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New Zealanders are choosing to travel to countries including India, Thailand, Mexico and increasingly Turkey for medical, dental and cosmetic surgeries.
Some people choose to go independently, but there were several travel groups offering assisted medical package deals.
Travel industry veteran Jackie Brown, who runs Bums, Tums and Gums, was one of those offering deals, mainly to Mexico and India.
Brown said she would usually take a group of about six people overseas at a time.
“Everything is paid for before you go. I start a Whatsapp group two months before the trip and let them know what to pack, what to expect, how to deal with judgement from others.
“When I first started taking groups over a decade ago, medical tourism and plastic surgery was still seen as more of something the rich and the famous did, but times have changed with social media.
“People are more open now and often discuss their surgeries online.”
After the procedures, Brown said patients needed to spend at least six days out of hospital, or 10 for larger surgeries, before travelling home.
Medical tourism was a well-established practice, the New Zealand Dental Association’s chief executive Dr Mo Amso said, which he believed was mainly driven by cosmetic needs.
Moana McRae, a New Zealander living in Turkey who also ran her own medical tourism travel company, Oceanscape Group, said she had seen an increase in New Zealanders coming to Turkey for bariatric surgery in the last few years and as she had a background in travel, she launched her business.
She said with her group, rigorous pre-screening was done for all clients. Sometimes the surgeons she used did decline clients if they didn’t fit necessary requirements.
Clients completed an online screening form, then would send photos which were assessed by surgeons, and she would take care of the travel side.
She said while her clients were in Turkey, her main job was to make them feel supported and help with any language or cultural barriers.
Moana McRae, a New Zealander living in Turkey, runs her own medical tourism travel company, Oceanscape Group.
Supplied / Facebook
What are the risks?
Waikato bariatric surgeon Dr Rowan French said he worried about the way medical tourism was being marketed online as it seemed to be targeting Māori and people in low decile groups.
“They target people who are less likely to ask specific questions which need to be asked.”
This was especially true for weight loss surgeries like a gastric sleeve or bypass, as French said about 50 percent of those he operated on in New Zealand were Māori .
Some immediate risks were true for surgery anywhere, French said, including bleeding, but flying soon after a surgery carried a heightened risk of a person developing deep vein thrombosis (DVT), a serious blood clot.
President of the NZ Association of Plastic Surgeons Dr Michelle Locke warned a DVT or pulmonary embolism could cause a person to become seriously ill or even die.
Major surgery along with a long-haul flight increased this risk, she said. When she was doing elective surgery, she advised people not to travel long-haul for six weeks.
Amso said medical tourism was a “buyer beware” situation, as it was hard to know the clinical calibre of overseas providers.
“Most patients expect New Zealand level care and compliance, but every country has its own compliance landscape.”
Most dental clinicians in New Zealand would have come across dental work done overseas that needed revision, he said.
Anyone set on having dental work overseas, should check credentials of the clinicians and verify their qualifications and meet beforehand even if it was on Zoom.
“Dentistry is invasive and can be irreversible.”
For example, Amso said veneers, sometimes known as “turkey teeth”, involved shaving the teeth down heavily to clip on false ones, while in New Zealand veneers were far less invasive and the aim was to take away as little of the teeth as possible.
French said as a bariatric surgeon, he had dealt with people needing revisions after overseas surgeries.
In one case, he had a patient who had been given the wrong operation, he said.
He’d also recently removed the gallbladder of a woman who previously had a gastric sleeve in Turkey and became pregnant five months later.
After a gastric sleeve, French said patients were told to wait a year before trying to conceive, but she told him she had not been told of the risk.
Most people who had surgery overseas would make it back safely, French said, but “people were taking a risk”.
Plastic surgeon Dr Zachary Moaveni said surgery was not a single event, but a process that included assessment, the procedure itself and structure follow-up.
He’d seen complications including bleeding, poor scarring and people unsatisfied with the overall look of a cosmetic procedure which only became apparent weeks later when a patient was already back home.
“Patients are sometimes reassured concerns will settle, and while this can occur, it is not always the case. At that point, access to the original surgeon is limited and responsibility for care can become unclear.”
Brown said on her tours, she’d only had one person get sick while overseas following a surgery but put it down to the client not listening to instructions.
“She hadn’t brought her medication for high blood pressure with her and was in her hotel room eating chocolate and vaping despite having Type Two diabetes.
“She became sick, so I spent an extra week with her in hospital until she was well enough to go back to New Zealand.”
She said it was important anyone debating overseas surgery did their research as the market of medical tourism was now oversaturated with companies.
“I would make sure the tour guide has accreditation, insurances and knows the health system in the country.”
Moaveni said patients needed to think carefully about who would take responsibility if something went wrong.
That included who was responsible for follow-up care once back in New Zealand, how accessible is the surgeon and what is the plan if revision surgery is needed.
“It is also critical to understand revision surgery is not simply a second attempt. It is almost always more complex, more expensive and less predictable than primary surgery.
McRae said she had seen complications occur and would never recommend someone have surgery overseas independently.
“I’m shocked some people think they can navigate it independently. Many people I encounter who do that do it for a cheaper deal.
“Research is not Facebook groups; it’s not social media influencers.”
McRae said medical tourism wasn’t inherently unsafe, but the pathway mattered.
She said the safest pathway was pre-approval by a licensed surgeon before travel, full medical screening and agreed treatment plans, use of internationally accredited hospitals, complication insurance and clear ownership of aftercare.
“When structured properly medical tourism can provide access to high-quality care, when it’s not, that’s where problems arise.”
What are people getting done?
Bariatric surgery was the main thing McRae was seeing in Turkey, partly because she said dental work and aesthetics needed a lot more personalisation.
Brown said New Zealanders were choosing to have all sorts of surgeries overseas, but the most frequent ones she saw were weight loss surgery, “mummy makeovers”, loose skin removal, orthopaedic surgeries and face lifts.
Moaveni said in terms of plastic surgery, patients were generally more discerning about who they saw for any procedure done to their face, so the more commonly marketed procedures overseas included breast surgery, tummy tucks, weight loss surgery, liposuction and hair transplants.
Why do people do it?
Affordability was the main driver behind medical tourism, Amso said, noting there was a big difference in prices for things like dental implants.
Brown said in India, someone would be able to have a full face-lift for about $12,000, up to $20,000 in Thailand and up to $40,000 in New Zealand.
She said hip replacements could also be done in India for about $12,000 compared to between $20,000 and $40,000 if going private in New Zealand.
It also meant people didn’t need to wait for years on the public waiting list, she said.
Brown herself had a facelift in Thailand in 2014, which led her to beginning her own business to take other people overseas.
Most of Brown’s clients were women over 40, she said.
McRae said more people were choosing overseas surgery as social media had made it look possible for people.
“It’s accessibility, affordability, desperation. Not always about the cost.
“Social media influencers play a big part in it.”
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