By Alastair Brown, Consultant Plastic Surgeon
22:01 28 Oct 2023, updated 10:29 29 Oct 2023
The images show enticing sun- dappled beaches, luxurious five-star hotels and bikini-clad models. But these adverts are not for holidays – they are promoting Turkish clinics that offer cosmetic surgery at a fraction of the cost in the UK.
Anyone considering a boob job, butt lift or even a full-body ‘mommy makeover’ – multiple operations including a tummy tuck, liposuction, thigh and arm lifts and genital rejuvenation – is offered a cut-price procedure carried out by ‘world-class doctors’. And, into the bargain, you get to stay at a five-star Mediterranean resort.
Too good to be true? Unfortunately, yes.
As a consultant plastic surgeon working in the NHS in Belfast, and a spokesman for the British Association of Plastic and Reconstructive and Aesthetic Surgeons (BAPRAS), I have seen first-hand the life-changing and potentially fatal consequences of travelling abroad for budget surgery.
I see patients returning with serious infections, wounds re-opening or breaking down completely, collections of blood or other fluids, and implants which have become exposed.
As a consultant plastic surgeon working in the NHS in Belfast, and a spokesman for the British Association of Plastic and Reconstructive and Aesthetic Surgeons (BAPRAS), Alastair Brown has seen first-hand the life-changing and potentially fatal consequences of travelling abroad for budget surgery Reality TV star Lauren Goodger, pictured, has undergone extreme plastic surgery
One patient lost a significant portion of her breast after a devastating complication of surgery in Turkey – where infection set in and the breast tissue died, known as tissue necrosis.
Doctors performing bariatric surgery are regularly horrified by the results of botched weight-loss procedures, while dentists describe how the lure of having pearly white teeth – known as ‘Turkey teeth’ – can destroy a smile for ever.
Other countries have jumped on to the surgery tourism bandwagon, with equally mixed outcomes. But there has been a flood of cosmetic surgery tourists to Turkey in recent years – an estimated 150,000 from the UK last year alone – and at least 25 Britons are known to have died since January 2019 following medical procedures there.
There is often a common theme – very little or inadequate pre-operative assessment. This is where a patient meets the surgeon in advance to discuss if the procedure is right for them. Is the outcome they want realistic, for example, and has the surgeon considered their psychological wellbeing?
Charlotte Crosby, pictured, is another celebrity who has undergone plastic surgery
Often with Turkish clinics, this is done over WhatsApp, so patients cannot be properly examined – a vital part of the process. I have heard of many instances where patients have been forced to agree to a change of plan as they’re being wheeled into theatre.
Many fly home too soon after their op, and I’ve heard of people standing in airports, with blood dripping down their legs or fluid oozing from wounds.
That leaves the NHS to pick up the pieces. It will treat anyone in a life-threatening situation, regardless of how they got their injuries. But it cannot be relied upon to fix the disfigurement patients might be left with, so they may have to spend thousands on private surgeons to attempt to rectify any issues.
Complications can happen even in the best of hands – UK or abroad. There are some excellent clinics and surgeons in Turkey, but unlike in the UK, it’s harder to work out who they are. If you’re presented with a rock-bottom price for something that usually costs significantly more, ask yourself why it’s so cheap. Is experience lacking or might materials be poorer quality?
My warning is this: what was meant to enhance your appearance can result in quite the opposite.
Here’s why that cheap deal may cost you much more in the longer term – not just financially, but physically and psychologically.
Why the UK halted the Brazillian butt lift
Made popular by curvier celebrities, Brazilian butt lift (BBL) surgery – where fat is injected into the buttock muscles to make them larger – is much in demand, despite being one of the most deadly cosmetic treatments in the world.
The danger comes if fat is injected into the wrong place. If it gets into the bloodstream, rather than staying in the muscle, it can travel to the heart, lungs or brain causing a blockage, known as an embolism.
It was this which caused beautician and mother-of-three Leah Cambridge, 29, from West Yorkshire, to suffer three heart attacks and a pulmonary embolism on the operating table.
