A staggering number of patients travel on ‘holidays’ to these overseas destinations, have very little work up done, have very little post-operative care provided and have absolutely no follow up organised. Dr Dilip Gahankari MBBS, MCh (Plastic), FRCS (Edin), FRACS (Plastic Surgery) Fellow of Royal Australasian College of Surgeons Member, Australian Society of Plastic Surgeons Member, Australian Society of Aesthetic Plastic Surgeons GENERAL HEALTH Over the years, I have had a fair share of patients with such complications. Examples are many, but some of the most interesting ones are as follows: There are dozens more patients and their sometimes tragic and sometimes almost incredible medical ‘misadventures’. I have treated several patients with infected breast implants, nasal prostheses in Australian patients of Asian origin, poorly executed eye lid procedures, poorly performed liposuction procedures, and more in my plastic surgery practice, spanning over several years. The experience of other plastic surgeons and perhaps other specialists is no different. Quite often, the cost of treatment of these complications to Australian taxpayers runs into many thousands of dollars. I am treating a young Middle-Eastern student next week, who had multiple injections of an ‘off-label’ collagen in the Middle East, producing a signifi cant knobby appearance of his chest. Such procedures are not performed in Australia by any qualifi ed surgeon or doctor. It can be argued that not all procedures performed overseas develop complications, and I am sure there are a lot of patients who do have satisfactory results and a positive experience from surgical procedures overseas. The big question is are these procedures considered a ‘lucky draw’? All medical and surgical procedures have potential risks. The Royal Australasian College qualifi ed surgeons in Australia (myself not excluded) also have our fair share of complications. But, at least we can be relied upon to provide a reasonable level of post-operative care and follow up, and most of us, as a courtesy to our patients, also provide an appropriately suited service to manage these complications and endeavour to get a satisfactory fi nal result. I have no personal reservation for people who wish to have surgery overseas for fi nancial or other reasons, but I do have a reservation about taxpayers (myself included) footing the bill for follow up and management of complications of these thousands of patients. Not only does this seem irrational and illogical, but it is evident that many of these patients seek further treatment in an already over burdened public system, thus potentially depriving other needy patients of their effi cient and timely treatment. If medical tourism is here to stay and thrive, can we at least legally compel the ever enthusiastic and entrepreneurial medical tourism companies or agents to pay for the treatment of complications, or follow up, say for an arguable statutory period of at least two years or so after these procedures? I certainly feel and hope that the burgeoning costs of treatment of complications of these patients who have been treated in an unregulated and uncontrolled environment, may eventually make the federal government think about strategies to impose restrictions on these medical tourism operators. pm ‘J’had an abdominoplasty procedure performed in one of the reputed Bangkok hospitals. Post-operatively, within days, she claims that she noticed blackened change of skin under her umbilicus. This concern was dismissed by her surgeon and she was advised to return back to Australia. She reported to Pindara A & E, with foul smelling discharge and blackening of nearly half the skin in the lower abdomen. She was referred to me and has so far required three operations, including removal of the substantial skin over her lower tummy and a large skin graft, and is likely to need at least one more major procedure for reconstruction. Fortunately she was privately funded and the taxpayer estimated expense so far has run past the $20,000 mark; nearly three to four times more than what she paid for the ‘budget’ abdominoplasty procedure. ‘K’ was seen a few years ago by me for ugly scars over her face and behind her ears and forehead. Her story was funny though tragic! She is a lady in her late thirties. She had an accident while travelling in a tuk-tuk in Thailand. She had a cut on her forehead for which she was taken to a ‘well known’ hospital for suturing of the cut on the forehead. All she remembers after “some sleeping drugs were administered” (her words – not mine), is someone asking her about doing a facelift at the same time while she was under. She apparently signed the consent and allowed it to be charged to her credit card (that she did not remember). She woke up with a suture on her forehead cut and a ‘facelift’. According to her, this did nothing to her face but caused fairly significant scarring in front and behind her ears – which required numerous injections of steroids and scar revision procedure. ‘N’ is a local Gold Coaster who went to Delhi, India, where a facelift surgery was performed. His reason for a consult with me within a couple of months of his surgery was significant asymmetry between the two sides, with one side much more tightly strung back than the other. The scars were sub optimal too. ‘P’ is a Caucasian lady in her late forties, who had an abdominoplasty procedure performed in a wellknown hospital in Kuala Lumpur, Malaysia. She woke up from general anaesthetic with second and third degree burns from diathermy (electrically induced heat), which took three months to heal and produced bad scarring. Pindara Magazine 66 Summer - Autumn | 2014
Pindara Private Hospital Magazine - Issue One
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