Destination Disaster: Overseas Surgery Gone Wrong

Jackie (00:00):
It's like buying stuff on Amazon. You can read all the reviews, look at all the photos, and then when you finally get what you ordered, you're like, "What the hell is this?"

 

Dr. Chang (00:11):
Yeah. Only they don't have a free return policy.

 

Jackie (00:13):
Right, exactly.

 

Dr. Chang (00:14):
Can't just go back to Whole Foods and be like, "Let's redo this."

 

Jackie (00:16):
Exactly.

 

Dr. Chang (00:20):
You are listening to Secret Services where we discuss the procedures nobody admits to, but everyone's curious about. I'm your host, Dr. Christopher Chang. Hi everybody. We're back. This is the Secret Services podcast from Congressional Plastic Surgery. I'm Dr. Chang.

 

Jackie (00:35):
And I'm Jackie.

 

Dr. Chang (00:36):
Okay, Jackie. So we got another story out of Australia. So 60 Minutes that CBS show, they always do news articles. So 60 Minutes Out of Australia has their own program and they had an investigation last weekend, which was six months behind one of Bangkok's biggest medical tourism operators, and they'd been doing an investigation. And the results were not what the brochures had promised. So I've seen the aftermaths and things about medical tourism and people who have gotten procedures overseas. So we'll kind of talk a little bit about what that's like.

 

Jackie (01:10):
Yeah. So if someone's come to you and they've already had surgery overseas, what are you looking for?

 

Dr. Chang (01:16):
It's a mixed bag. I mean, having surgery overseas can be great and it can be a total black box. Sometimes we have no idea what was done or why it was done or how it was done. Even if we get records, they could be in another language. And so it's a little bit of a challenge. And if you had something done that was not done well or you were botched or you need to have a revision, that can certainly be very, very challenging. So I think that that is a common thing in plastic surgery because people are not only looking for great care, but they're also looking for a great price.

 

Jackie (01:50):
Yes. I feel like it's always price. So this person said, "I'm seriously considering going to Thailand for a breast lift and tummy tuck in the USA would cost around 18,000. I found a package in Bangkok for 4,500, including the hotel. The clinic has good reviews. What am I actually risking that I'm probably not thinking about?" Yikes.

 

Dr. Chang (02:10):
I mean, this is a common thing nowadays. So with social media and international marketing, so people are constantly seeing more and more results, more advertising, things from clinics from outside of the US which are much cheaper. It's cheaper because there's less regulation, the cost of living is lower, and sometimes the skill or the experience is also lower and essentially less expensive because they haven't gone through as much training. Sometimes that's not the case. There's some very excellent surgeons overseas as well and very excellent clinics and hospitals, but the cost could be lower for a number of reasons. But that being said, this question asks, I've seen good reviews and other things like that. There's a lot of false advertising outside of the United States. So I often hear about Korean beauty clinics that have five star reviews. Oh, this one looks good. But in South Korea where you know they have the most plastic surgery in all of the world, there's good and bad just by the numbers.

 

(03:12):
There's good and bad. Not everybody's good because South Korea has the most, right? So you could easily get botched in another country, even a great country like South Korea.

 

Jackie (03:23):
Well, and I would fear also it's like some of these reviews could be fake too.

 

Dr. Chang (03:28):
Oh, I'm sure they are.

 

Jackie (03:29):
Yeah.

 

Dr. Chang (03:30):
Sorry, that's where I meant to go with this. Yes, I'm sure there are lots of fake reviews.

 

Jackie (03:34):
Right. And so you're flying sight unseen. I would assume you do maybe a virtual chat, but you're basically going there based off of random strangers on the internet giving it five stars.

 

Dr. Chang (03:46):
I mean, there's tons of false advertising in Photoshop and AI now. Remember the viral Instagram social media post of a lady, I think it was in Turkey -

 

Jackie (03:57):
Yes, her facelift.

 

Dr. Chang (03:58):
Who had a facelift and they essentially proved that it was either two different people or completely photoshopped or whatever. I can't remember exactly what was, but it went so viral. It was on everywhere.