Louise Bradley, who paid £2,000 for the op in 2022 after being on the NHS waiting list for four years, will now be tube-fed for life after Turkish surgeons removed 92 per cent of her stomach, rather than the 75 per cent previously agreed
Two other British women have died from BBLs performed in Turkey in recent years.
Patients often come back with asymmetry, lumpiness or an infection. The fat can also be harmed during the procedure, causing the tissue to die – known as fat necrosis – which means it will not be taken up by the body.
All these issues led to UK bodies strongly advising against performing the BBL in 2018.
Any sort of filler or implant can lead to similar problems. About 25 per cent of the complications we see come from breast augmentation. Patients can get a bleed around the implant or an infection. The wound can break down or an implant – often too large for the patient – can become exposed. Sometimes the technique is at fault, or the aftercare isn’t sufficient.
Breast reductions also cause problems if surgeons plan ops badly or have poor technique. Infections can be problematic, and skin and tissue can die.
Turkey teeth that can ruin your smile for ever
They are a must-have for the Instagram generation: a set of blindingly white and straight teeth. Former glamour model Katie Price and Love Island stars have flashed their ‘Turkey teeth’ online to promote clinics offering the perfect smile in just a few days – for a low cost.
But my dental colleagues are warning that the cut-price procedures are ruining people’s natural teeth permanently, causing speech and muscular problems and leading to serious dental infections.
Paul Woodhouse, a dentist at Grange Dental Practice in Norton, County Durham, says he treats two patients a month who come back from Turkey and need repair work.
He told me: ‘One 19-year-old came back with 20 crowns – he couldn’t talk properly any more.
Former glamour model Katie Price and Love Island stars have flashed their ‘Turkey teeth’ online to promote clinics offering the perfect smile in just a few days – for a low cost
‘He was lisping and couldn’t pronounce certain letters. His jaw was in trouble and he was in agony.
‘Three of his teeth were dying off because they’d been shaved down so badly they’d killed the nerves, and another two or three were going that way.’
Turkish clinics often use strips of crowns joined together, rather than individual ones, which means shaving down healthy teeth to little pegs in order to fit them on properly.
Dr Woodhouse adds: ‘It’s done for speed and low cost, not what’s best for patients. You can’t floss. You can’t clean them properly. You get gum disease because food gets trapped there and festers.
‘And they only last ten years, then need replacing.’
Few NHS dentists are prepared to repair these botched jobs, he warns, so patients face hefty private bills – in his example, it cost the patient £27,000.
‘These people have perfectly good teeth which they’re destroying,’ Dr Woodhouse says.
‘He could have had a few months of braces, some whitening and maybe a few veneers to smooth some edges off.
‘It takes time, and it would be more expensive, but buy cheap and you buy twice, as my grandfather used to say.’
Life-changing problems from weight-loss ops
This is the most grave and growing problem for my bariatric surgery colleagues.
As Professor David Kerrigan, a past-president of the British Association of Obesity and Metabolic Medicine, says: ‘We are seeing a regular stream of patients coming back from Turkey seriously ill after gastric sleeve surgery. Almost every NHS Trust which performs bariatric surgery has had patients in with complications.’
If you DO choose to go abroad
Weigh up the potential savings against the risks before you go. Get travel insurance.Research the clinic and the specific surgeon. Do they have the right training and experience, and are they a member of a recognised organisation, with indemnity insurance? Make sure there are no language barriers.Meet your surgeon face-to-face and get a full assessment before agreeing to anything. They should go through the whole procedure and take you through any possible risks and complications. Do they have before and after images? It is not appropriate to see your surgeon for the first time right before surgery.Ask what aftercare is available. If something goes wrong, you need the team to be on hand within hours. Will there be extra costs?Avoid getting on a plane too soon after surgery as there is a risk of life-threatening blood clots.Don’t be pressurised into anything. Some patients are made to change what they planned minutes before their op – with additional costs. If it doesn’t feel right, don’t proceed.
In the UK, gastric sleeve procedures are carried out safely and with few complications.
They involve removing about 70 to 80 per cent of the stomach, leaving behind a sleeve shape which reduces feelings of hunger as well as the capacity to eat.
But NHS waiting lists are long and private surgery in the UK is expensive, driving some patients to cut-price treatment in Turkey.
