14 Aug
Cosmetic surgery for Men, Turkey

Welcome to the Era of the Fake Six-Pack

Chiseled, visible abs were once something you’d see only on genetically-gifted gym rats.  But these days, a growing number of men are paying big money to have a surgeon do the chiseling for them. And in Turkey it’s not the big prices plastic surgeons want in the US or Australia! And the men are flocking!

At the 1993 conference of the International Society of Aesthetic Plastic Surgeons, in Paris, a young doctor gave a speech with a provocative hook: What if liposuction could be used to give men six-pack abs? To the crowd of surgeons, the idea seemed foolish. “There was a little bit of uneasiness with the technique,” remembers the surgeon, Dr. Henry Mentz. He was largely ignored.

But Mentz had proof that this procedure could work. In 1992, he had been approached by a male model who, despite being in excellent shape, was never quite able to get a chiseled stomach. Could Mentz help? The model specifically asked if Mentz, who was just starting out in his practice, could use liposuction to carve grooves that would reveal his underlying abdominal muscles.

He gave it a shot. The results looked good. So Mentz did the procedure a second time, and a third, and a fourth. He co-authored a paper on this new technique, which he called “abdominal etching.” Now, 30 years later, he’s performed the operation over 3,000 times, and says the results have been “extremely durable.” Over the years, Mentz gave more speeches at more conferences. New technologies made the operation easier and available to more patients. Other surgeons embraced and evangelized the tech—some learning from Mentz, others cooking up similar ideas on their own. (Like agriculture and calculus, abdominal etching seems to have been invented in several places at around the same time.)

Ab Etching Welcome to the Era of the Fake SixPack

At plastic surgery conferences, ab etching went from fringe topic to headlining act; Dr. Daniel Markmann, ​a Baltimore-based plastic surgeon who independently began etching abs 20 years ago, says that at a 2021 conference it was “all anyone could talk about.” When Markmann started his practice decades ago, less than 5 percent of his clients were men. That has jumped to 30 percent, and, he says, “It’s all six packs.”

Now abdominal operations are everywhere. “If you look on almost any plastic surgeon’s website, they will have a section on men, and they’ll have a picture of a model who has zero body fat and really defined abs,” says Dr. Joshua Korman, a plastic surgeon based in Mountain View, California. He isn’t surprised by the rising popularity. The lure of a six-pack is obvious. “That’s what high school boys want,” he says. “That’s what college guys want. That’s what people of all ages want.”

And it is also what celebrities want. Fake abs might be the best kept secret in Hollywood. Dr. Gregory Lakin, another plastic surgeon who developed ab etching on his own, says that his patients include actors, singers, dancers, models—“even porn stars.” (He can’t disclose their identities for obvious reasons.)

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You can understand why actors would be tempted—it’s not easy to replicate the abs of a Jersey Shore guy. Just ask a Jersey Shore guy. “I’ve always been a workout fanatic and I’ve always been in shape, but it also takes a lot of hard work to stay in shape,” Jersey Shore star Ronnie Ortiz-Magro said on E!s “The Doctors,” which devoted an episode to his ab etching transformation. Or take the Australian reality-star-turned politician, Darryn Lyons, who went public with his ab etching, saying “basically it’s the male version of the boob job.”

It’s gotten to the point where virtually no one, no matter how rich and famous, is safe from accusations of faking their six-pack. Not even Drake. After the rapper posted his abs of steel in a since-deleted Instagram post, Carnage, a well-known DJ, wrote in the comments, “You got fake ab surgery in Colombia you ain’t foolin’ anybody,” leading to a public spat. While Carnage is not the only person who has questioned Drake’s abs, this was probably just a joke; the two are friends. But it’s also true that (in an unrelated context) when asked which country is known for their abs operations, Lakin didn’t hesitate: “I’d say Colombia.”

Most of the men getting abs enhancements are not celebrities. They’re guys like defense contractor Tim Jahnigen, a 44-year-old dad. Jahnigen is a jock. He ran track in college. He’s always been in good shape—if never quite Thor-shape. No matter how many crunches he did or miles he ran, he could never achieve a six-pack.

So he paid a visit to Dr. Markmann. And the doctor asked him a crucial question: You’re in shape now, but are you going to stay that way? Will you gain weight in the future? Markmann asks this because not everyone is a candidate for ab etching. Most aren’t. The ideal patient is already fit, has a BMI under 30, has tight skin, and simply struggles to shed that final layer of belly fat. Their weight doesn’t yo-yo. Markmann’s typical patients are bodybuilders, cops, military guys, and security guards, but he’s also treated lawyers and doctors and trash collectors. His youngest patient was 20, his oldest 69, and he says his clientele is a mix of gay and straight guys.

Markmann can be blunt. “If you have a potbelly, that will look awfully funny,” he says. “On big beer-belly guys, I tell them to go home and lose weight and come back.” He adds that if you have “big love handles” or “big man boobs” or “a lot of fat under your arms,” all of that first needs to go. Basically, he says, you are a good candidate for a surgical six-pack “if you look like you should have a six-pack.”

This is the blessing and curse of ab etching: It will last for life. “The nice thing about fat cells is that you don’t make new ones,” explains Markmann. Your fat cells will expand or shrink when you gain or lose weight, but lipsuction eliminates the cell itself. This means that the six-pack is here to stay, forever, which is good news if you stay trim. On the flip side, as Lakin puts it, “If you gain weight, you’re going to look stupid.”

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Often the surgery for abs doesn’t end with the abs. Frederick Hamilton, 60, is a retired law enforcement officer. He’s fit and trim with broad shoulders and a large chest. He speaks with confidence. But Hamilton was self-conscious about what he considered to be his “man boobs.” So he looked into plastic surgery and discovered Dr. Mentz, who told him about ab etching. Mentz used liposuction to chisel the chest, trim his love handles, and etch grooves into his abs.

“You don’t want to have a six-pack and round boobs,” explains Mentz, who estimates that half of his abs patients also get etching for the pecs, to give them a more “quadrangular appearance.” Plastic surgeons now have the ability to flip the liability of one body part to be an asset for another. For one recent patient, a bodybuilder, Markmann took some fat from beneath the armpit and slapped it on top of the pecs, giving more definition to the chest. As Markmann puts it, “I do the pecs, I do the love handles, I do the six-packs.” (He also does the butts; Markmann prides himself on being one of the first surgeons to perform the in-demand Brazilian Butt Lift.)

The procedure itself takes a few hours, maybe longer if you’re getting add-ons. The cost can range from $5,000 to $30,000. When Jahnigen woke up from the operation he was groggy, in a bit of pain, and found his torso wrapped in a bodysuit. Compression is key, post-surgery. Markmann had created a custom piece of foam and inserted it into the new grooves of the abs, like a puzzle piece. “This prevents the other fat cells nearby from falling back in that area,” he explains. “Fat’s like jello. If you squeeze it, you squish it flat. I want to keep the creases.”

Then the pain kicks in. Once the anesthesia wears off, Markmann acknowledges that it can feel like “getting punched in your stomach 100 times.” He recommends patients take a week off from work. No driving. No showering.

Robert, a 49-year-old veterinarian and another patient of Markmann’s, who requested to not use his real name, says the pain can be absolutely brutal. “They’re scraping all that tissue out of you,” he says. “When they push through all that fat, there are nerves and vessels.”

Like Jahnigen, Robert had spent a lifetime trying and failing to get his ideal abs. He dreaded taking his shirt off in public. “I’m in the gay community, and those guys can be really hard and judgmental,” says Robert. Every day he hit the gym—sometimes twice—and even starved himself on the quest for abs, trimming his caloric intake to 1,000 per day. That backfired, because even when he was able to briefly achieve that shiny six-pack, he lost so much weight he lost his other muscles. Part of him knew this was absurd. He acknowledges that our culture (including men’s magazines) has created an impossible standard for abs. “I’ve been tricked by the media to buy into that,” he acknowledges. But it was a look he had to have, so he came to Markmann. He wanted his abs etched. It was only after the surgery, in recovery, when feeling the shards of pain, he began to doubt his decision and he wondered, “What the hell did I do with my body?”

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It’s easy for fake abs to truly look fake. Darryn Lyons, the Australian reality TV star (and later mayor of the city of Geelong), even admitted that when he eventually gained significant weight, “I’m looking more like a Ninja Turtle these days than a ripped, spartan specimen.”

And not all surgeons are properly trained to create a realistic-looking six-pack. “This is very hard,” says Lakin, who considers it to be a trickier procedure than plastic surgery staples like breast implants or face lifts. “This is art. This is one of the truest art forms of plastic surgery.” Lakin, who was once a medical consultant on Grey’s Anatomy, studies photographs of his patients and his operations every night, reviewing his work to analyze what he could have done better, like a football coach obsessing over game tape. Lakin gives ab etching to virtually every patient regardless of what they came in for, almost as an added bonus. “I throw it in for free,” he says, knowing that it fetches him referrals—he now sees abs as his calling card, luring patients to his Michigan office from L.A. and Miami.

“There are so many levels of detail that go into it, and it’s technically very challenging,” says Lakin, who calls his abs operation “Ab Silhouetch,” as in abs-plus-silhouette-plus-etch. (Surgeons often have their own marketing spin on the procedure.) If you draw the lines too straight it will look fake. Too shallow looks fake, too—so does too deep. “I’ve seen this with some young surgeons,” says Mentz. “They tend to make it look like a checkerboard. Like a tic-tac-toe board. It just looks too linear.”

This is why patients still have doubts until they can peel off the bandages and see the results. When it was finally time for Jahnigen to remove the wrap, he found that his torso “literally looked like Iron Man.” (Superheroes are a common theme. Mentz once told patients that he can give them “Superman” abs, but then he realized that Superman doesn’t always have a six-pack. Now he gives them “Batman” abs.) His girlfriend loved them. He told his friends, family, and even coworkers about the procedure. Whenever he lifts up his shirt to reveal the abs, he says the typical reaction is, “Holy fuck, are you kidding me?” His coworkers even gave him a new nickname. “Etch.”

Kenny Sloan, who’s 39 and lives in Fort Lauderdale, had a similar experience. He’s a patient of Dr. Lakin. He had dutifully worked out his whole life and never achieved a six-pack—until now, thanks to Ab Silhouetch. On a recent gay cruise, which Sloan describes as a “very sexualized experience, where everyone notices everyone’s body,” the new abs gave him a jolt of confidence. “I made the right decision. It was worth every dollar.”

Robert, who felt those stabby shards of pain, spent $19,000 on the operation. It took him three years to save up for it. But when he saw the results he felt vindicated—he looked ripped. On a recent trip to Miami, he was with a younger gay crowd packed with “gym-looking guys” and finally felt like he fit in. He knows that $19,000 is a lot of money—that he could have spent it on something more useful. Sometimes he’ll show his abs to his husband and ask, “How does my Honda Civic look?”

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Ab Etching Welcome to the Era of the Fake SixPack

In some ways the “fake abs” from etching aren’t fake at all. They are, quite literally, the abdominal muscles you are born with. The six-pack is simply the original clump of muscles that, thanks to the removal of fat, can now be seen in all their sinewy glory. Saying the abs are fake is like saying Michelangelo’s David is fake; the sculpture was there all along—it just took an artist to chip away the outer layer.