 

Jackie (04:10):
I think it was all AI, the after, or heavily edited.

 

Dr. Chang (04:14):
They found the actual patient and they were like.

 

Jackie (04:17):
I mean, she literally looked like a supermodel afterwards, a totally different. But a lot of people were sending them to me. They're like, "This is incredible." Yeah,

 

Dr. Chang (04:26):
This is sorcery. Yes, because it's fake.

 

Jackie (04:28):
Yeah. This facelift in Turkey is amazing. And you're like, "Yeah, that did not happen." Right. And I don't know, I'm sure my algorithm knows what industry I work in, but I see a lot of turkey pushed on my TikTok and stuff. And I think what gets a lot of people is, as this person mentioned in Thailand, including the hotel. So they're like, "Oh, not only am I paying for the surgery, but I'm getting to stay in this hotel for a week and I get a nurse."

 

Dr. Chang (04:59):
No, I have a driver that's going to bring me from the airport to the hotel.

 

Jackie (05:03):
But then you're like, okay, well yeah, you have a nurse with a license in another country. What schooling do they go through? What is -

 

Dr. Chang (05:12):
Are they calling them a nurse, but really it's the doctor's -

 

Jackie (05:14):
The front desk person. Yeah,

 

Dr. Chang (05:16):
Doctor's kid's sister or something that's going to look after you.

 

Jackie (05:20):
Exactly. So it's like, yeah, it all sounds great, but.

 

Dr. Chang (05:24):
Yeah. It's hard to know because each place has its own rules. It's funny because actually in Asia there's a lot, it seems like on some of these Instagram post surgery channels, there's a lot of stolen before and afters. There was a picture of Denise Richards on a Chinese surgeon's Instagram before and after page, and they had photoshopped her face or AI'd her face into his clinic robes as if she'd had the day of surgery and had a little Chinese logo and the name of the hospital, the clinic and Chinese on her gown, hospital gown shoulder and bandages after the surgery. It was like the same day after surgery picture, preoperative markings. And maybe to them, all white people look the same. So he didn't think anybody would notice. Lo and behold, it's a movie star, which we've all seen. And she's been very public talking about how -

 

Jackie (06:20):
She got her facelift.

 

Dr. Chang (06:21):
Had it done in Beverly Hills. So that picture's been everywhere multiple times. So it's very obvious.

 

Jackie (06:27):
Yeah. And I would say the age range of women in the market for a facelift, maybe older. I feel like their media literacy isn't as good. They don't really have an eye for this clearly is AI. And so I feel like in these foreign countries, they can really get away with it and entice someone who's just like, "Wow, this is amazing."

 

Dr. Chang (06:48):
Right. Yeah. So as you said, the cost is certainly a big draw as well as the reputation or credibility based on the social stuff. But remember that is all, as they say, Instagram versus reality, you have to balance all of that stuff.

 

Jackie (07:03):
Another thing that comes up is the travel home. So if you're traveling across the world for a procedure, at what point is it safe and good to get on a 12-hour flight?

 

Dr. Chang (07:17):
Yeah, absolutely. I think that people travel for all sorts of reasons. I think a lot of people travel to, for instance, South Florida to get liposuction and fat grafting to the buttocks. So that's a very common thing. You see people sitting with these special BBL pillows on an airplane in the Miami airport or even coming in from South America. You see people coming, I've been to Istanbul a couple times. You see people coming back from Turkey with hair and head bandages and things like that, all the guys with their heads shaved. So it's common. I mean, it's not super rare, but the safety thing is a serious factor. I think you got to -

 

Jackie (07:56):
Well, yeah. I'm thinking I just had a mommy makeover, should I be getting on a plane, my risk of blood clots, stuff like that.

 

Dr. Chang (08:04):
Well, you got to factor that into your cost because you got to stay to lower your risk of blood clots, you have to be further out from surgery and you got to plan to stay in that country for a little longer until you're a little more recovered.

 

Jackie (08:17):
Right. And my biggest fear also would be like, okay, so I'm in the hotel with my nurse. If something goes south, then what? What hospital are you going to end up at?

