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Medical tourism and plastic surgery – The good the bad and the ugly

Samui Times Editor



Medical tourism and plastic surgery – The good the bad and the ugly | Samui Times
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Medical tourism is on the rise in Thailand, but while Bangkok based Steve Finch tells a story of a professional and very popular hospital, Bumrungrad International, there are others who are giving this growing industry a bad name, unscrupulous individuals who are offering plastic surgery but have no qualifications to do so.

Steve Finch, in an article written for the Canadian Medical Association said –

Bumrungrad International Hospital in Bangkok, Thailand, can feel like a shopping mall or five-star hotel. It offers 21 VIP suites and the mezzanine has a McDonald’s. On the floor below, people line up to buy lattes and Americanos from a Starbucks.

Sitting nearby with coffees, a father and son from Oman silently faced each other in the lobby. They had been in Bangkok for 50 days already, traveling to Thailand to seek treatment for the father’s prostate cancer.

surgery 5“Some friends at home told us about this hospital,” said the son, declining to give their names. “They said it is very good.”

The largest private hospital in Southeast Asia, Bumrungrad is the unofficial leader of medical tourism in Thailand, itself the most popular destination for medical travelers in the world, though accurate data on this fast-growing industry remain elusive.

The Ministry of Public Health claimed Thailand received 2.5 million medical tourists last year, but medical tourism directories, such as, consider the true number to be fewer than 700 000 patients.

Singapore and India are the next leading destinations, but data for these countries are also unclear, say industry analysts. Together these three countries account for an estimated 80% of the global medical tourism market, and Thailand alone for about 40%.

“Why is Thailand so popular? It’s because of the Thai health care system. It’s advanced and affordable, and these are the two most important criteria for would-be medical tourists,” said Adele Kulyk, CEO of Saskatchewan-based Global Healthcare Connections Inc., an agency that arranges patient travel to Asia and Central America.

Assessing its own credentials as an international medical hub in late 2010, the Thai government noted it led its Asian competitors on service, matched India on cost and Singapore on quality of staff, but fell short on medical hardware compared to nearby Singapore.

Both Thailand and Singapore had 13 hospitals accredited by Joint Commission International, an organization that promotes rigorous standards of care in more than 90 countries. In 2002, Bumrungrad became the first hospital in Asia to meet the standard. Over the past three years, 17 more Thai facilities received the endorsement, compared to Singapore’s nine.

surgery 6Cost is where Thailand really excels, though, said Kulyk. For heart bypass surgery, Bumrungrad offers a package including a week’s stay for around $19 000, according to its website, compared to at least US$80 000 in the US for a patient without health insurance.

Although heart surgery costs much less in Canada, wait times mean patients are increasingly seeking treatment overseas, said Kulyk, who started Global Healthcare Connections after a close friend died of cancer following a late diagnosis.

“Thailand isn’t as popular [with Canadians] as Mexico, the Cayman Islands, South Korea and other countries,” she said, citing the lengthy travel time. “But Thailand got a head-start on these others, so they’ve had a number of years to work very hard on this program and to understand the needs of the international traveler.”

Part of Thailand’s medical tourism success is due to its wider popularity as a holiday destination. Bangkok is expecting 16 million foreign visitors this year, more than any other city in the world. More than 900 000 of these are expected to seek medical care as ever larger numbers from across the globe experience Thai hospitals and clinics first-hand.

In the Middle East, Thailand’s reputation for quality health care is already well known, a side-effect of tragedy in the US. After 9/11, many people in Arab states stopped traveling to Europe and North America for treatment amid discrimination and visa problems and instead took the seven-hour flight in the other direction to Bangkok, said Kenneth Mays, Bumrungrad’s marketing director.

“Then it started really booming,” he said, as the number of Middle Eastern patients at the hospital soared 12-fold to 120 000 visitors per year in the decade after 9/11.

More recently, overseas delegations have toured Bumrungrad in a bid to emulate their model, but Mays said these visits have been stopped to retain competitive advantage.

“We found that, for example, [some groups] were touring our facility and taking pictures, measuring walls and going back and trying to create places to compete with us,” he said.

As the multibillion-dollar medical tourism market develops, other Asian countries are expected to remain Thailand’s main competitors with patients tipped to increasingly favour destinations closer to home, said Mays and Kulyk.