On the other hand, when you see someone with abs, there’s an unspoken understanding (at least for now) that they achieved this through hard work, sweat, iron willpower, and a zealous aversion to carbs. It’s true that these patients all worked hard. They all showed discipline. But it’s also true that they now have a sneaky extra edge.

“I do feel like I cheated,” says Robert. When strangers compliment his abs and ask how he got the stunning results, sometimes he’ll tell the truth and sometimes he’ll lie. And sometimes he feels guilty. Not just for fibbing, but for perpetuating unrealistic body images.

These feelings aren’t universal—Jahnigen didn’t view his abs as some existential problem. It wasn’t that deep. He read about the procedure, he figured the health risks were low and the results looked good, and he had the money, so why not? When the nurse at Dr. Markmann’s office asked him why he was doing this, he replied simply, “I don’t know, because I wanted to?” Hamilton had a similar matter-of-fact rationale, saying, “I just wanted to tighten up some areas.” Simple. We don’t question or mock people for getting their teeth whitened.

Other patients point out that it seems to be more socially acceptable for women to get cosmetic surgery. “Men actually do have confidence issues, too,” says Sloan, pointing out that the average guy is not as stoic, self-assured, or indifferent to their appearance as they present on the surface. Hamilton says something similar. “There’s an unwritten thing that you have to be a manly man, and look the way you are, and that’s just the way that is.” If men want to use new techniques for upgrading their appearance, he asks, what’s the harm?

Psychology aside, there is one final practical question to consider. Jahnigen, Hamilton, Robert, and Sloan are all working hard to stay in peak shape. They know they must. “I needed to get the rest of my body up to par,” says Jahnigen, who has hit the gym nearly every day since his surgery three months ago. He wants to ensure his chest and arms and legs won’t look out of place with those Iron Man abs.

You could even say the extra motivation to stay in shape is healthy. But what about the future? What about when you’re 70 years old? Or 90? Because ab etching is so new (relative to other cosmetic procedures), there simply aren’t many octogenarians on the planet with six-packs. But there will be. Someday there could be a mini-generation of frail old men with abs of steel.

“It’s a risk,” Lakin concedes. Then again, Markmann considers this no different than the long-term consequences of breast implants. “There are definitely women out there in nursing homes with some nice boobs,” says Markmann. “I expect the same thing for guys with six-packs.”

07 Jul
Turkey

Sun, sand, nip, tuck: one in three up for medical tourism

Looking for an affordable face lift without breaking the bank? Want to combine a tummy tuck with two weeks holiday abroad ? You’re not alone.

Nearly a third of people surveyed around the world say they are open to the idea of medical tourism – traveling abroad to enjoy cheaper medical or dental treatment according to a new Ipsos poll of 18,731 adults in 24 countries.

Indeed, 18 per cent said they would definitely consider it.

TURKEY

What better place to tuck up that turkey neck. Turkey is up and coming as one of Europe’s most reasonable destinations for cosmetic and plastic surgery. Prices are significantly lower than in North America or in Western Europe, but quality standards are decent. Many experienced Turkish surgeons are internationally trained and multilingual, and several Istanbul medical facilities are clean and modern. Of course, you need to choose your surgeon and facility wisely. Ask a lot of questions, verify credentials, check referrals and more. Budget shouldn’t be your only criteria when considering a serious cosmetic procedure.

“The concept of medical tourism is well accepted in many countries,” said Nicolas Boyon, senior vice president of Ipsos Public Affairs.

“With the exception of Japan there are at least one third of consumers in every country we covered that are open to the idea,” he said in an interview.

Whether for economic reasons or perceptions of superior treatment elsewhere, for treatments ranging from cosmetic to life-saving surgeries, Indians, Indonesians, Russians, Mexicans and Poles were the most open to the idea of being medically mobile.

Thirty-one per cent or more people in each of those countries said they would definitely consider traveling for a cosmetic, medical or dental treatment.

Conversely, people in Japan, South Korea, Spain and Sweden were least likely to be medical tourists.

Boyon said it was not surprising that men and women from emerging nations would be medically mobile if the treatments were cheaper.”This probably reflects perceptions of medical care in other countries that is superior to what is available at home,” he said.

But he was intrigued by the percentage of people in developed nations such as Italy, where 66 per cent said they would definitely or probably consider medical tourism, along with Germany (48 per cent), Canada (41 per cent) and the United States, where 38 per cent of people were open to the idea.”It is a reflection that the medical profession is no longer protected from globalisation,” Boyon said.

RISKS VS. BENEFITS

Although medical tourism spans a range of treatments, the most common are dental care, cosmetic surgery, elective surgery and fertility treatment, according to an OECD report.

“The medical tourist industry is dynamic and volatile and a range of factors including the economic climate, domestic policy changes, political instability, travel restrictions, advertising practices, geo-political shifts, and innovative and pioneering forms of treatment may all contribute towards shifts in patterns of consumption and production of domestic and overseas health services,” the report said.

Various studies using different criteria have estimated that anywhere between 60,000 to 750,000 US residents travel abroad for health care each year, according to the Centers for Disease Control and Prevention.

Along with variations among countries, the Ipsos survey showed that younger adults under 35 years of age were more likely in most countries to consider medical tourism, than people 50 to 64 years old.

Boyon suggested that the cost of travel, proximity, borders and quality of care may also be factors considered by potential medical tourists. In both Italy and Germany, about 20 per cent of adults said they would definitely consider medical tourism. Both countries are near Hungary, a popular destination for health treatments.

Ipsos conducted the poll in Argentina, Australia, Belgium, Brazil, Canada, China, France, Germany, Great Britain, Hungary, India, Indonesia, Italy, Japan, Mexico, Poland, Russia, Saudi Arabia, South Africa, South Korea,Spain, Sweden, Turkey and the United States.

Based on story published in The Sydney Morning Herald- Traveller

Reuters

03 Jul
Thailand

Case study: VANITY; Location: BANGKOK; NipTuck and Frequent-Flier Miles

How Thailand as a developing country in an economic crisis and floundering economy and a significant H.I.V. problem managed to turn it all  around and become a world centre for medical tourism is a fascinating, yet in typical Thai- style they did it in a rather odd and roundabout kind of way.  If you know anything about Thai culture you will know what I mean, and this is what makes this story and this strategy cooked up by Thai tourist officials at TAT and hospital administrators all the more brilliant!

They came up with a strategy when Thailand found itself in the economic crisis of 1997 based on their strengths. Their strategy was to market Thailand as a place you would actually travel to for plastic surgery and maybe even other medical procedures as well (like dental) as well as other medical procedures. They started on the one plastic surgery procedure that Thai doctors have come closest to perfecting —  the sex change operation. 

They thought, Thailand had doctors who earned a fraction of what their western counterparts do, though many of them had studied in the U.S. or Australia. It had highly trained nurses who were paid around $600 a month, a culture with a tradition of massage and other spa-worthy healing practices and in Bangkok and Phuket, at least, a lot of high-tech medical equipment purchased during the economic boom and now sitting idle. Medical tourism would have a better rep than sex tourism, and it could easily be as lucrative. But the sex-change industry was the beginning of medical tourism in Thailand, as it make sense to start here and  build on some obvious strengths.

Tourism Authority of Thailand (TAT)  issued new directives to travel agents, suggesting that they offer their clients health-tourism and medical-tourism packages and offered Famil’s each year to agents. I went every year – it was a great!

And media was invited from the US and Australia including NBC,  MSNBC and ABC veteran anchor and journalist and multi Emmy awarder Kendis Gibson who has worked for all three broadcasters — ABC News, NBC News, and CBS News & Stations, where they were advised and introduced to the ”fine hospitals” throughout Thailand at the hotels they provided.

Thai travel agents talked up the country’s medical bargains, and hospitals found new ways to advertise and the hospitals and clinics in Bangkok and Phuket pitches to attract foreign tourists, esp. plastic surgery and advertises itself as a ”breakthrough integrated medical rejuvenation center providing spa, medical and fitness facilities.”

Hospital’s websites began to target westerners, featuring  opening page features a sun-dappled photograph of a handsome Caucasian couple, explains that ”in Asia, retaining that youthful look is important. This has, in turn, led to the development in Thailand of cosmetic surgical techniques that are the envy of the medical profession in many G7 countries.”

Plenty of people in Thailand — from government officials to hotel owners to doctors and nurses — banked on the country’s new status as an international capital of discount plastic surgery. All this investment to payed off as Thailand became the number 1 medical tourism destination by volume of care in 2014 and attracted over 2.4 million foreign patients in 2017.

Westerners, or Ferangs, as they are called in Thailand were a good fit for Thailand as medical tourists. MISSION ACCOMPLISHED- HUGE SUCCESS!!!!!!  

But then, politics.  It was the Chinese tourists that Thailand was now interested in woowing…… Some Western countries had downgraded their diplomatic ties when the military seized power back in 2014 and the Thai government was seeking to strengthen ties with Beijing.   And of course, China is a top trading partner…..

And back on the Gold Coast Australia where we were based, it became a very competitive business where clinic’s offered ‘bargain boob job’ for less than $5000 to compete with medical tourism in Asia. This was the lowest price in Australia with a discount to compete as growing numbers of women flock to Asian clinics for cheap surgery. It was competition that Thailand didn’t count on.

As a high-profile Glitter Strip cosmetic surgery promoter, Claire Licciardo, it was said I was hoping for bumper bookings for her next cosmetic surgery tour to Thailand to help pay for the damage.

Indeed!

And then there was covid. And lock-downs. Thailand only this year in 2023 in January welcomed back Chinese tourists. With ‘arms wide open’ as key market returns.

Ouuuchhhh.

What a ride that was! And a fascinating insight into how Thailand became number one. In 2023 there is an increase in inflation and a lot of global competition in medical tourism…….

But let’s think back. It’s a facinatinating insight thanks to the New York Times Magazine. It’s 1999, Thai Airways International, the government airline of Thailand, began offering travelers an unusual new package-tour option. Most tourists might still prefer the old add-ons: the river cruise, the round of golf, the Thai cooking course. But others, those who were part of a new market that government officials were calling ”medical tourists,” could now combine their Asian holiday with a comprehensive physical, including abdominal ultrasound, chest and barium stomach X-rays and a complete laboratory analysis of blood, urine and stool samples. They could get a written report sent to their hotel within three days. And they could get it all done at Bumrungrad Hospital, a modern medical complex in Bangkok that had all sorts of inviting, foreigner-friendly amenities, starting with a Starbucks and a McDonald’s in the lobby.

This might not seem like a plausible promotion at all except for the fact that thousands of tourists were already coming to Thailand to avail themselves of its best-known medical attraction, discount plastic surgery. In Thailand, you can get a $2,400 face lift or a $1,200 nose job. You can get tumescent liposuction, body contouring, extra-large silicone breast implants, a buttock lift, a brow shave, a laser resurfacing of the face — and pay a fraction of what you would pay back home. At the luxurious Bumrungrad, which offers high-speed Internet access and cable TV in every room, you can choose among precisely delineated packages: liposuction, ”the thighs and love handles” package; liposuction, ”the love handles only” package; liposuction, ”the under chin only” package; and on and on. You can find Thai plastic surgeons who market these operations directly to you on English-language Web sites, where you can book an appointment online if you like what you see.