 

Dr. Chang (08:27):
Are they going to speak your language?

 

Jackie (08:29):
Exactly.

 

Dr. Chang (08:29):
Who's going to pay for that?

 

Jackie (08:30):
That's my biggest fear is a medical emergency in a foreign country. I don't know why. It's a big one for me.

 

Dr. Chang (08:37):
Yeah. No, it seems scary. I think we kind of don't realize that when other people are in the hospital, they don't speak English and we're taking care of them. We do have some translator services in most hospitals and things like that, but if they're from a country where you don't have a translator, it can be difficult.

 

Jackie (08:59):
Correct. A lot of hospital systems in America, it's mandated now. You have to have a translator for every language. They have that little -

 

Dr. Chang (09:08):
Translator phone.

 

Jackie (09:09):
Yeah, they have a phone. And then now Inova, they got the. It's like a big screen on wheels and it's like you FaceTime.

 

Dr. Chang (09:16):
It's like a Zoom or FaceTime.

 

Jackie (09:18):
With the translator, that's mandated. If they do not speak English, you have to have this. It has to be documented. You have to document the translator's ID code, their name, the time. It's very heavily regulated. So yeah, then you're in a foreign country, they don't have those regulations. So then you're just trying to get by. And yeah, a lot of people do speak English, but you can't always bank on that. Right. And then for you, say you get a patient coming in, you're doing a revision, the record's in another language, say you can't even get ahold of that surgeon. You can't even get the records. How does that change how you approach the surgery?

 

Dr. Chang (09:55):
Automatically, I mean, one of the things, if you've traveled for surgery, you lose your. What you're giving up is the opportunity to go back to your surgeon for any complications or any touch-ups, any kind of reassurance. I mean, you can Zoom call with them or however they want to do follow-ups, but essentially they're done with you. And if everything is perfect, that's great. But if everything is not, which is not uncommon that you might need to be seen for follow-up or touch up or-

 

Jackie (10:23):
Like wound healing delays, stuff happens. So to just know that you don't have anyone to physically be seen by, you can only get so much done over a Zoom.

 

Dr. Chang (10:35):
It's every surgeon's nightmare when they get a call about a new patient that wants to be seen because they had something injected or something done to them in another country and they're having complications. Or I remember being on call and they'd be like, oh, this patient had liposuction in South America and now has a terrible infection and has been horrible fevers and it's raging throughout the soft tissue and she's got necrotizing fasciitis. You know what I mean?

 

Jackie (11:04):
Yeah. And you're just like, oh my God, what am I about to see?

 

Dr. Chang (11:06):
Yeah, that and also now I got to be the bad guy, cut away all this dead tissue and trying to save this patient's life. I'm trying to really not inherit this disaster that was basically born out of being worried more about the cost than my safety.

 

Jackie (11:25):
Yeah, exactly.

 

Dr. Chang (11:26):
Guys, don't do that, please.

 

Jackie (11:27):
So speaking of disaster, the 60 Minutes Australia segment was called Destination Disaster on August 9th, 2026. A six-month investigation into Destination Beauty, one of Bangkok's largest medical tourism operators claiming 30,000 plus patients served. Women describes nipples near their armpit, severe open scarring and unexplained burns. One woman drained her retirement savings for her 60th birthday makeover and woke up to find her breasts completely gone. Separately, a Thai woman paid a hundred thousand plus bot about three grand US dollar for six pack liposuctions and woke up with distorted wrinkled abdomen, which is pretty unsightly. The clinic said she had signed the forms. The surgeon who reviewed the 60 minutes photos called the nipple placement a rookie mistake. What do you think actually went wrong and could these things be corrected?

 

Dr. Chang (12:20):
What's interesting about this is. I'm just going to sidestep for one second. Australia, I know this because my au pair's Australian and I was actually just talking to an Australian surgeon the other day and they've both told me that Australia has extremely strict rules about medical advertising and social media. So she was stunned to see the Otezla and - Oh, like all the ads. Ads on TV.

