor of aesthetic plastic surgery at Anglia Ruskin University in London and the President of the UK’s Association of Plastic Surgeons.

Frame is another industry heavyweight who’s noticed the rise of social media and its influence on young women and medical tourism. However, he’s not sure it deserves the negative press it gets.

“Rhinoplasty in young women has exploded in my practice and this shows the power of the media.” he explains. “I operated on a TOWIE lady and she went on National TV only a few weeks later clearly showing huge emotional benefit from the surgery which related to many listeners.”

Anyone wielding influence over young women has a level or responsibility, and there is a lot that goes on in the murky world of Insta-marketing which is far from responsible. “I’ve seen girls on Instagram and they are almost certainly body dysmorphic, they’re having procedure after procedure, their body shape is well outside what I’d call normal” says Dr Lambe. “They’re going for further tweaks – but never mentioning the risks that they’re taking. It’s completely the wrong way to promote it, and it is preying on people who are vulnerable.”

It’s not all doom and gloom. Occasionally, there are also some good stories which emerge from this hugely amoral world. Take Ivo Pitanguy, who died in 2016. The godfather of plastic surgery in Brazil was renowned for his celebrity patients – and for turning his home country into a global leader in plastic surgery. The list of clientele who are rumored to have visited his private island Angra dos Reis for his magic touch include Jackie O, Elizabeth Taylor and Sophia Loren. But as well as treating the 0.01 percent, he also operated on thousands of women – who had major burns and deformities – for free.

Turns out something good can come out of our obsession with looking perfect.

This article originally appeared on Amuse.