How a developing country with a floundering economy and a significant H.I.V. problem managed to market itself as a center for medical tourism makes an odd, roundabout story. It depends in part on the Asian economic crisis of 1997 and in part on Thailand’s thriving cabaret culture. Most of all, perhaps, it depends on the one plastic surgery procedure that Thai doctors have come closest to perfecting — namely, the sex change operation. Without the international transsexual grapevine, which since the late 90’s has been spreading the word about the affordable talents of Thai plastic surgeons, the new campaign to bring hard currency into the country by touting its medical bargains would never have gained momentum. And so it makes a strange kind of sense to begin this story with somebody like Michelle Moore — somebody who, it is fair to say, had never given Thailand a moment’s thought before she flew there and changed her life forever.

Moore lives in Philadelphia, not far from where she grew up in the blue-collar town of Glenside. Back then, she was known as Michael Maier. She is now 36 and for the last 18 years has operated a moving company called Maier’s Relocation Service, which runs trucks between Florida and Pennsylvania. For vacations, she likes Daytona Beach, Fla.; in her spare time, she collects and repairs old televisions and radios. Her boyfriend is the cook at a nearby nursing home. In Moore’s previous life, the subject of what might or might not be happening in a developing country in Asia just didn’t come up.

Then last spring Moore heard from a friend about a doctor in Bangkok named Preecha Tiewtranon. Preecha is a talented plastic surgeon with an unusual niche: he and two other Thai surgeons perform the cheapest sex-change operations in the world. Even before the Thai government started actively promoting the country’s medical care, the work of Preecha and his students had made Thailand a pilgrimage destination for American and European men who could not afford sexual-reassignment surgery in their home countries, where it can easily cost upward of $20,000. Moore was one of those customers. Twenty thousand dollars was more than she could afford, but $5,000 — Preecha’s going rate, plus air fare to Bangkok — was a sum she could manage. She would even have cash left over for breasts and, as Moore put it, ”fake cheekbones.”

The good thing, besides the price, was that Thai surgeons didn’t set so much store by the extensive psychological evaluations that Western surgeons demand before they will undertake a sex change. In the United States, doctors commonly adhere to a protocol known as the Harry Benjamin standards, which require sex-change candidates to have seen a psychiatrist for at least six months. In Thailand, they don’t. As long as their foreign patients have passed the ”real life” test of living as a woman for six months, they seldom throw up roadblocks. Moore, who isn’t big on roadblocks of any kind, liked this a lot. As she put it, ”I don’t want to pay some psychiatrist money I don’t have to tell me something I already know.” The convenient thing was that Thai immigration officials were by now so accustomed to their country’s brisk business in sex changes that they hardly blinked when a foreigner in a dress offered up a passport with a name like Chuck on it.

Of course, it was a long way to fly — especially with some very sore nethers and probably some bleeding and, depending on how long you decided to convalesce in Thailand, maybe an inability to urinate normally or some sort of brewing infection. But then the whole operation itself was so extreme that, in some ways, the distance and the arduousness of the journey and the strangeness of the destination seemed fitting.

Once Moore had settled on a trip to Bangkok, her biggest difficulty was choosing between the three Thai surgeons who performed sex changes on foreigners at a rate of two or three a week. Suporn Watanyusakul in Chonburi was kind of new at it, but he had studied with Preecha and his prices were great. (Besides, effused one satisfied customer in a Web site posting, Suporn was willing to provide the giant-sized breast implants that other doctors discouraged.) Sanguan Kunaporn, whose practice was on the swinging resort island of Phuket, was known for laboring hard to make a sensitive ”clitoris” from a small chunk of penis he preserved during surgery. His procedure, however, took 11 hours over two days.

Then there was Savannah, The Canadian-born Australian that had our own Dr Sanguan who is one of the pioneers in male-to-female gender reassignment surgery, and among those who are still performing this type of surgery in Thailand. This has gained him a following from all over the globe in Phuket as her surgeon in male to female gender transition

Then there was Preecha — who at 57 and with 1,200 male-to-female sex changes to his credit, the old man of the business. Having studied plastic surgery at Chulalongkorn University in Bangkok, he started out back in the 1978 doing sex changes on Thais, but then many of those transsexuals moved overseas (a lot of them to Germany, he says) and married Europeans. These ”lady boys” abroad were admired for their beauty, and word started to trickle out that Thailand was a place to get sexual reassignment surgery done cheaply and fairly artfully. By the late 90’s, Preecha’s clientele was made up almost entirely of Americans, Europeans and Australians. Preecha was fast — in three hours, he could do sexual-reassignment surgery, add breasts and shave an Adam’s apple — and his fans claimed he didn’t sacrifice aesthetics or sensation. He did most of his surgery at Bumrungrad, where many doctors had trained in the U.S. and the decor suggested a new Hyatt in some prosperous American exurb.

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Michelle Moore picked Preecha, who first operated on her last August. When I met her, on a March morning so humid my glasses fogged over the instant I stepped outside, she was back in Bangkok to get a bit of repair work done. ”I wasn’t real good about dilating the new vagina every day,” she explained. ”I didn’t do what Preecha told me, and it kind of like collapsed on me.” In the tiny, lace-curtained waiting room of Preecha’s clinic, into which several rows of plastic chairs have somehow been crammed, rangy, raw-boned Moore was a large and incongruous presence. She was wearing jeans and a faded T-shirt with a drawing of a Formula 1 car. Her brown hair was long and a little raggedly cut. She looked a bit like David Bowie as a Philly motorhead.

Normally, Moore is a friendly sort, but at that moment she was kind of ticked off because Preecha had told her that another surgeon, whom she did not know, would be operating on her. ”I want to know who is this guy, where’d he go to school and blah, blah, blah,” she said, gesturing with a plastic fork full of a street vendor’s yellow curry. ”I’m afraid, and nobody can blame me. This is serious stuff.”

The person patiently listening to her was Eddie Chaichana, Preecha’s young nurse. Eddie is from a poor village in the north of Thailand. After he earns a little more money in Bangkok, he wants to go home and provide some much needed medical care there. But in the meantime he lives above Preecha’s clinic and deals all day long and into the night with the requirements of transgendered foreigners. Some of them want a pizza; some want a better selection of cable TV; some want advice on the best beaches to head for when they are ready to strut their brand new stuff. Some of them have never been abroad and are scared to leave the darkened hotel rooms where they are recovering.

At the moment, however, Moore was making perhaps the one request Eddie had not heard from a patient before. She wanted information on how to become a permanent resident of Thailand. She likes the people, the weather, the fact that she can get tailored suits for practically nothing. Having surgery abroad had opened her eyes to a life beyond Pennsylvania. ”I like the United States,” she said. ”But there’s too much red tape, especially in long-distance trucking.” She asked Eddie to help find her a job, maybe figure out a way around some immigration problems. It was one thing Eddie couldn’t do. It is medical tourists he had learned to serve — the people who want a new body, for a good price, to take home.

These days, there are plenty of people in Thailand — from government officials to hotel owners to doctors and nurses — banking on the country’s new status as an international capital of discount plastic surgery. The sex-change industry is only the beginning, as they see it, though it certainly made sense to start there and build on some obvious strengths

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Thailand, as it happens, is a country whose male-to-female transsexuals make up an unusually accomplished and accepted subculture. There are no legal sanctions against homosexual or transgendered lifestyles, and kathoeys, or drag queens, are everywhere. In the late 90’s, one of the country’s most popular celebrities was a cross-dressing kick boxer who kissed his opponents and wore lipstick in the ring. The second-highest-grossing Thai movie ever made, ”Iron Ladies,” tells the (true) story of a transsexual volleyball team. Drag-queens and lady-boys are stock characters on Thai soaps. And the country’s many transsexual cabarets employ performers who are delicately featured marvels of plastic surgery. I visited two transsexual bars and a cabaret in Bangkok one Sunday night; talking to Iman and Bam-Bam, two pretty, gum-chewing dancers with lustrous hair and matching mauve eye shadow, it was easy to forget that they were not genetic girls. It is true that the breasts they kept flashing genially at me were perfectly spherical and their hips exiguous, but then that kind of made them look like Victoria’s Secret models, who are genetic girls as far as I know.

Given the amount of reshaping transsexual performers require in order to increase their value in the tourist-driven entertainment business, it is not surprising that there are skilled plastic surgeons in Thailand. But in a country where the per capita income is $2,000, not even showgirls have unlimited money to spend on cosmetic surgery. And they had even less of it after the Asian economic crisis and the devaluation of the Thai baht in 1997.

By then there were 131 private hospitals in Bangkok alone, most outfitted with up-to-date medical technology. Somebody had to fill all those beds and pay all those doctors, and after the baht took its plunge, not even the Thai middle class could afford private medical care anymore. (Those who couldn’t pay out of pocket went to government hospitals.) That is when tourist officials and hospital administrators came up with a strategy: market Thailand as a place you would actually travel to for plastic surgery and maybe even other medical procedures as well. Thailand had doctors who earned a fraction of what their American counterparts do, though many of them had studied in the U.S. or Australia. It had highly trained nurses who were paid around $600 a month, a culture with a tradition of massage and other spa-worthy healing practices and in Bangkok, at least, a lot of high-tech medical equipment purchased during the economic boom and now sitting idle. Medical tourism would have a better rep than sex tourism, and it could easily be as lucrative.

And so two years ago, the Tourism Authority of Thailand issued new directives to travel agents, suggesting that they offer their clients health-tourism packages — trips that might include, say, laser eye surgery along with airfare and hotel. Thai travel agents talked up the country’s medical bargains, and hospitals found new ways to advertise. At the hotel where I stayed, a regularly broadcast message advised me that I could get CNBC at ”fine hospitals” throughout Thailand. And several hospitals and clinics in Bangkok started making concerted pitches to attract foreign tourists. The St. Carlos Hospital, where you can get a full range of plastic surgery, advertises itself as a ”breakthrough integrated medical rejuvenation center providing spa, medical and fitness facilities.” The hospital’s Web site, whose opening page features a sun-dappled photograph of a handsome Caucasian couple, explains that ”in Asia, retaining that youthful look is important. This has, in turn, led to the development in Thailand of cosmetic surgical techniques that are the envy of the medical profession in many G7 countries.”

But it was Bumrungrad that took the merging of hospital and tourist accommodation the furthest. Under the administration of an American C.E.O. named Curtis Schroeder, the hospital began showing travel agents a slide-show presentation to get the word out about its bargains: $205 for an MRI, $267 for a complete physical, $1,200 for abdominal liposuction, $750 for full face resurfacing. From a medical point of view, Bumrungrad was already well equipped, with coronary care and dialysis units and sophisticated imaging technology. Now Schroeder, who is 44 and the former administrator of the U.S.C. Medical Center, set about furnishing it with the kind of lavish niceties to which American tourists are accustomed.

