From obesity surgery to buttock augmentation: UK concerns over unregulated plastic surgery grant

The list of services offered ranges from the imaginative to the painful, from the dazzling to the bizarre.

There are organ replacement procedures to obesity surgery, Brazilian buttock augmentations to hair transplants and full-body MOTs. This isn’t the body-modification menu from a science fiction novel, but packages for sale at the Health Tourism Expo, a two-day sales conference for surgical alterations held in London last month.

The event was attended by many doctors and hospital representatives manning advertising stands. Many came from Turkey, where clinics attract thousands of British tourists looking for surgery at a lower price, with flights and accommodation included.

Among the exhibitors at the QEII Centre – a conference venue set back from Parliament Square, where tourists stream in and out of Westminster Abbey – was the Association of Turkish Travel Agencies – with many of the agencies it represents offering to coordinate flights and hotels for those undergoing surgeryChambers of Commerce from other cities and towns were also present and proudly advertised the number of hospitals and clinics in their region.

The gathering of travel agents and clinics for the expo is symbolic of the boom in surgical tourism in the UK. According to data from the Office for National Statistics, the number of British residents leaving the country for medical treatment rose from 234,000 in 2021 to 348,000 in 2022.

There is no evidence that any of the clinics exhibiting at the London Expo have been involved in malpractice. But while the surgical tourism industry appears to be thriving, one aspect of the industry seems to be completely lacking: regulation of promotional events such as this one.

The Guardian has learned that the event, which featured 74 exhibitors who were direct to the public, was not overseen by the UK’s health, advertising or business regulators. Experts say this needs to be addressed urgently to protect patients.

Offering complex and expensive treatments at a low price and with no waiting times may seem attractive to British consumers, but experts who have noted a rise in the number of people seeking medical care after botched operations warn about the lack of oversight in this relatively new market.

According to data from the Ministry of Foreign Affairs, six Britons died in Turkey in 2023 after medical procedures, while data from the British Association of Aesthetic and Plastic Surgeons (BAAPS) has revealed that the number of people requiring hospital treatment in the UK after undergoing cosmetic surgery abroad has risen by 94% in three years. In the four years to 2022, 324 patients required surgery when they returned home.

The BAAPS report, published in November last year, found that procedures carried out in Turkey accounted for more than three-quarters of such cases in the preceding six months, with the cost to the NHS estimated at around £15,000 per person. However, it noted that there was considerable variation depending on the treatment each person required.

Marc Pacifico, the president of BAAPS, said the lack of oversight at events such as the Health Tourism Expo was concerning. “I find it really remarkable that an exhibition like this seems to fall between the cracks with all the UK regulators who are responsible for healthcare and patient safety,” he said. “I would have thought it would make sense if there was some sort of oversight.”

Organisations including the General Medical Council, the Care and Quality Commission, the Department for Business and Trade, the Advertising Standards Authority (ASA) and the Medicines and Healthcare products Regulatory Agency have told The Guardian that the Health Tourism Expo does not fall under their auspices.

A Department of Health and Social Care spokesperson said doctors must make it clear to potential patients whether they are licensed to provide medical advice in the UK, noting that it is a criminal offence in the UK for a doctor to falsely imply that they are registered or licensed. But, they added: “These are marketing events and as such do not fall within the remit of health regulators.”

The ASA said it was regulating the content and targeting or placement of surgical tourism ads. An investigation at the start of the year led to the banning of 13 ads aimed at people in the UK from overseas cosmetic surgery clinics after they were found to have breached rules including failing to make clear potential risks, trivialising the decision to have surgery and making misleading claims about safety and doctors’ qualifications.

However, the ASA said it could not regulate events such as the Health Tourism Expo. “We also do not cover any promotional material on stands within the expo,” it said.

The Guardian understands that providers offering their services to patients in the UK, including at trade fairs, must ensure their marketing complies with UK consumer law, even if treatment takes place abroad.

That means surgical tourism customers – some of whom have suffered life-changing injuries as a result of shoddy work – are protected by the same law that protects consumers if they buy a faulty kitchen appliance. Experts have said that’s not enough.

“If something goes wrong with your body, you can’t get it fixed by your local electrical company,” said Omar Ahmed, a plastic surgeon and spokesman for the British Association of Plastic, Reconstructive and Aesthetic Surgeons. “You have one shot, and if it goes wrong, you have no recourse, so to speak.”

Mark Soldin, a consultant plastic and reconstructive surgeon based in London, said St George’s Hospital in the capital was seeing about one patient a week with complications from procedures linked to medical tourism. Soldin added that he was concerned that aggressive marketing could negatively influence patient choices, and said events such as the Health Tourism Expo should be regulated.

“The government must take the lead, with stricter regulations and laws that prevent money-driven healthcare companies from negatively impacting patients,” he said.

ALZ Grup, the organizer of the Health Tourism Expo, has been asked for comment.