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Medical Tourism. Breast Implants in Thailand

Friday, May 20, 2011

Should I Have my Breast Implants Overseas?

These days, there is often a new type of patient in our consulting room.  This is usually a young woman who has travelled to Thailand to have her breast implants inserted while she is on holiday. This is called “medical tourism”.  Women are attracted to this idea because of the comparatively lower price of the surgery.  But what are they really getting for their money? Are they aware of the potential complications? How will these be managed once they are back in Australia?

Travelling to Thailand for Breast Implants

Thai_Elephant

The other day I saw an attractive young woman who had travelled to Thailand for breast implants.  Prior to her operation, she had a consultation with the surgeon.  He was quite personable and there was an interpreter present at the consultation.  The operation was performed in a modern hospital facility which was quite reassuring.  She began to become concerned 2 days following her surgery when her right breast became swollen.  As she was still in Thailand she returned to see her surgeon who inserted a needle into her breast to aspirate some excess fluid from around the implant.  All seemed to be well and she returned home to Australia.  Unfortunately, when she started work a month later, her right breast again became swollen.  She saw her GP who prescribed antibiotics and anti-inflammatories.  An Ultrasound examination of her right breast showed extensive fluid around the breast implant.  Fortunately, by the time she came to see me, her right breast had settled down as a result of her treatment.  But what can she expect in the future?

Her Future

The woman told me that she had textured silicone implants inserted in front of the muscle.  She was not sure about the manufacturer of these implants and therefore I was unable to advise her as to whether these implants had been approved for use in Australia.  It is not unreasonable to assume that, as the cost of surgery is kept to a minimum, then the cheapest implants would be used.  Could it be that  implants that have been rejected for sale in Australia are sold cheaply to hospitals in Asia?  For example, it is known that certain types of texturing causes the implant to act like sandpaper and makes the patient very prone to fluid collection due to the constant inflammation around the implant.  Textured implants have also been associated with a rare type of lymphoma (cancer) that can form around breast implants.  Obviously, I did not wish to alarm this young woman but I did caution her that should her fluid collection re-appear, then this should be aspirated under Ultrasound guidance and the fluid sent for bacteriological and cytological examination.  She would also need to have an MRI examination every 2 years to check for silicone leakage.  It is certainly difficult to be confident about the longevity of these implants given this early complication.

It Gets Worse

But it can be lot worse.  One of our medical journals recently described the tragic case of a 31 year old Swedish woman who responded to a website advertisement by a travel firm specializing in organizing medical treatment abroad.  In this case, the woman (who lived in the UK) went to Poland to have her breast augmentation.  The operation was performed in an old hospital that was quite different from the modern hospital depicted in the advertisement.  Due to grave mistakes in anaesthetic care and lack of appropriate post-operative recovery routines, this patient sustained severe brain injury because of prolonged hypoxia.  It took more than 7 hours before she was transferred to the Intensive Care Unit across the street.

Now, 6 months following her operation, the patient is in a Nursing Home with only vegetative functions of her brain left. Probably there are no prospects for improvement and the life of her family has been ruined as well.

Choosing a Surgeon

Surgeons in Australia are familiar with many similar stories regarding patients having surgery in Asia. It is strange that patients desiring breast implant surgery, although fairly knowledgeable about how to choose and check on doctors at home, are surprisingly naive about treatment in foreign countries.  Often it is the travel agent who selects the available surgeon and the facility.  Many of the patients seeking treatment abroad are either young, poorly informed, or simply very easily attracted by the promises of lower price and immediate surgery.  I hope that none of my readers will succumb to this type of surgery. Click here to find out more about breast implant surgery.

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