After the hospital’s makeover, a foreign visitor could expect five-star hotel extras: meet-and-greet service at the Bangkok airport, a multilingual personal escort to take him from test to test during physicals. And the rooms themselves were luxe and, by American standards, cheap — some just $54 a night. There were 250-thread-count cotton sheets and complimentary toiletries in baskets woven by Thai hill tribes. The hospital brought in chefs from Bangkok’s most glamorous restaurants — a new one each month — to cook patients’ menus. For customers who found the cuisine too exotic, a McDonald’s was installed in the lobby’s food court.

To advertise all these attractions, Schroeder opened outreach offices in cities across Asia. He figured it wouldn’t be all that hard to attract elites from countries whose medical services lagged far behind Thailand’s but who had the wherewithal ”to shop around for Grandma’s heart operation.” Last year, he also opened an office in London, on the assumption that the National Health Service’s waiting lists could propel some intrepid Brits halfway around the world for medical care. ”I have a newspaper article from England right here,” Schroeder told me one day, ”that shows how people can wait three years for hip replacement surgery with the National Health Service. And it’s the same thing in places like Sweden. There’s got to be a market for us there.” Schroeder handed me a newly produced brochure aimed at luring British patients to Bumrungrad. It promised what sounded like a medical paradise of ”instant” care — a place where the people (read: nurses) are ”gentle, serene and gracious” yet modern and efficient, a soothing amalgam of Buddhist compassion and Western infrastructure.

All this investment is beginning to pay off. Bumrungrad saw some 165,000 foreign patients last year. Schroeder knows that the kind of people who can afford plastic surgery or executive physicals in the United states are not necessarily the most price-sensitive, but he figures that everybody likes a bargain, especially if it can be combined with a vacation to a warm, tourist-friendly country. ”We’ve got one couple from New York who comes here every year for their physicals,” he said. ”They love Thailand, and it’s just an easy way for busy people to kind of multitask.”

Walking through the lobby at Bumrungrad one morning, past the lush ficus trees and the splashing fountain, I ran into Ruben Torral, a bouncy American who is Schroeder’s right-hand man. We ordered two Starbucks lattes, and Torral recounted a couple of his sample pitches for surgical vacations. To promote the month’s special on Lasik surgery, which corrects near-sightedness, Torral said he told prospective customers, ”Have the surgery and see beautiful Thailand — get it?” And for face lifts and such, Torral said the anonymity afforded by a hospital so very far from home might be an incentive for some Americans. ”Look, you can come here, get a face lift and spend five days vacationing on the beach, and it’s still going to cost you 30 or 40 percent less than it would if you had the same procedure in L.A. or New York. And guess what? Nobody at home needs to know what you’ve been up to. They just say, ‘Wow, you look rested.’ And you say ‘Yeah, Thailand’s great!”’

Personally, I find it hard to imagine spending any vacation time in a hospital if I can help it, let alone flying 24 hours to a country where vaccinations are recommended, the H.I.V. rate is 2 percent and the nurses don’t speak my language just to get an operation I could get at home. I worry about surgical complications discovered in Economy Class somewhere over the Pacific. I envision having to ask a flight attendant for 9 or 10 yards of gauze and a shot of morphine. I think about less exacting imitators of the doctors at Bumrungrad trying to cash in on the foreign market and ruining, oh, say, your face.

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And most American plastic surgeons would agree with me. They take a dim view of all the sun-and-surf-and-nip-and-tuck destinations: Central America, Mexico, Thailand. Follow-up visits are a problem, they point out, and cultural ideals of beauty differ — and more importantly, so do medical credentials and standards of care. ”These are third-world countries — what more do I really have to say?” said Daniel Morello, the president of the American Society for Aesthetic Plastic Surgery. ”All the best plastic surgeons in those countries come to the U.S. to train. So why would an American go there for surgery?” Every year, Morello said, ”I am beset by 10 or 12 patients who went abroad for surgery and who have problems they want me to fix. These are people whose phone calls have not been answered, who have been abandoned by the doctor they saw.” Morello added that many plastic surgeons here are reluctant to take such patients on, because ”these are angry, disappointed people who tend to transfer that anger to you. You feel badly for them, but you feel they’ve been dumb, too. The notion of a vacation and surgery of any kind — they really shouldn’t be mentioned in the same sentence.”

There may, however, be less risky strategies for coaxing well-heeled Westerners into the Thai health system. After my coffee with Torral, I made a brief stop in a public bathroom where yellow roses float serenely in a marble bowl by the sink and then took the elevator to Curtis Schroeder’s office on the top floor.

Schroeder is a tall, well-tended man with sandy hair slicked back from his forehead and a youthful, pink complexion. The day we met, he was wearing a pearly gray suit and waxing enthusiastic about his latest project, something called the Vital Life Wellness Center, set to open this month. Schroeder leaned forward, elephant-print silk tie dangling. He thinks the center will be a big attraction for Americans into vitamin therapy, and he may be right. The lingo sounds spot-on, and ”wellness” sounds like a smart direction for medical tourism to go in: ”nutraceuticals,” prevention, treatments that are trendy and costly and nonsurgical — and, like plastic surgery, not covered by insurance at home. ”We’ll do body fluid assays, check for vitamin deficiencies, anti-oxidants, free radicals,” Schroeder promised. At the Wellness Center, doctors analyzing data about a client’s body would create ”custom compound” supplements for him. ”Some people now are taking 30-40 vitamin pills a day that they’re buying at the local mall, and they don’t need it,” Schroeder explained. ”It’s passing through them, and all they’ve got is the most expensive urine in the world. Well, we don’t want expensive urine here! We’ll give you exactly what you need to take and no more, and then you’ll come back and we’ll test you again.”

So savvy and so neat was this vision, so far removed from the messy work of turning a man into a woman, that I nearly lost sight of the fact that, so far, the most successful Thai medical tourism — the root of it all — was sexual reassignment surgery. Curtis Schroeder, it was made clear to me, did not wish to talk about sexual reassignment surgery. Before I interviewed him, I met with a woman named Yadda Aparaks, the business director of Bumrungrad. She is a petite, impeccably groomed and rather obdurate person with whom I had the following conversation:

Aparaks: ”We do sex changes, but we are not going to speak about that. We don’t want to be known for doing sex change operations. Sex tourism, sex change, nothing like that.”

Me: ”But you have a whole section of your Web site on sexual reassignment surgery at Bumrungrad.”

Aparaks: ”No, we don’t have that.”

Me: ”Yes, you do.”

Aparaks: ”Well maybe somebody looking at our Web site can pull that up. If they’re looking for that. But we’re not going to talk about that.”

It seemed fruitless to press the point, so that was that. But later that day I met a man who knows intimately just how important sex changes are to the whole boom in medical tourism, who has made quite a nice living on them himself and who just chuckled when I told him what Aparaks said.

Not much seems to bother Preecha Tiewtranon. He gives off an aura of quiet jollity, as though he had just heard a good joke or eaten a warm, tasty meal. And his vast and tolerant bemusement takes in all sorts of phenomena discomfiting to other people. Just for the heck of it and kind of expecting an oh-don’t-be-silly reply, I asked him whether something I had read in a guidebook was true: namely, that penile reattachment surgery was performed more often in Thailand than in other countries and that Thailand was, in fact, the international capital of penile reattachment.

”Oh, yes,” he said. ”We have many wives and girlfriends cutting off the husband’s penises here. A few years ago, you had that Bobbitt, and everybody in America was so excited. And in Thailand, we though what’s all the excitement? We have that all the time. We got very good at the microsurgery for reattaching the penis; it’s a specialty for us.” Preecha chuckled heartily. I joined in rather more hesitantly.

Long ago, Preecha said, he had thought ”transsexual people were kind of dirty people and I looked down on them.” But then he started seeing a few transsexuals as patients, people who came in with horribly botched surgery to be repaired, and he felt sorry for them and thought, If they are going to do this anyway, somebody good should do it so they don’t mutilate themselves. And after a while and to his surprise, he found that he liked his transsexual patients. Maybe even especially the foreigners — those blundering Americans who didn’t know the first thing about Thailand but who trusted him.

In the end, what he liked was that the sex-change patients were grateful, which ordinary tourists, and people in general, so often weren’t. ”You know, someone you do stomach surgery on, maybe it’s very hard for them, and you do a good job, but the patient is just saying, ‘Oh pain, pain, pain,”’ Preecha said. ”The sexual-reassignment surgery patients are always happy. They don’t complain! They say they are born again here in Thailand, and they are happy.”

A version of this article appears in print on May 6, 2001, Section 6, Page 86 of the National edition with the headline: 6. CASE STUDY: VANITY; LOCATION: BANGKOK; Nip, Tuck and Frequent-Flier Miles.

30 Jun
Cosmetic surgery for Men, NEWS, Turkey

Medical tourism in Turkey: Why it is a cosmetic surgery hub

Known for its pristine Aegean beaches and architectural wonders, Turkey also draws tourists for its cosmetic treatments.

Turkey’s health and cosmetic surgery industries have the winning tickets in a globally competitive marketplace with throngs of red scalped men in Istanbul’s public squares and bandaged noses in its metro stations. It’s unlikely to disappear anytime soon with Australia the latest nation to take notice.

The bottom line is that cosmetic surgery is big business for Turkey and it’s all about the price!

Patients are drawn to Turkey for procedures like hair transplants due to cheap prices and the speed of procedures 

Flights back from the Turkish city to Western Europe or the United States and now Australia are often full of people bandaged up, avoiding eye contact with fellow travellers.

Fillers, botox treatments and rhinoplasties are also popular procedures for tourists looking to change their appearance.

Affordable prices, visa free entry and short flight distances from much of West Asia, North Africa and Europe, all add to the appeal of visiting Turkey to get medical and cosmetic procedures done.

Some experts are watching the trend with concern, though, pointing to unethical marketing tactics, results that do not match up with promises and lack of legal protections.

Despite this, the country is a top ten destination for medical tourism globally, with 600 registered clinics in Istanbul alone, according to Patients Beyond Borders (PBB), an organisation that surveys medical tourism.

According to local media reports, more than 100,000 people visit the country for hair transplant procedures alone, the vast majority from Arab states. 

The importance of cost

“People can find quality service at affordable prices and work with surgeons and technicians who know the job well,” Ekram Caymaz tells Middle East Eye, succinctly explaining the appeal of “getting work done” in Turkey.

A leading clinician in hair transplantation at Istanbul’s Hair Upload clinic, Caymaz says patients are drawn to Turkey for its comprehensive approach to customer care.

For example, most clinics will not offer the surgery alone but as a package deal, which can include everything from flights, transfers, luxury accommodation, regular aftercare and even tours of the city.

Patients with bandaged heads after undergoing hair transplants in Turkey 

For the customer that means every aspect of the procedure is taken care of – they simply need to turn up.

Prices are another draw, with Caymaz charging between $4,000 and $6,000 for his hair transplant procedure, which is considered cheap. Others can be as low as just over $1,000, though the quality of service inevitably varies wildly.

