19 Feb 2015

Thailand: where cut-price plastic surgery is booming… and can be fatal

Plastic surgery in Thailand is a booming business – but procedures there carry risks, as was shown by the death of a young British woman in a Bangkok clinic last year.

They’re coming in their millions for bargain boobs and tummy tucks. Yes, Bangkok is the place to fix life’s imperfections – or simply roll back the clock.

This mega-city in south east Asia is now a major hub for cosmetic surgery with 800-odd clinics. What’s more, the beauty business is booming as visitors from the UK and elsewhere seek out “mummy makeovers” and “severe facelifts” at a fraction of the price it would cost them at home.

The city’s private hospitals and clinics and look modern and sophisticated, and they certainly generate a lot of money – £2.6bn in 2013, we’re told. But the industry is governed by a regulatory regime that could only be described as “loose”, and there are growing concerns about the risks associated with cosmetic surgery in this country.

Last October, a young British woman called Joy Williams flew to Bangkok for an operation at the SP Clinic.

Her friends described her as bright and caring, but she’d never liked the way she looked. Ms Williams selected buttocks implants but the initial procedure went poorly. The wounds became infected and she returned one week later to have them removed. Ms Williams died shortly after the operation.

Dr Sompob Sansiri was charged with recklessness causing Ms William’s death and performing a procedure outside licenced opening hours – the operation was done at 11 pm. A police source told Channel 4 News that the physician was trying to operate and administer the general anaesthetic at the same time.

He is currently out on bail awaiting prosecution, but as you will see in our special report, Dr Sansiri has reopened the SP Clinic and begun seeing patients.

In the UK and most other European countries, doctors facing criminal charges are usually suspended – immediately – by their professional regulatory bodies, but the situation is different here. Short of a conviction in court, it seems there’s little to stop Dr Sansiri from reopening his business.

A Channel 4 News investigation shows that there are plenty of other reasons to worry.

We have discovered that Dr Sompob Sansiri is not a qualified cosmetic surgeon. In fact, like the vast majority of doctors doing cosmetic surgery in Thailand, he is a GP who has “learnt on the job”.

Dr Samphan Komkrit, the head of the regulatory Medical Council of Thailand, told that us this was a perfectly acceptable arrangement “historically (in Thailand), breast implants, eyelid surgery, rhinoplasty – these jobs were not done by plastic surgeons… we don’t want to discriminate against doctors who are not plastic surgeons. This is about self-interest and business interest.”

However, Dr Samphan conceded that GP’s needed more training.

“In the beginning we will try to encourage doctors to do specialist training and after 5 or 10 years we might make it compulsory” he said.

When I asked why the medical council didn’t simply make it compulsory now, he said, “some people might like to make it sooner but a sudden change would cause chaos and misunderstandings.” Clearly, it won’t be easy to enforce higher standards in an industry where the vast of majority of procedures are currently performed by GPs.

That’s not the only problem however. One way some cosmetic clinics in Bangkok manage to keep prices low is by doing the general anaesthesia “in-house”. The alternative – of performing the operation at private hospital with a qualified anaesthetist – drives up the cost of procedure. Furthermore, the country suffers from a severe shortage of fully-trained anaesthetists.

For the head of cosmetic surgery at Bangkok’s internationally accredited Yanhee Hospital, Dr Greechart Pornsinsirisak, this practice is a serious problem. “Even qualified (cosmetic) surgeons can’t do anaesthesiology. When you get to that point it gets really dangerous as no-one can guarantee the patient’s safety. Even if the doctor is skilful, he cannot manage the breathing as well.”

Dr Greechart told us that 50 per cent of his patients come to him to fix mistakes made by other doctors – the most common being asymmetrical scars and incompletely healed wounds.

It came as a surprise, then, when the government body in change of the industry in Thailand, the “Bureau of Sanatorium and Art of Healing”, told us that in the past five years they have received absolutely no complaints about any Thai cosmetic surgery facilities.

It seems the industry has been awarded a clean bill of health then, despite what happened to Joy Williams.

But prospective customers are strongly advised to select clinics and surgeons with care. Here’s what Kevin Hancock, consultant plastic surgeon and member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons, has to say: “People need to be extremely cautious.

“Just because it is cosmetic surgery does not mean that patients can’t suffer from serious complications – or even death.” Mr Hancock continued, adding: “lack of regulation is a huge problem. Nobody (in Thailand) checks to see if information on the clinics’ websites is accurate. It is the sort of thing that customers really need to know.”

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