Meanwhile, India has announced a target of one million overseas patients by 2015. Singapore is also hoping to boost medical tourism. Soo Siew Keong, director of business development enrichment at the Singapore Tourism Board, said his office’s recent programs include a prototype ward with the Raffles Medical Group for Middle Eastern patients and a VISA partnership offering medical concierge services to visiting Indonesian cardholders.

“With additional private health care capacity coming on stream in the next few years, the [Singapore] industry has made efforts to reach out to key markets,” he said.

Steve Finch

However news reports about individuals posing as cosmetic doctors only reiterate how important it is to ensure that you chose the right doctor, clinic or hospital if you are thinking of using medical services in Thailand, whether you live here or come from overseas.

On November 14th a 22 year old university student who was claiming to be a plastic surgeon was arrested as part of a police crackdown on the unlicensed medical clinics in Bangkok.

surgery 7The owner of the Pulchala Clinic, Ms. Natchanan Bhitakchaikorn was arrested after she claimed, on her website, to being a specialist in the beauty business. She will now face charges of counterfeiting documents and computer crimes for providing false information online.

According to Mr. Tharit, Chief of the Department of Special Investigations said that Ms. Natchanan was only a sophomore student at a private university in Bangkok who is strapped for cash. He said that she used a fake graduation certificate to pass herself off as a cosmetic surgeon.

Minister of Public Health Pradith Sintawanarong, MD. Told a Khaosod correspondent that there are 10,695 medical institutions run by the state authorities and over 18,000 privately run establishments who are registered with the Ministry. However between October 2010 and September 2013 many unlicensed medical facilities have been reported to the authorities.

The penalty for the illegal operation of medical or cosmetic establishments is a maximum of three years in jail and a fine of no more than 30,000 baht. Unlicensed physicians face three years in jail and a 30,000 baht fine. However a surgeon with counterfeited certificates faces three years in jail but only a 6,000 baht fine.

Unlicensed cosmetic treatments have resulted in injuries and deaths in recent years and Mr. Pradith urges anybody who is seeking treatment to check whether their preferred cosmetic medical institutions are properly registered by visiting

Last week, the Health Ministry and police declared a small victory after arresting someone they called “the most dangerous” operator to date: a 37-year-old former beautician’s assistant with no medical training who had set up an all-purpose clinic in her home.

Inside the woman’s pale yellow town house in a working-class Bangkok neighborhood, authorities found box-loads of counterfeit Botox, cheap facial fillers, intravenous skin-whitening chemicals and a variety of banned products known to have dangerous side effects. The arsenal of potentially toxic beauty products underlined the lengths that women – and some men – take to improve their looks.

surgery 4“This is terrifying,” said Phasit Sakdanarong, chief adviser to the Public Health Minister, who joined the raid and has since advised the government to expand the crackdown nationwide. “This woman was not a doctor. This clinic has no license, and the products she was using are not FDA-approved.”

“We are facing a very, very serious problem,” said Phasit. “When people go to illegal clinics like this, it is very easy to get an infection – and sometimes it is easy to die.”

The clinic operator, Jiratha Saraban, told authorities through tears that she had ordered her products cheaply off the Internet and catered to low-paid office workers and college students.

“I wanted to help people who can’t afford to do these procedures at expensive clinics,” Jiratha said. She faces up to 11 years in prison on three charges that include posing as a doctor and illegally selling medication.

She offered standard black market rates: $30 Botox shots and $50 filler injections, a popular method for elevating the nose bridge to look “less Asian.” In licensed Bangkok clinics, Botox injections range from roughly $150 to more than $400.

Dangerous beauty treatments have become a worldwide problem as people seek cheaper alternatives to plastic surgeons. In Hong Kong, a woman died last week of septic shock after getting a blood transfusion that a clinic claimed would whiten her skin. An American woman died in March from an illegal buttocks implant in Georgia, caused by suspected counterfeit silicone.

While many visitors and Thai nationals enjoy superb results from plastic surgery in Asia while at the same time enjoying the savings it provides, getting the wrong plastic surgeon can be catastrophic.

surgery 325 year old Ratphilia Chairungkit had dreams of looking like Jennifer Lopez, so the street food vendor hit the internet and typed in “cheap botox”. This was the start of a five year makeover that include two nose jobs, two eye widening surgeries, chin augmentation, lip trimming, skin whitening and dozens of botox treatments.