 

Jackie (12:47):
Skyrizi.

 

Dr. Chang (12:48):
Skyrizi.

 

Jackie (12:48):
Every day, all day.

 

Dr. Chang (12:50):
Yeah, all these things. You're not allowed to do that in Australia because they don't want the drug companies to be directly influencing doctors and patients, I guess the public, but it's very, very regulated. And in terms of advertising and showing things on your social media channels, they've really clamped down so that you cannot show people in bikinis after surgery. You have to be very careful with your language. It has to be very clinical. You can't say, "Oh, she's got her confidence back," or anything like that. It literally just has to be the pure medical term of the procedure. So mastopexy, you can't say mommy makeover, you have to say abdominoplasty. So maybe these Australian consumers are getting a little bit sort of romanced by the aggressive advertising of the largest destination beauty.

 

Jackie (13:43):
You'd be like, "Wow, they're saying all these key terms that most people look for when they're looking up cosmetic surgery."

 

Dr. Chang (13:55):
They're losing the algorithm more to them because it's much more attractive to look at and more engaging. But anyway, so I would just say that when the nipples are too high, that is definitely a rookie mistake. When you're doing a breast lift or reduction, we're just trying to place the nipple and the areola in the correct, more youthful position. But they always teach you do not place them too high because correcting a nipple that's too low, if you have to revise it and touch it up is much more straightforward than if it's too high and you have to bring it back down.

 

Jackie (14:36):
Yeah, because you don't have much to work with on the -

 

Dr. Chang (14:39):
Right. Well, if you have to move it down, you're leaving a spot up here that's going to be a scar because you're pushing this nipple down. So that scar is much more visible if you're wearing something with a strap or a low cut blouse or something versus having a scar under your breast, which is a lot easier to hide in clothing. So yeah, I agree with this doctor that it is absolutely rookies. Of course, we have solutions or corrections for these things, but it's not going to be aesthetic. It's going to be more reconstructive in my opinion.

 

Jackie (15:10):
Right. And so it says they're paying for these packages that include hotel, airport pickup. And so they're framing these situations as a vacation.

 

Dr. Chang (15:24):
Sounds good to me.

 

Jackie (15:24):
Right. It sounds lovely, right?

 

Dr. Chang (15:26):
Let's go get a Thai massage.

 

Jackie (15:27):
But I think an important thing, the average person, they don't even view plastic surgery as surgery. "Oh, it's elective. It's for me. It's not medical. It's not a big deal." And so I think when they're framing these packages as a vacation, "Oh, I'm going to Thailand, all expenses paid," all this stuff, it kind of removes the severity of you're still having surgery. This is still very serious. There is pain associated with every surgery, whether it's elective or not. And I think it takes away from the reality of people and they get sucked into all that.

 

Dr. Chang (16:04):
Yeah. I mean, don't get me wrong. I want you to be very positive. I want you to have a very good outlook. I want you to feel like, Hey, that was a great experience, but don't get it mixed up. This trip has a purpose. Actually, I say this all the time. I don't like to mix the purpose of when I'm going on a trip. If I'm going on vacation, I'm going on vacation, enjoy that with my family or my friends or whatever I'm doing. That is for vacation. But they'll also put a medical conference at a very nice resort or ski lodge or whatever, and they'll be like, "Oh yeah, come here and you have a vacation with your family." I'm like, "No." Then I'm going to the meeting because I'm trying to learn something or enjoy. I can't be there. And then also going on vacation with my family, I'm splitting my attention. So if the third option were to be to go to have plastic surgery or go to have an operation, that is the goal, not to be thinking, "Oh, well, I'll bring a companion and oh, you can go on the boat tour while I'm under surgery and then we'll go for gelato and then take some scenic roots." You can't be mixing these ideas.

 

Jackie (17:11):
Right. Yeah. So if someone comes to you for a consult and then they're like, "Well, hey, I got a quote from Bangkok and it was only $4,500," what would you say?