‘There is aggressive marketing by Turkish clinics but the quality of the equipment is lower and the techniques used are poorer,’ says Prof Kerrigan, who runs Phoenix Health, which carries out weight-loss surgery for the NHS.
‘Patients are coming back with leaking from the staples which secure their stomachs back together – it’s like having a burst ulcer, with stomach fluid and acid leaking into the stomach cavity.
This leads to peritonitis and can cause sepsis, which can be fatal.
‘Other patients are left with such a narrow stomach that they can’t swallow or eat, and they need revision surgery.’
Louise Bradley, who paid £2,000 for the op in 2022 after being on the NHS waiting list for four years, will now be tube-fed for life after Turkish surgeons removed 92 per cent of her stomach, rather than the 75 per cent previously agreed. The mother-of-two, 33, from Derbyshire, said: ‘My advice to anyone thinking of having surgery abroad is don’t.
‘People say, “Well this could have happened in the UK,” which it absolutely could have – but they would have had a duty of care to fix it.
‘I feel like people are sold a fairy tale, but it’s just a butcher’s table out there.’
Tummy tucks – removing excess skin or fatty tissue, and tightening up the abdominal wall – also lead to problems.
We see belly buttons that can get infected and fill up with fluid and blood.
Facial ‘tweakments’ causing paralysis
When facial surgery goes wrong it is impossible to hide, as some patients who have travelled to Turkey for cosmetic tweaks, facelifts or eyelid operations, known as blepharoplasty, will know.
There are some very important and delicate structures in the face. Catch the facial nerve and it can lead to severe paralysis, which can look like a stroke.
Patients have come back with significant scarring from facelifts. And with blepharoplasty, if too much skin is removed it can pull the eyelid down and cause other problems such as very dry eyes, watering and tearing.
One woman on TikTok told how she couldn’t blink any more after her Turkish treatment.
And there are countless horror tales from people going for smaller so-called ‘tweakments’, such as a ‘fox eye’ procedure which involves inserting a thread to drag the skin around the outer edge of the eye upwards, creating a slanted effect in an attempt to mimic some top models but instead ending up with lopsided faces, scarring and pain.
These ‘threadlift’ procedures may not be permanent but they still carry a serious risk of damaging nerves. The tiny hooks that hold them in place in the face can dislodge and cause infection or even disfigurement.
Plastic surgeon Monica Fawzy, who specialises in facial procedures, says: ‘Even facial fillers can have complications. Filler can be injected into a blood vessel which can cause the skin to die over that area, blindness if it’s near the eye or a stroke.
‘With blepharoplasty there’s a risk of blindness if there’s bleeding behind the eye putting pressure on the optic nerve. You can get inflammation, swelling and asymmetry, too.’
The hair transplant that leaves you balder
Complications from a hair transplant may not be life-threatening but can still be distressing.
Clinics in Turkey may offer to perform the procedure for about £1,000 – a fraction of the £6,000 often quoted in the UK. But I’ve heard of cases where the procedure has actually worsened the thinning, requiring lots of extra work to repair the damage by UK private clinics.
There are two types of transplant. Follicular unit transplantation – the ‘strip method’ – involves taking strips of hair from the back of your head and dividing them into ‘grafts’ of several hairs each, which are then inserted into tiny cuts in the scalp in the area you want hair to grow.
Complications from a hair transplant may not be life-threatening but can still be distressing
The alternative is follicular unit extraction – shaving the back of the head and removing hair follicles one by one and placing those into the tiny cuts.
But with either method there is always the risk the surgeon takes too many hairs or that the hair grafts may not take root – particularly without good aftercare.
These issues can leave the patient with new gaps at the back of the head, and also continuing baldness in the problem area.
A good surgeon will also make sure the graft matches the direction of the existing hair follicles. If this isn’t done, and the hairline isn’t carefully planned out, it can grow back unnaturally – and end up looking like a transplant rather than normal hair.
In many of these cases, where procedures are botched in Turkey, even corrective surgery cannot bring you back to where you were. The consequences can be lifelong.
In my opinion, it’s not a price that anyone should pay.