The idea behind the treatments had been to redesign her whole face but things did not go according to plan. She said “I started to look like a witch” when her upper eyelids sagged, her lower lids erupted in bumps, her chin drooped and her nose swelled. After expensive corrective surgeries, that caused considerable pain she is now content with her appearance, although she certainly bears no resemblance whatsoever to her American pop idol.

Unscrupulous plastic surgeons attract customers by low prices and prey on young girls desires to look fair and delicate. Thai society often looks down on the facial feature associated with the lower classes such as wide noses and dark skin. Ratphila said “ I used to look like a factory worker, but now when I look at myself in the mirror I am happy, with a better face, you have better chances in life. But her quest of bargain beauty certainly came with a very painful price. A pseudo beautician injected commercial grade silicone into her cheeks, chin and under her eye and it all had to be surgically scraped out, and it cost her half a million baht to repair the damage from the original surgeries.

Far from having regrets, she says, her ordeal has turned into a business opportunity and she plans to open her own cosmetic clinic later this month. “Now, I’ve become a beauty guru. Everyone comes to me for advice,” she said.

However an Australian model has many regrets over her decision to visit Thailand for her breast augmentation.

surgery 1Mindy Bouchet an Australian model claims her career has been ruined after a “surgery holiday” to that left her with botched breast implants. Mindy appeared in Zoo Weekly’s Beach Babes competition in 2010 and purchased the budget holiday and surgery package last year.

But after her surgery, the 25-year-old Perth woman was left with uneven breasts, scarring and a “double bubble” effect.

Ms Bouchet told A Current Affair the Thai surgeon who performed the operation was dismissive when she made a formal complaint.

“I sent them photos saying what was happening and he sent me an email back saying they looked great, ‘what was I talking about?” Ms Bouchet said.

“I just want other girls to know it’s not worth it”.

The company who supplied the package, Restored Beauty Getaways, blamed Ms Bouchet’s previous breast augmentation in 2009 for the complications, and said the company offered to have the Thai surgeon perform corrective surgery, which she declined.

Restored Beauty Getaways sends on average 60-80 patients to Thailand each month.

Ms Bouchet said will spend $15,000 for surgery back in Australia to correct the damage — about three times what she paid for the surgery holiday package.

Her surgeon, Kourosh Tavakoli, said he believed a large number of women return with complications after surgery holidays.

“Somewhere between 20 and 30 percent of people who go overseas will need corrective surgery,” he said.

“Mindy’s case is particularly bad … Everything that could go wrong did go wrong.”

Lotus Medical International in Phuket responded by saying

surgery 2Cosmetic Surgery whether having it in Australia or Thailand is not without its risks and from time to time complications can occur. The risk of complications is reduced by using a surgeon with a good reputation and by following the instructions given by the surgeon before and after the surgery.
Thailand boasts some of the best cosmetic surgeons in the world. It is however important to do your research on any surgeon before having surgery with them. Lotus Medical only works with the top surgeons in Thailand and our results speak for themselves, we have had hundreds of happy clients. We also guarantee our work. This means that in the rare instance where therer are complications and when they are the fault of the surgeon or hospital that we will fly our clients back to have any problems fixed.

We have researched this case and we know that this lady had already had a previous Breast Augmentation and that she had complications with it, this already put her at higher risk than most patients. When she did have complications the surgeon offered to fix her problems at no cost, this is something which most Australian surgeons do not do. The patient decided of her own accord not to go back to Thailand to let the surgeon redo her surgery.

The Australian surgeon interviewed on the current affair programme staded that between 20 – 30% of people who have surgery abroad have to have corrective surgery when they get back to Australia. This is simply factually incorrect. Our own figures show that less than 1% of clients need any restorative work. Australian surgeons charge more for their surgery than in any other country in the world. This means that many people opt to have high quality surgery at a fraction of the cost in Thailand. A few years ago The Association of Plastic Surgeons in Australia put $10,000,000 in to a campaign to rubbish Thailand. If you look for bad cases of surgery you will find them. We have had many women that have had bad surgery in Australia contact us to help them to get it fixed. The surgeons in Australia, unlike in Thailand, actually charge their patients to fix any problems.

For those people who do not want to pay exorbitant rates for surgery the simple fact remains that Thailand offers one of the best options. Lotus Medical is very proud of the quality of surgery that it provides and we are very happy to have helped so many people to achieve the outcomes that they have wanted.

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