In comparison, procedures such as hair transplants are not available for free on the UK’s National Health Service (NHS) and can cost as much as £30,000 ($36,700) when done privately. 

Similarly, cosmetic rhinoplasties can cost around £7,000 in Britain ($8,570), not including the cost of consultations and follow ups, whereas in Turkey the procedure costs less than half that.

Key overheads, such as staff salaries, are much lower in Turkey than in Western Europe or the US, while standards of medical training are relatively high compared to other countries in the Middle East or Asia.

Turkey’s ongoing economic crisis has also helped depress prices to a degree that keeps them affordable for Europeans. 

Speed of treatment

But price is not the sole reason for the popularity of cosmetic and other procedures in Turkey.

Speed of treatment is another factor, albeit one that serves as something of a double-edged sword.

Weight loss surgeries, for example, are only available on the NHS in extreme cases, for people who have a body mass index of 40 or more, meaning they are severely obese.

Before proceeding, patients must agree to a rigorous long term follow-up after the surgery, including making healthy lifestyle changes and regular check-ups. Even for people who are eligible, the wait for treatment can last years.

A general view shows the Blue Mosque and the empty Sultanahmet square after a blast in Istanbul’s tourist hub on January 12, 2016. – At least 10 people were killed and 15 wounded in a suspected terrorist attack in the main tourist hub of Turkey’s largest city Istanbul, officials said. A powerful blast rocked the Sultanahmet neighbourhood which is home to Istanbul’s biggest concentration of monuments and and is visited by tens of thousands of tourists every day.

Safety and the black market

Some experts, though, have warned that patients in search of quick and affordable solutions could be setting themselves up for trouble further down the line.

Cosmetic dentist Sam Jethwa, from the UK-based Perfect Smile Studios, tells Middle East Eye that patients can easily be misled when it comes to cosmetic procedures. 

“Getting a dental procedure abroad means you risk not having any legal protection, which can leave patients with difficulties afterwards,” he says, adding that patients can also be misinformed, resulting in needing further treatment or repeat procedures.

“The need to have corrective work done back in the UK due to botched cosmetic dentistry procedures (abroad) is on the rise,” Jethwa says. 

“We see these patients attending our clinic afterwards regularly, sadly after patients have already chosen treatments that they were not fully appreciative of the risks of.”

While there is no suggestion that a typical procedure in Turkey will result in problems for patients, there are those looking to capitalise on the trend and exploit vulnerable patients.

The International Society for Hair Restoration Surgery (ISHRS), a global non-profit medical association active in over 70 countries, has launched a campaign named Fight the Fight in an effort to shed light on the dangers of the “medical black market” and medical tourism package deals. 

Launched in 2019 in response to the growing number of people going to unlicensed technicians to get hair surgeries, the organisation offers support to victims of treatments that have gone wrong and provides education and training about the subject. 

ISHRS says there have been cases where doctors or those purporting to have medical training have misled patients and carried out illegal practices, resulting in injuries, scarring and the depleted or uneven appearance of hair. 

Caymaz reiterates that the onus to make an informed decision lies with the patient.

“Although clinics and hospitals are inspected, there are so called ‘under the stairs’ places, which are much cheaper,” he says. 

“It is very important to examine their social media and videos, the words they say and what is written must match up.”

According to the doctor, one of the main issues within the industry is the lack of follow-up after the operation to ensure there are no complications.

“This is a very important detail, and most clinics in Istanbul do not follow up after the operation. Even customers who have had operations in other clinics ask us about this,” Caymaz says. 

Social media and medical tourism

Anyone likely to have mentioned hair loss, weight gain or insecurity about their looks online is likely to have been bombarded with Instagram or Google adverts promising affordable and sometimes miraculous solutions to their issues.

Part of the reason for the popularity of medical and cosmetic tourism is social media advertising.

This trend is compounded by entertainment news coverage of celebrities going public about their own procedures.

rhinoplasty
Rhinoplasties are one of the most common surgeries patients come to Istanbul.

Hair transplants are very popular among footballers, with Wayne Rooney confirming he had one in 2011 and Emirati singer Hussain Al Jassmi putting his dramatic weight loss down to a gastric bypass in 2010.

Selena Marianova, a UK based 22-year-old social media content creator and clinic owner, says that social media has an “undeniable influence” on individuals considering surgical enhancements. 

In a YouTube video, viewed over 300,000 times, Marianova recounts her experience to her followers. She says that she wants to help other people by sharing information, and that she chose Turkey for her surgery because of their advanced medical technology and experienced doctors. 

Marianova went to Istanbul for a rhinoplasty in 2019, cautioning, however, that young people need to feel confident in who they are before they proceed with any surgical enhancements.

“Plastic surgery isn’t to be taken lightheartedly,” she says. “Being a content creator, it is extremely hard to not pinpoint parts of myself that would need ‘improvement’ because I am constantly looking at myself in videos, photos and in the mirror, which can be very mentally draining for people who do not have a strong self concept.” 

The link between social media use and negative self-image is well established by researchers but for all the ethical considerations, the bottom line is that cosmetic surgery is big business for Turkey.

In 2018, the cosmetic enhancement industry was worth $2bn in Turkey and hair transplants alone are now a billion dollar industry. 

Those valuations are likely to have increased in the aftermath of the Covid-19 pandemic, with a surge in interest in cosmetic surgery globally.

Despite the concerns, Turkey’s health and cosmetic surgery industries are winning tickets in a country otherwise suffering economically.

The throngs of red scalped men in Istanbul’s public squares and bandaged noses in its metro stations are therefore unlikely to disappear anytime soon.

This article is available in French on Middle East Eye French edition. and English

29 Jun
Australia, Cosmetic Holidays

As Botox parties take off, doctors warn of risks

BOTOX parties are on the rise in Queensland, but doctors have urged caution, saying they were regularly called on to fix botched Botox procedures.

Botox party host Claire Licciardo and Hollie Anderson, who says the parties are less intimidating than visiting a clinic.

BOTOX parties are on the rise in Queensland, as everyone from brides-to-be to high-flying lawyers look for a cheaper, more convenient way to turn back the clock.

But specialist doctors urged caution, saying they were regularly called on to fix botched Botox party procedures undertaken by unqualified practitioners.

Cosmetic Holidays International managing director Claire Licciardo said there had been a surge in demand for at-home cosmetic injections in the past few months, and she was now hosting as many as three parties a week with a qualified doctor in southeast Queensland.

She said men in their 40s, lawyers, businessmen, gym owners, strippers and bridal parties were just some of the people flocking to attend parties, at which she said it cost $8 a unit for anti-wrinkle treatments and about $400 for lip fillers.

An internet search turned up evidence of other clinics and registered nurses who are willing to host at-home Botox parties

An internet search turned up evidence of other clinics and registered nurses who are willing to host at-home Botox parties

The parties usually last for at least three hours and Ms Licciardo travels to customers’ homes with a doctor registered with the Medical Board of Australia who can administer cosmetic injections and dermal fillers. The venue host receives a discount.

Ms Licciardo enforces a six-person limit at her parties and said for safety reasons, the consumption of ­alcohol was not allowed.

“I’m not going to boss people around, but we’re very clear,” she said. “We prefer people not to have ­alcohol before.

“What they do after we leave is none of my business.”

Hollie Anderson, 27, plans to host a Botox party and said it was less intimidating than visiting a clinic.

“Plus, we can make an evening of it,” she said.

Mishaps don’t just happen at Botox parties. Lawyer Raluca Crisan claims this reaction was the result of mistakenly being injected with snake venom – in a clinic.

Brisbane Skin director and specialist dermatologist Shobhan Manoharan said he’d been approached to give injections in a party setting, but said it’s something he would not do as patients could not be sure what was being injected and a home wasn’t as sterile as a clinic.

He said he regularly sees patients with complications from a Botox party and was especially concerned that the parties were expanding to offer fillers, which could cause serious issues, such as tissue death.

He said that while smaller complications tended to be more common, poor injection skills could lead to brow drops, dribbling problems, and even blindness.

“I’ve had patients who have had to fly in (to Brisbane) from North Queensland to see me because of a Botox party injectable complication there,” he said.

Queensland Health also warns against the practice.

Ms Licciardo, who has worked in the cosmetic surgery industry for years, said Botox parties sometimes got a “bad rap”, but she’d only ever work with a registered doctor. 

Story was published in The Courier Mail

29 Jun
Cosmetic Holidays

Lay-by boob jobs? How very GC!

JUST like lay-bying the kids’ Christmas presents and paying them off, mum can now put her cosmetic surgery on a payment plan too.

JUST like lay-bying the kids’ Christmas presents and paying them off, mum can now put her cosmetic surgery on a payment plan too.

Cosmetic surgery clinics and travel agencies are offering boob jobs and procedures on payment plans to cater for demand from potential clients who cannot afford to pay upfront.

But those who commit to certain schemes be warned — they could end up paying twice the original surgery price.

Hire purchase used to be for household electrical goods or furniture, now it’s being applied to body parts, a Gold Coast Bulletin investigation has found.

Claire Licciardo, managing director of the Coast’s Cosmetic Holidays International now re-branded as NipTuck Holidays, will today launch a new lay-by option where clients can enter a six to 12-month payment plan and only pay weekly transaction fees.

It means a $6500 procedure would only set them back a further $338.

“I think this will be really successful because we’re catering to that part of the market I never used to, I only catered for the middle to high end,” she said.

Make-up artist Ellie Wright, who runs local styling business Beauty Queen, said this gave women a good option if they weren’t good savers.

Ms Wright wants to go to Thailand next year for a nose job and possible chin implant.

“It’s a way of paying that money, just not spending it week to week on little things you don’t really need,” she said.

Australia’s biggest cosmetic surgery provider, The Cosmetic Institute in Sydney provides payment plans using Zip money which charges a 19.9 per cent interest rate if the loan is fully repaid within three months.

After that a minimum $150 or 3 per cent of the outstanding balance must be repaid every month.

A $6500 loan paid back over six years at around $155 a month would see a woman pay over $4600 in interest as well as a $349 sign up fee and a $5.95 per month ($357 over six years) administration fee.

The fees and interest would total over $5380 almost the same as the original cost of the procedure.

Ellie Wright. Image: Instagram

Ellie Wright. Image: Instagram

Institute managing director David Segal said his company had no financial interest in Zip money and not all clients used it.

“People have been doing it on their home loan, extending their mortgage, getting a personal loan,” he says.

Gold Coast-based Cosmeditour provides an interest free payment option where the person pays n instalments for travelling to Thailand for surgery or using the business’ Gold Coast service. It charges a non refundable deposit of $500.

Sydney’s Enhance Clinic offers breast enlargements for $5790 with finance available if you pay $2970 upfront and $80 per week for a year, clients paying $1,000 in excess of their surgery.

Melbourne’s Elysium Cosmetic and Medical offers payment plans that for around $155 per month over five years would see the person outlay $2318 in interest.

Choice spokesman Tom Godfrey says the interest rates being offered for cosmetic surgery loans “are inflated”.

“It really pays to shop around,” he said.

“Don’t assume the company providing the procedure is providing the best credit,” he said.