 

Dr. Chang (17:23):
I would say just you're comparing apples to oranges in so many ways. If you're from Bangkok or you live in Bangkok, that's a different story. That might be the right fit for you. But what you're comparing are two totally different experiences. If you're an American and you live here and you're going to get follow up with us and see us consistently and be a patient for life, that's a totally different experience than doing a drop-in into another country.

 

Jackie (17:47):
It's like buying stuff on Amazon. You can read all the reviews, look at all the photos, and then when you finally get what you ordered, you're like, "What the hell is this?"

 

Dr. Chang (17:58):
Only they don't have a free return policy.

 

Jackie (18:00):
Right, exactly.

 

Dr. Chang (18:01):
Can't just go back to Whole Foods and be like, "Let's redo this."

 

Jackie (18:03):
Exactly.

 

Dr. Chang (18:05):
That would be something that I would say be careful. I know it sounds exciting and a trip is always fun, but definitely be careful.

 

Jackie (18:15):
Well, they say there's 30,000 satisfied patients. I'm sure there are people that are satisfied.

 

Dr. Chang (18:21):
Yeah. Well, you have a big number. There's going to be everything. There's going to be some satisfied, some unhappy, and some like, "Well, maybe I wouldn't do that.

 

Jackie (18:30):
Well, some patients, they're like, "I want a breast lift. I don't really care what they look like. I just don't want them hanging this low." You know what I mean? So to them, being satisfied would just be, "Well, my boobs aren't hanging down to my belly button now." They might not look like beautiful breasts, but it's like how do you gauge happiness from all these other people? It's different for everyone.

 

Dr. Chang (18:50):
Right. Absolutely. But I still think that those numbers probably are -

 

Jackie (18:54):
They have to be inflated. 100%.

 

Dr. Chang (18:56):
And these guys can say whatever they want. They could say a million happy patients. And how do you even calculate?

 

Jackie (19:01):
You can't fact check.

 

Dr. Chang (19:02):
Right. Exactly. It's just, you have to really know what you're getting into.

 

Jackie (19:07):
Be able to accept the risks and deal with it when you get home to your-

 

Dr. Chang (19:12):
Yeah, you're going to be on your own. A lot of surgeons will say, "Sorry, I can't help you when you have a-"

 

Jackie (19:18):
Who's to say they'll even respond later on when you have a complication, because they're like, "Well, I'll never see you again. You're on the other side of the world. What's it to you? We took your money."

 

Dr. Chang (19:29):
Yeah, exactly.

 

Jackie (19:31):
There's no really safety net where you have in America if things do go really south with your surgeon.

 

Dr. Chang (19:37):
Yeah. I would plan to dedicate a significant amount of time or multiple trips to come back just for reassurance.

 

Jackie (19:44):
Proper follow-ups.

 

Dr. Chang (19:45):
And if you don't need those follow-ups, that's fine, but I would put that in your budget of this potentially could cost two or three trips, plus the time you got to take to go there. Even after that. Let's say you're healing fine, but you still need a checkup. You deserve a checkup. You do.

 

Jackie (20:01):
Right.

 

Dr. Chang (20:01):
So keep that in mind. That should be on the plan.

 

Jackie (20:06):
Definitely. Well, let us know guys if you would ever go to a destination disaster or if you've ever considered traveling anywhere for plastic surgery.

 

Dr. Chang (20:16):
Yeah. Let us know what's your favorite destination or your wishlist for getting a procedure done and tell us where to go.

 

Jackie (20:22):
Yeah.

 

Dr. Chang (20:23):
All right. Have a good one. Like and subscribe down below.

 

Jackie (20:26):
Bye.

 

Dr. Chang (20:28):
Thanks for listening to Secret Services, the podcast where we see everything and say nothing except right here. I'm Dr. Christopher Chang, double board certified plastic surgeon located in Tysons, Virginia. Follow us on TikTok @congressionalpsurgery or on Instagram @congressionalplasticsurgery. To send us a classified message or to hear more episodes, go to secretservicespodcast.com. Links to everything we talked about on today's show are available in the show notes. Oops, patient's here. We got to go.