Guiding clients towards appropriate Cosmetic Surgery

Many of your clients will at one time or another consider having plastic surgery but there are risks they need to be aware of so they should never undertake cosmetic surgery without careful consideration. Cosmetic tourism has become an attractive option. Packages offering cosmetic surgery combined with a holiday in the sun are increasingly common. The picture painted is “kill two birds with one stone”. However, these “holidays” can become problematic. For example, there may be communication barriers, inadequate pre-operative screening, the inability to establish and maintain a rapport with the surgeon, insufficient post operative care and increased risk of deep vein thrombosis. Cosmetic tourism might sound wonderful, but before your clients start packing their suitcase, we suggest they carefully consider the real cost and the very real risks involved. 11 things to consider before deciding on cosmetic surgery overseas 1. Qualifications: can your client verify their overseas doctor’s qualifications? Are they a plastic surgeon? What training and experience do they have? While highly-qualified surgeons operate in countries all over the world, verifying the qualifications of the doctor performing your client’s surgery could be difficult. The International Society of Aesthetic Plastic Surgery website (www.isaps.org) is a good place to start, but if a doctor isn’t listed there it may be very difficult to know if that person is properly qualified and registered. 2. Confidence: will your client be comfortable only meeting the surgeon briefly before surgery? One of the biggest problems with cosmetic tourism is that patients may not meet the doctor performing the procedure until very shortly before the operation. By then they will have already paid a considerable amount to be there. If they don’t feel comfortable with the doctor, don’t like their manner, have trouble communicating with them, or are presented with a different doctor than they were expecting, what will they do? Can they also be certain that the doctor has full knowledge of their medical history? It’s important that they have all medical records – particularly if your client has had other procedures in the past. 3. Anaesthetic: cosmetic surgery is real surgery which should never be taken lightly – particularly when a general anaesthetic is involved. In New Zealand, an anaesthetist undergoes full medical training and at least a further seven years of post-graduate specialist anaesthetic training and examinations before being legally qualified to ‘put you under’. In some other countries nurses carry out the anaesthetic duties instead. Can your client verify that an anesthetist will be present and what their qualifications and experience are? 4. The right operation: Your client might believe they need a particular procedure, but a qualified plastic surgeon will draw on many years of training and specialist expertise to help advise whether it is the right operation for them. For example, a tummy tuck might be more appropriate than liposuction, or a breast lift could work more effectively than a breast enlargement. These are decisions that should not be made hastily – or to fit your client’s holiday schedule! 5. Quality: will the medical devices used be the best available, or just the cheapest? The New Zealand Institute of Plastic and Cosmetic Surgery recommends the use of only the highest quality implants and products. These are products that are going to sit inside your client’s body – either temporarily or permanently. Cheaper surgery usually means cheaper products. 6. Post-operative: What sort of a holiday does your client think they will have? Often a big part of the sales pitch for cosmetic tourism is the ‘holiday’ afterwards. Brochures show sparkling swimming pools and beautiful beaches, but what they often don’t mention is that after surgery patients are more likely to be lying in a hospital bed or hotel room with bruising and bandages rather than on a beach. Sunbathing, swimming, drinking alcohol, even walking around in the heat are all to be avoided after surgery. Your client needs to consider whether ten days recovering in a foreign hotel is really a ‘holiday’. 7. The journey home: flying after surgery increases the risk of complications. Long flights and surgery both increase the risk of blood clots (deep venous thrombosis) and pulmonary embolism (when a clot breaks off and travels into the lungs). These complications will leave your client with long-term medical problems, or in the worst cases, will be fatal. Airplane travel and surgery put together is a risky combination. It is very important that there is a reasonable length of time between surgery and flying (both before and after) – up to two weeks for some procedures. 8. Follow-up care: after-care is a big part of any surgical procedure. Is your client confident they will receive the care they need immediately after their operation? Who will be available to care for them if things don’t go to plan? They should also consider what care is in place once they return home. Many procedures require follow-up checks weeks, or even months, after surgery. Infection, pain and poor scarring are some of the common reasons why patients who have had surgery overseas seek medical help back in their own country. Is that something your client is willing to risk? Most overseas cosmetic tourism promotions have no plan in place for after-care once the patient has returned home. 9. Problems: What if it all goes wrong for your client? Increasingly, plastic surgeons here in New Zealand are being called upon to carry out ‘revision surgery’ – in other words, to ‘put right’ procedures performed overseas that have not gone according to plan. This is often difficult, in fact sometimes not possible, once things have gone wrong and damage has been done. This is particularly so when the New Zealand surgeon has little or no information about exactly what methods or procedures were used by the overseas doctor. 10. The real cost: we all love a bargain – a designer suit in an end-of-line clearance sale or a new car at a ‘once-in-a-lifetime’ price can make us feel great about the money we’ve saved. But is a bargain wise when it comes to cosmetic surgery? Remember that this is your client’s ‘once-in-a-lifetime’ face and body we’re talking about. If your client doesn’t like the results, revision surgery can be costly and is seldom as successful as having it done properly in the first place. 11. The alternative: simply comparing prices is no way to choose a plastic surgeon. If your client is seriously considering surgery we believe they should be talking to a fully-trained medical professional about what is involved and what can be achieved – not a tour operator! Cosmetic surgery requires careful consideration and pre-operative planning but more importantly your client should have complete confidence in their surgeon and their nursing team. It is important they plan their surgery, it should not be undertaken in combination with an overseas vacation. Encourage them to take the time to do their research – it is their body and their life, so they need to make their decisions wisely and with due care.

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