Published in The Gold Coast Bulletin

29 Jun
Phuket, Thailand

Bed, board and a new pair of boobs

NIP-TUCK holidaymakers booking again!

NIP-TUCK holidaymakers booking in again post-covid for cut-price cosmetic surgery in Asia in record numbers are being greeted with at five-star hospitals.

A Sunday Mail investigation in Thailand a decade ago found Australians are using our partnered pkush hospitals complete with chandeliers and the full VIP service!
Our patients can wake up with new breasts or a trim tummy the day for up to a third the price of surgery at home.

Queenslanders are among the patients flocking to the cosmetic surgery hotspot for new breasts and flat stomachs for as little as $6500.

Some hospitals the Courier Mail visited operated like well-oiled machines with highly trained surgeons  some managed by US and Australian management teams,   leading impressed patients to “upsize” from a single procedure to a range of extras, including botox, dental work, eyelid lifts or liposuction.

Group Tours are are back again with Australians are signing-up to cosmetic surgery group tours popular again.

Pre-covid, in the country’s south, Phuket International Hospital was treating 1000 Australians a year  20 times the number four years ago.

The hospital estimates 10,000 Australians a year are flying to Thailand for cosmetic surgery.

“When you are talking about plastic surgery, it is doubling each year,” they said.

Queenslanders make up a quarter of the patients at the hospital, mostly women having breast enlargements.

In Australia, implants can cost between $8000-$17,000.

That compares to about $5000 in Thailand at a major hospital, including surgery, flights and accommodation.

University of Technology Sydney senior lecturer Dr Meredith Jones and researcher on the Sun, Sea, Sand and Silicone project said more Australians were considering cosmetic surgery only after hearing about the cheap price overseas from their girlfriends.

“They were getting it because it is cheap not because they decided I have to have this, now what is the cheapest option?” she said.

Original story published in The Courier Mail



19 Jun
Thailand

GRAND OPENING “LAGUNA WELLNESS by BDMS PHUKET”

Dr. Narongrit Havarungsi, Deputy Chief Executive Officer of BDMS Group 6 and Hospital Director of Bangkok Hospital Phuket, along with BDMS Group 6 management and Mr. Ho Kwon Ping, Executive Chairman & Founder of the Banyan Tree Group has officially opened “Laguna Wellness by BDMS Phuket” in the presence of distinguished guests and press members.

The new facility offers a wide range of healthcare services and holistic personalized wellness solutions, including preventive healthcare and screening, cutting-edge regenerative medicine, further underpinning Phuket as a premium wellness hub in the region for local and international clientele.

Phuket Vice Governor Danai Sunantharod presided over the grand opening ceremony on 12 June 2023.

The new medical and wellness facility Laguna Phuket, is Asia’s premier integrated destination, and owned by Bangkok Dusit Medical Services (BDMS), the most prestigious private hospital network in the Asia-Pacific region, formally signed a memorandum of understanding on 11 August 2022 outlining the plans to develop a world-class medical and wellness centre within Laguna Phuket.

Scheduled to open early next year, Laguna Wellness by BDMS Phuket will complement the destination’s collection of hotels, resorts, residences and spas along with a golf course and recreational facilities. The new facility will be situated at the heart of Laguna Phuket in the retail and community services hub of Canal Village and will offer residents and medical tourists healthcare and wellness support, including world-leading regenerative medicine, rehabilitation and preventive cardiology services.

Unprecedented in its scale and scope, the new facility will position Laguna Phuket as a premium medical tourism hub in the region, as well as giving the Laguna Phuket residents access to the latest medical technology and the expertise of world-class medical professionals.

“We are delighted to announce this expansion of our long-standing partnership with BDMS. Since the formation of Laguna Phuket over 30 years ago, our on-site emergency clinic operated by BDMS has been integral to the Laguna Phuket lifestyle. 

We are very excited to build on it to offer tourists and residents alike access to a world-class medical and wellness facility,” said Mr. Ravi Chandran, CEO of Laguna Resorts & Hotels. “This development will be a game-changer and further cement Laguna Phuket’s reputation as Thailand’s leading integrated destination for tourism and residential lifestyle offerings.”  

“BDMS Phuket is very keen to put efforts in the project in the Laguna Wellness by BDMS Phuket as it would align with Phuket’s Strategy as Medical & Wellness Destination. We will also collaborate with BDMS Wellness Clinic, our pioneer model based in Bangkok, for their wellness and regenerative expertise” said Dr. Narinatara.

The services planned by BDMS include regenerative medicine, preventive cardiology, sport medicine, rehabilitation, aesthetic, dermatology and mental health.

*Stay tuned for more information about Laguna Phuket and the upcoming Laguna Wellness by BDMS Phuket.

15 Jun
Phuket, Thailand

Plastic surgery and medical procedures in Thailand: Why more of us are doing it

TRAVELLING for medical procedures is a growing industry but what’s it really like? 

The changing face of healthcare in Australia.

Australians are racing overseas for cheap medical and cosmetic surgeries, after a long pause amid the COVID-19 pandemic.

From dental surgery to face lifts and Botox, these surgeries are generally considered to be much cheaper in locations such as Indonesia, Malaysia and Thailand, and are often coupled with relaxing, resort-style vacations.

Now you know a medical procedure you needed could be done at the same quality but half the price internationally, would you jump on a plane to have it done?

Prior to covid- it was estimated that around 15,000 Australians are heading overseas for nip tuck holidays every year, spending a total of $300 million on medical procedures — some of them life saving.

It’s called medical tourism, and it’s having a significant impact on global healthcare, including in Australia, where our health system is straining under the weight of an ageing population and long waiting lists for elective surgery.

Pre-covid Thailand was leading the world as a medical tourism destination. Of the 26.5 million people who visited Thailand in 2013, 2.5 million came purely for medical reasons. That number has been growing at an average of 15 per cent a year over the past decade.

“It’s changing the landscape in terms of price; in any facet of our life people want value for money,” says one Sydney based plastic surgeon.

“Medical tourism has been around forever when people would travel for procedures not available in their country. Now people are going to underdeveloped countries for things that are offered in Australia because it’s cheaper,” he says.

So what are the risks involved when travelling to a foreign country for medical treatment? And why is the Australian Medical Association and Society of Plastic Surgeons staunchly against it?

“The biggest risk I think is the post operative care. You might get two to four weeks of care overseas but in Australia you would see your plastic surgeon at least four to six times over the following 12 months,” says Dr Rizk.

However Thailand is changing this image dodgy backyard jobs and unqualified surgeons by offering a select group of world class hospitals, state of the art technology and internationally trained physicians.

And then there’s the value. A trip to the dentist for a filling in Australia will set you back around $150, in Thailand it’s $30. Breast implants will cost at least $8000 at home, compared to around $3000-$4000 in Thailand. It is this reality that is changing the medical landscape, as Australians and travellers worldwide are lured by cheaper costs, no wait lists and technology often better than what they’d find at home.

The hospitals — what they’re really like

The two biggest hospitals targeting medical tourists are Bumungrad International Hospital and Bangkok Hospital Group, both located in the country’s largest city.

The impressive private hospitals look more like hotels, which is important when they’re trying to cash in on the huge business of medical tourism.

Bumungrad International Hospital treated more than one million patients in 2013. Forty per cent of these were international patients, including around 8500 Australians.

The country’s move into medical tourism started as a survival strategy in 1998, after Thailand was hard hit by the Asian financial crises. It has transformed the way they deliver healthcare.

The 9/11 attacks were a big turning point, as Middle Eastern patients who once travelled to the US for surgery found it harder to get a visa, so they turned to Asia. Primarily Thailand.

Bumungrad hospital went from treating 10,000 Middle Eastern patients each year pre 9/11 to more than 120,000 today.

Walking into the hospital today like PPSI, you’ll feel like you’ve stepped into a five-star hotel rather than a hospital ward. Lounge areas offer free (non alcoholic) drinks, check-in desks look more like civilised bank tellers, in-house travel agents organise visa extensions and a whole wing is dedicated to interpreters offering translator services for its international patients.

Then there’s the hospital rooms. The top of the line rooms are like small apartments with a living room, bathroom and kitchen all tastefully decorated, offering Wi-Fi, and room for partners or family to stay.

Yes, this is actually a hospital room.

All the comforts of home and room for visitors.

Bumungrad has invested heavily in technology, there’s even a pharmacy robot that dishes out medication into pre made packs to reduce the chance of human error.

Bangkok Hospital tells a similar story. It treated 800,000 patients in 2013, of which 200,000 were medical travellers, including around 2600 Aussies.

Australians and Russians are the biggest customer groups for this service,” Bangkok Hospital Phuket’s director Dr Narongrit Havarungsi.

They can combine the trip to the service with a stay in a four- or five-star hotel,” Narongrit said.

More than 1,000 people, most of them foreigners, visit the Bangkok Hospital Phuket each year for breast augmentation.

The service costs between Bt120,000 and Bt170,000.

He believed foreigners come to his hospital for the service because it was relatively low in cost and good in quality.

People travel here for more than cosmetic surgery. Chronically ill patients are hoping an operation in Thailand could save their life.

A revolutionary Novalis Shaped Beam Surgery is used for cancer treatment, and a less invasive form of open heart surgery, known as OPCAB is also successfully treating patients.

An entire wing is dedicated to sports injuries, where Australian soccer players, AFL stars. and boxers have been treated.

Attached to a shopping mall, it is anything but clinical. Ironically, both hospitals even have a McDonalds to cater for their international visitors.

Cancer patients are choosing Thai hospitals for their revolutionary equipment.

The anti-gravity treadmill treats our injured sports stars.

Then there’s the patient nurse ratio. In Australia the patient to nurse ratio is 8:1, in Thailand it’s 4:1. “The only time the nurse didn’t come was when their buzzer had broken,” said Jackie, a 31 year old professional from the Hunter Valley in NSW who travelled to Thailand for a breast lift, construction and augmentation.

Costs — why is it so much cheaper?

Thailand’s medical procedures are around 30 to 40 per cent cheaper than we’d pay in Australia and up to 50 to 70 per cent less than in the US. While there’s no difference in the cost of medical technology and drugs, it’s the difference in labour costs that make it so competitive.

A nurse can expect to be paid around $17,000 in Thailand compared to $70,000 in Australia. Doctors earn around $50,000 in Thailand compared to $150,000 plus at home. Malpractice premiums are far less too. Doctors may pay around $1000 in Thailand, compared to the US where annual premiums have sky rocketed to $100,000. Then there’s the competition that keeps prices low, as the market battles for the international tourist dollar.

Surgery costs: Australia v Thailand

Breast implants: Australia — $8,000-$12,000, Thailand — $3,000-$4,000

Facelift: Australia — $9,000-$10,000, Thailand — $4,000-$5,500

Tummy tuck: Australia — $7,000-8,000, Thailand — $5,000-$5,200

Dental implant Australia — $3,500-$7,500, Thailand -$2,300

Knee/hip replacement in Australia — $20,000, Thailand — $12,000 -14,000

Fees in Thailand do not include airfares or hotel accommodation (needed for recovery once patients are discharged).

Why are Australians choosing Thailand?

