Cosmetic and obesity surgery abroad is costing the NHS nearly £20,000 per patient when things go wrong, analysis suggests.
A review of surgical tourism found people can spend several weeks in NHS hospitals when they return home from having procedures such as bariatric surgery for obesity, tummy tucks and breast enlargement.
Complications treated by the NHS include infected wounds, with some people needing intensive care and prolonged use of antibiotics.
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Researchers said they were also aware of reports of multiple organ failure due to sepsis from wound infection, and death due to hypoxic brain injury and cardiac arrest.
The authors of the new study, published in BMJ Open, said the scale of the problem is underestimated due to a lack of data.
Experts from Cardiff and Bangor universities examined 37 studies, of which 19 included complications treated by the NHS due to metabolic/bariatric surgery, 17 included complications due to cosmetic surgery, and one involved complications arising from eye surgery.
The data included 655 patients treated by the NHS between 2011 and 2024 for complications.
Researchers calculated the NHS cost of people having their surgeries abroad and then needing care in the UK, with figures ranging from £1,058 to £19,549 per patient, although there was some uncertainty over this evidence due to available data.
Of those studies that reported length-of-stay in hospital, the maximum stays were 45 and 49 days, with the average for metabolic/bariatric surgery being 17 days.
Most patients in the studies were women (90%), with an average age of 38, and the most common destination for surgery was Turkey (61% of patients).
The most commonly reported procedures were sleeve gastrectomy (where about 80% of the stomach is removed to leave a pouch), breast enlargement, and tummy tucks.
Overall, 22 studies on 371 patients reported more details on complications, with at least 196 patients (53%) in this research experiencing moderate to severe complications.
The study calculated hospital costs but warned that extra costs, such as people seeing their GP, a nurse or pharmacist, were on top.
Emergency and semi-urgent surgery, dental and transplant surgery, cancer treatment and fertility treatment was also excluded.
The authors said: “We still do not know how many people resident in the UK go abroad for elective surgery or how many people subsequently experience complications.
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“Without these data, we cannot fully understand the levels of risk that people seeking surgery abroad are taking.
“Those seeking medical treatment abroad should be made aware of which complications the NHS is responsible for treating, and costs for which the patient may be potentially personally liable, including non-emergency treatment.”
The authors said doctors in the UK also do not have access to full notes or know exactly what happened during surgery when they are treating people.
When looking at why people go abroad, research suggests it may be because procedures are not available on the NHS, private operations are cheaper abroad, and NHS waiting times can be long.
The number of medical tourists has risen steadily over the past several decades, a trend that shows no sign of abating, the researchers said.
The Royal College of Surgeons of England (RCP) echoed calls for national data on the problem.
RCP England vice-president Professor Vivien Lees said: “Too often people are drawn in by cut-price deals and glossy online marketing, only to return with serious, sometimes life-changing complications.
“When things go wrong, the NHS is left to pick up the pieces, often in emergencies and without full information about what surgery was done or by whom.
“It should not be the role of the NHS to routinely mop up the mistakes of private providers overseas, and we would encourage the Government to continue bringing pressure to bear on foreign providers and other governments, including to cover the costs of complications that happen in their countries.”
In 2024, Health Secretary Wes Streeting said he would work to improve safety for Britons travelling abroad for cosmetic procedures in the wake of several deaths.
He said his “strong advice” to British travellers seeking Brazilian butt lifts, tummy tucks and other cosmetic treatments was to think carefully before taking up offers that are “too good to be true”.
Asked whether the NHS should be picking up the pieces when things go wrong, he said: “We’re never going to turn people away who are in need of care but this is another pressure the NHS doesn’t need.
“So I would urge Brits – before travelling abroad – to think very carefully before accessing those cosmetic treatments that are currently being marketed at rock-bottom prices.”
Deaths as a result of surgeries abroad
Kaydell Brown, 38, from Sheffield, signed up for multiple surgeries but died after going into theatre in Turkey 2024.
An inquest also heard how Hayley Dowell, 38, suffered medical complications at a private clinic and died after she had a Brazilian butt lift, tummy tuck and liposuction in October 2023.
Janet Lynne Savage, 54, from Bangor, died after major artery trauma during a gastric sleeve weight-loss procedure in Turkey in 2023.
And Anne Towlson, 58, who travelled to Turkey in April 2024 for a tummy tuck, liposuction and arm-tuck surgery was found dead at home with open wounds to her armpits and triceps.
A Department of Health and Social Care spokesperson said: “Too many people are also being lured overseas for cheap cosmetic procedures, only to come home with life-changing complications that – as this report shows – end up costing the NHS thousands of pounds.
“We have launched a major drive to crack down on dangerous medical tourism and raise awareness of the risks medical tourism brings.
“The UK Government has been actively engaging with governments overseas on how to support the safety of patients who decide they wish to travel for medical treatment, and will be updating its guidance in due course.”
For advice on surgery abroad:
Foreign Travel Advice – Gov UK
British Association of Aesthetic Plastic Surgeons
Have you been impacted by botched surgery abroad?
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