Every patient news.com.au spoke to had a different story for why they are sitting in a five star Bangkok hotel waiting for surgery or recovering from a procedure.

“It’s like the Athlete’s Foot of the boob,” said Michelle, a 33 year old media professional from the Hunter Valley in NSW who had breast implants, teeth whitening and fillings.

Michelle says her experience in the Bangkok medical system was better than anything she had at home. From the doctor patient interaction to the compassion and care of the nurses, the biggest difference was the after-care. She spent three days in hospital and eight days in a five-star hotel after her procedure. She compares this to a friend at home who paid $12,000 for breast implants and was discharged from hospital the same day.

Michelle post breast implants and dental work.

Then there’s 30-year-old Calli from Subiaco in Western Australia, who flew over for rhinoplasty and breast implants. After having her nose fractured twice when she was 19, she booked her surgeries 12 months ago after hearing about it from a couple of friends.

“There’s a get ‘em in, get ‘em out attitude in Australia,” she says. “After one night I wouldn’t have even be able to lift a glass to have a drink of water,” she added, relieved she had longer to recover in a Thai hospital.

From breast implants to whole body transformations, patients range in age from early 20s to 60s.

The end result was worth all the pain for Calli.

Jaye, a 20-year-old recruitment manager from Bunbury in Western Australia paid $2000 for veneers and to have her wisdom teeth removed, and says she is finally confident to smile again.

Tracy, a 51-year-old Australian mother, googled “cosmetic surgery in Thailand” and two hours later it was a done deal. Recovering from an arm, face and neck lift, as well as a tummy tuck and liposuction she paid $20,000 after being quoted more than $80,000 at home.

“It’s been a confidence lift, I did it to make myself feel better,” she said. Two surgeries and seven days in hospital, she said the support has been unbelievable. “They are more interested in what your expectations are here compared to Australia.”

Jaye, a 20-year-old recruitment manager from Bunbury in Western Australia paid $2000 for veneers and to have her wisdom teeth removed, and says she is finally confident to smile again.

Tracy, a 51-year-old Australian mother, googled “cosmetic surgery in Thailand” and two hours later it was a done deal. Recovering from an arm, face and neck lift, as well as a tummy tuck and liposuction she paid $20,000 after being quoted more than $80,000 at home.

“It’s been a confidence lift, I did it to make myself feel better,” she said. Two surgeries and seven days in hospital, she said the support has been unbelievable. “They are more interested in what your expectations are here compared to Australia.”

Michelle can’t stop smiling after having her teeth whitened for a quarter of the cost in Thailand.

Her friend agreed” You’ll forget you’re in a hospital!”

“I’d go back to the hospital just for the service, it was like a hotel,” said Jackie.

“It was the best experience of my life.”

30 May
NEWS, Turkey

Sun, sea and stitches: Why Britons (AND NOW AUSSIES) are flying to Turkey for cosmetic surgery!

Medical tourists are flooding into Antalya for cut-price procedures. This story was written by journalist Tim Moore and published by The Telegraph in the UK on 10 April, 2023 as a piece of investigative journalism about the boom in medical tourism, where approx.150,000 British are travelling to Antalya and Istabul to have ‘work done’ just last year. last year.

He explains the rationale behind this phenomenon- is pretty basic: cosmetic work in Turkey comes cheap. Really cheap!!!! And investigates does it add up to a holiday bargain, or health-endangering hell?

I’ve only come to the CatchLife Aesthetic clinic in Antalya for a chat about Turkey’s medical-tourism boom, but the managing director can’t help blurting out a frank appraisal of my facial shortcomings….

‘We can resolve these things for you so easily…’

In a city with an estimated 1,500 cosmetic-treatment agencies, all squarely pitched at foreigners, you become swiftly hardened to plain-speaking, stigma-free assessments of your physical appearance, and the options for its clinical improvement.  As I checked in at my hotel two days earlier, the receptionist looked up with a smile and said: ‘So you are here for dentist?’

 

More than 1.2 million foreigners visited Turkey for medical procedures in 2022, the vast majority cosmetic. The proportion of Britons among them is growing faster than any other nationality, with an estimated 150,000 of us travelling there to have ‘work done’ last year.

Medical tourism now brings £2 billion into Turkey every year, a vital injection of foreign money into a struggling economy currently burdened with 55 per cent inflation. Each medical tourist spends more than three times as much here as a standard tourist,’ says Cagatay Tekguzel, manager and owner of the Formedi clinic, which last year treated almost 1,000 UK patients in Antalya. At his clinic, the numbers of Brits are up more than 20 per cent year-on-year.

Hair transplantation and cosmetic dentistry top the treatment list, followed by laser-eye correction, weight-loss surgery (typically the removal of half your stomach) and the classic surgical makeovers: nose jobs, boob jobs, facelifts, eye lifts. Istanbul is home to the most clinics, with Antalya number two and rising fast. It’s where Katie Price comes to get her teeth done, and redone, and done again.

 

The rationale behind this phenomenon is pretty basic: cosmetic work in Turkey comes cheap. Incredibly cheap, generally a third of what you’d pay at a UK clinic, sometimes even less. A new nose for £2,500, a new pair of breasts for £3,000, a new head of hair for £1,700. 

A full set of ‘Turkey teeth’, those dazzling, perfect pearly whites that are suddenly everywhere, starts at £3,200. And these prices are inclusive, typically covering four or five nights B&B in a decent hotel and all transfers as well as, often, a cheeky extra like facial filler or blemish removal at no extra cost. By comparison, rhinoplasty (a nose job) in the UK starts at around £6,200, breast implants about £7,000, a full 4,500-follicle hair transplant can cost up to £9,000 and a new set of teeth at least £12,000.

‘We’re now at a point where anyone can afford this stuff if they save up for a year or two,’ says Paul Adams, a 60-year-old from Manchester who’s in Antalya with his partner Joanne Murray. She is getting her teeth transformed; he had his own done here last September while she was getting a facelift, and got his eyes laser corrected the previous year. The pair have spent a shade over £20,000 in all for the three medical trips. Tens of thousands of Brits who could never have dreamt of cosmetic surgery are now having it done in Turkey. Some of them, in thrall to shape-shifting, twinkle-toothed social-media influencers and these irresistible prices, hardly know when to stop.

For better or worse, thanks to Turkish clinics cosmetic surgery has been democratised, normalised, stripped of taboo. Almost every patient I meet is happy to discuss the experience under their real names, often with gleeful gusto.

 

Antalya is located in the south of Turkey and backs onto the Mediterranean CREDIT: Uladzimir Zuyeu

‘I mean, look at the state of me here!’ cries Murray, brandishing the clinic’s pre-facelift ‘before’ shot on her phone. It’s difficult to know how to respond, but by any assessment she now looks a good 15 years younger.

Mediterranean resort city of two million, Antalya has long depended on the tourist dollar. Hotel complexes and holiday apartment blocks stretch along the coast for more than 20 miles, bookending the minarets and steepling alleys of the old town.

Off season, when flights are at their cheapest and the milder weather is better suited to the gentle healing of post-op wounds, the streets are thronged with black-glazed luxury minibuses that speed patients to and from clinics, bearing clunky, sometimes unsettling names and slogans: Time Travel, CosmetoCity, Corpus Renew, Aesthetic Travel – We Love to Change You.

There’s this holiday atmosphere that means you just don’t get nervous before your procedure,’ says Murray. ‘You’ve been shopping for leather goods at the bazaar, sitting in the sun, eating lovely mezes – and then suddenly you’re on the operating table.’

Two middle-aged men stroll past, conversing amiably in London accents. Both have shaved heads that are stippled with innumerable red pinpricks: the legacy of recent hair transplants, in which up to 5,000 individual follicles are excised from the bits of your scalp that still have hair, then grafted into the bits that haven’t.

In the days ahead, I complete my cosmetic-treatment-aftermath bingo card on the streets of Antalya: noses neatly tented with splints and gauze, bandaged jowls, skin-closure butterfly strips poking beyond the perimeter of oversized sunglasses.

Tekguzel, a quietly engaging 31-year-old with a degree in English, meets me by the well-appointed Konyaalti seafront hotel where guests at his Formedi clinic are accommodated. His anatomical vocabulary betrays the clinic’s target nationality: he talks of ‘bums’, ‘tummies’ and ‘super-huge boobies’.

‘As a business, ours is unusual in medical terms,’ he says, thoughtfully. ‘No one really needs a new nose or a rounder bum. This is elective surgery requested by people who are not sick. When they arrive, they are healthy, and we call them clients. Then we operate, and they become patients.’

 

This apartment is typical of the accommodation offered to travelling patients.

Just up the road, Tekguzel leads me through the Formedi’s glossy new expansion – a suite of five dental surgeries, furnished with expensive-looking equipment and executive leather. When it opens in a fortnight, he tells me, the clinic will be able to process 150 predominantly British ‘full-mouth’ patients a month, here for the signature Turkey-teeth set of 28 cubic zirconium crowns. It’s a £200,000 investment, he says. When I suggest that might take him a few years to recoup, he lets out a helpless giggle. ‘I think a few months!’

At the current Formedi clinic round the corner I’m introduced to a couple from West Yorkshire who’ve both just had the full-mouth treatment. Steven Rees, a Welsh-born tower crane operator, is 48 but has the smile of a much younger man.

I’m very, very happy,’ he says, flashing his new George Clooneys. ‘The procedure is pretty intense, 10 hours in the chair over two days, but they’ve been so gentle and professional.’

Intense indeed: the first stage involves filing all your teeth into slight points, allowing the crowns to fit over them. Whenever I look at those serrated, snowy mountains I’m reminded of a haunting photo posted by Katie Price midway through her most recent dental make-over, a crownless array of wide-set shark’s teeth.

Price, who has lost count of her boob jobs (she thinks it’s 12) and cheerfully admits to having injected so much Botox that it no longer works, might seem an improbable poster girl for Turkey’s aesthetic industry. Yet the Mono Clinic in Izmir, where she underwent full-body liposuction and a face and brow lift in 2021, devotes a whole proud page to her on its website.

‘Katie Price really knows no bounds when it comes to aesthetics,’ it gushes. ‘If you want to have an aesthetic body and face like Katie Price, you can contact us immediately.’

Dr Nilesh Parmar, a leading UK dental-implant surgeon, says that after so many veneers and crowns Price would now have ‘little or no tooth tissue remaining’, and it’s hard to imagine any reputable UK dentist taking her on as a patient.

But the Smile Team clinic in Antalya is more than happy to falteringly declare: ‘While the dentist had done Katie Price teeth she did her vacation in Turkey at the same time. So why wouldn’t you?’

 

Teeth must be filed down before veneers can be fitted CREDIT: Valeriia Mitriakova

For certain UK clients, it’s not just that Turkey is cheap. They come here because some Turkish clinics will push the boundaries that little bit further than their more conservative – or responsible – UK counterparts. Bigger implants, riskier procedures, trend-driven looks that might be tricky to undo once facial fashions move on. Get yourself a Meghan Markle ski-slope nose, and be prepared to live with it once the pixie look falls from favour, as major rhinoplasty is cosmetically irreversible.

Antalya, I discover, attracts three types of British patient. Some are here for a one-off, midlife makeover: a facelift, new teeth, hair implants. Others are returning to correct the collateral consequences of a previous procedure – most typically those who have shed a huge amount of weight following stomach-reduction surgery and need loose skin removed.

And a few are on a never-ending journey of reinvention, one made possible by Turkey’s low prices and its rather more libertarian approach to customer choice.

‘Germans, French, Swiss people want minimal procedures,’ says Dr Onur Ogan, the surgeon who performed Joanne Murray’s facelift. ‘They don’t want people to know they have had plastic surgery. It is the UK patients who ask for exaggerated results, the Love Island and Kardashian stuff, big lips, big boobs, big bums. They are happy to tell people they have had surgery, happy to show it on social media.’

For some of us, less is never more. This is conspicuous consumption distilled to its very essence.

At the MediFace clinic near Lara Beach I meet Amanda Lindsay, a 48-year-old north Londoner who’s been in for a slanted eye-lift that will – once the bandages are off – endow that on-trend, almond-shaped cat-eye look (yes, Katie Price has had it done).

Lindsay is an old hand: five years ago she underwent a full ‘mummy makeover’ (breast lift, buttock lift, tummy tuck) in the Dominican Republic. ‘If you’re not paying UK prices, plastic surgery is like going down the corner shop. I’m getting my teeth done next.’ I can see how it happens. You redecorate one room in your house, and suddenly the rest of it looks a bit shabby.

In fact, there’s a fourth type of UK patient.

Another British MediFace client, who requests anonymity, has come to Antalya for revision work – broadening her nasal airways after a botched Harley Street nose job left her struggling to breathe. ‘That cost me £5,000 and it’s been a nightmare. The consultation process here is so much more in-depth and open.’

A recently retired nurse, also endured expensive disappointments at private clinics in the UK. ‘We’ve both spent thousands having our teeth sorted back at home, and it never seemed to work out,’ says Rees. ‘I came here with a dead tooth and a composite that was falling out.’

The requisite remedial work almost doubled the cost of their Turkey teeth to £5,000 each – Joanna needed four implants and a bone graft into her jaw. But those implants alone, she says, would have cost more in the UK than ‘getting my whole mouth done here’.

Rees and Ludbrook have rationalised the expense as a blow-out holiday: ‘I mean we’re having a nice winter break in the sun here anyway, but £10,000 is what we might have dropped on a once-in-a-lifetime trip to Cancún.

Dr Ebru Yuceer, who spent those 10 hours reinventing Rees’s smile, emits quiet sincerity and an evident passion for her work. ‘I have small, careful hands, good at piano and painting when I was at school. Detail is my obsession: I wanted a career in precision.’

She has been working on foreign mouths in Konyaalti for 12 years, and still gets a kick from the expressions of delighted disbelief that typically accompany the first post-treatment looks in her mirror. ‘I get well paid, sure, but happy patients are the best salary.’

As the petite 35-year-old earnestly holds forth, flanked by two beaming examples of this professional perk, I realise that bargain prices and a holiday environment aren’t quite the whole story. The Turkish medical-tourism boom is also founded on the close personal relationships that good clinics foster with their patients, and more fundamentally on the dependable quality of their work.

 

 

Dr Ebru Yuceer: ‘Detail is my obsession’ 

 

Turkey can draw on a long heritage of cosmetic surgery: one pioneering 15th-century medical textbook shows that Ottoman doctors were conducting eye lifts and even moob-reduction procedures 600 years ago.

Since the medical-tourism boom got going 20 years back, Antalya’s cosmetic dentists and surgeons have built on this tradition, and in great numbers. They’re craftsmen who have become extremely good at what they do, honing their very particular skills through years of specialised repetition on thousands of patients.

Practice has made perfect. It’s a conclusion reinforced when I meet a bariatric surgeon who makes 25 British stomachs smaller every month, and a rhinoplasty supremo who reshapes twice as many noses over the same period. There are hair doctors in this city with more than 4,000 transplants to their name, surely a profound reassurance to any patient waiting to have the same number of tiny holes cut in his head.

Their cosmetic counterparts in the UK, with nothing like this throughput of patients, can rarely accrue such a depth of experience.

Paul Adams had both his eyes laser-corrected at an Istanbul clinic in under an hour. ‘It was like pulling a pint for him [the surgeon] because he’s done it so many times.’ A year since he binned his bifocals, Adams is still merrily amazed. ‘It was under £2,500 for both eyes, and that included a five-star hotel. At home I’d been quoted £3,000 per eye.’

Cagatay Tekguzel maintains that his industry is rooted in the Turkish people’s inherent urge to care for those in need – though this seems better evidenced by the glossy, well-fed stray cats of Antalya than bald foreigners with tiny new scars all over their heads.

Yet there’s no doubt that patient/clinic communications are nurtured to a degree unimaginable in Britain, before and long after surgery. All the doctors I meet scroll happily through WhatsApp messages they’ve been responding to around the clock, fielding queries from prospective future clients, addressing concerns about wound care from those recently treated, exchanging jolly banter with patients they haven’t seen in the flesh for years.

Every clinic employs a roster of multilingual ‘patient co-ordinators’, who talk clients through their procedures and detail the aftercare, offering a supportive word here, holding a hand there. (Sometimes their English lets them down: one coordinator tells me of the time he misremembered the word ‘sedation’, and informed a wide-eyed female patient that the doctor would be treating her ‘under seduction’.)

The personal touch is evident from the very start. ‘At the airport there was a driver with my name on a card,’ says Borce Drapic, a Macedonian-born German who’s just had a hair transplant at the MediFace clinic. ‘He came over and gave me a big hug!’

CatchLife patient coordinator Tunahan Özelçi tells me that when clients fly home, tears are commonplace. ‘They cry, we cry – we’ve built such a strong relationship.’

In truth, this overflow of TLC is run through with a stream of hard commercialism.

As the patients I speak to confirm, these clinics now source their clientele almost entirely via social media: reviews, video clips and the ubiquitous before-and-after shots that previous customers post on Facebook, Instagram and TikTok gather traction, abetted by the clinic’s own carefully curated accounts (CatchLife employs a three-man ‘digital team’). It’s a business where word of mouth has given way to photo of face.

In the scramble for positive online feedback, clinics can’t afford to have patients grumbling about poor stitching or infected wounds, let alone grumpy doctors and uninterested staff. Formedi, CatchLife and MediFace all offer ‘free revision’ guarantees: a pledge to put things right if they go wrong after your return, with the patient only liable for the cost of a return flight to Antalya.

‘It can take a year to fully recover from surgery,’ says Tekguzel, ‘and because our patients live abroad they need extra reassurance in case stitches tear or implants sink down or things like that.’

These concerns may also help explain why most of the clinics I visit are now edging further towards low-risk, high-gain procedures: hair transplants and Turkey teeth make great before-and-after material, and rarely engender the sort of complications that can badly compromise your online PR.

 

Cagatay Tekguzel: ‘When they arrive, they are healthy, and we call them clients. Then we operate, and they become patients.’

Surgery is always a roll of the dice. Studies show that post-operative sepsis affects just over one per cent of patients, with a mortality rate approaching 30 per cent. Any procedure involving liposuction – the removal (and typically relocation) of subcutaneous fat – comes freighted with the additional danger of fat droplets entering the bloodstream, thereby risking lethal clots.

Every clinician I talk to winces slightly at the very mention of BBLs – Brazilian butt lifts, the Kardashian-inspired treatment du jour that creates beach-ball buttocks through the heavy use of ‘lipo’. (The CatchLife team tell me the procedure is increasingly requested by male clients: ‘They read surveys that tell them women always look at men’s bums before their faces.’)

The doctors seem reluctant to detail their evident reservations, and the statistics tell me why: an extensive study concluded that one in 3,000 BBL procedures have a fatal outcome. The odds might be low, but with 150,000 UK medical tourists a year, they still equate to a grim toll of tragedies.

Three British women have died as a result of complications arising from BBLs undertaken in Turkey; Abimbola Bamgbose, a 38-year-old social worker from Dartford, succumbed to peritonitis in August 2020 after undergoing liposuction and BBL surgery at Mono Cosmetic in Izmir – a clinic that has reconfigured Katie Price. Since 2019, according to the Foreign Office, a total of 22 Britons have lost their lives following medical-tourism visits to the country.

After a rash of UK tabloid horror stories, in 2018 the Turkish health ministry imposed regulations requiring clinics that treat international patients to go through a licensing procedure which, I am repeatedly assured, is both stringent and very expensive.

The cowboy clinics are long gone, I’m told, and standards are now up with any in Western Europe. Every single clinic and hospital I visit in Antalya – both public and private – is spotless and arrestingly well equipped. Most exude the air of an upmarket chain hotel; one even offers valet parking. Doctor after doctor insists that mortality rates for cosmetic procedures are no higher in Turkey than elsewhere.

But despite these reassurances, the undoubted skill of the surgeons and dentists and the tireless empathy of their patient coordinators, there’s no escaping the fact that coming out here for cosmetic work is still a pretty ballsy undertaking. You’re 2,000 miles from home and someone you’ve only previously met on WhatsApp is going to file down every tooth in your head, or snip off half your stomach. They might be brilliantly dextrous, but they might also be exhausted, running on fumes in their fourth op of the day.

And though Antalya never feels in any way unsafe, there’s a vague but pervasive banana-republic vibe that makes a slightly jarring fit with complex medical procedures. Stray dogs, heady smells, nervous conscripts with big machine guns. Dusty old men hauling handcarts full of rubbish down potholed alleys. Almost everyone smokes, though at least the doctors go outside to do it. Nobody seems to accept credit cards, and Turkey’s rampant inflation stuffs your pockets with wads of grubby notes, some worth less than 20p.

Most clinics demand full upfront payment in cash – euros or sterling only.

‘I mean, who deals in cash these days?’ says Steven Rees. ‘When you hand it over, a part of you can’t help thinking it’s a scam, that you’ll come back for the treatment and the clinic’s vanished.’ Paul Adams had to fly out with £12,000 in cash, for his teeth and his partner’s facelift.

‘I was terrified, I thought I might get mugged on the plane! Half the passengers were out here for treatments – there must have been £200,000 on that flight.’

I suppose you just have to keep reminding yourself that there are several reasons why this work is so cheap, and a few of them are a bit murky.

‘In a funny way, I think that’s one of the reasons people can seem a bit jealous,’ says Joanne Murray. ‘It’s not just that we look so much younger, it’s that we’ve had the gumption, the bravery, to come out here and do this.’

Back at Antalya airport I wander through ranks of the walking wounded, scarred scalps, splinted noses, bandaged necks.

There are lots of headscarves, caps and enormous sunglasses. A woman in a white-and- gold tracksuit sits down very gingerly, grimacing as flesh hits hard plastic. Over at the duty-free queue, a middle-aged man extracts £20 notes from a big roll to pay for two cartons of cigarettes. He cracks a smile at the cashier, and I deduce it’s the remaining cash balance from his new Turkey teeth.

Turkey

 

 

 

 

 

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