Sun, sand and silicone

In summary: 
  • International research is prompting a re-think of the cosmetic surgery industry and the risks involved surgery overseas
  • Estimates show 15 000 Australians seek procedures overseas annually
  • The number of female ‘cosmetic surgery tourists’ in their early 20s is increasing

Cosmetic surgery: a vain attempt to prevent ageing or a rite of passage for 21st century women? Ethnographer and cultural studies researcher Meredith Jones is part of an international team examining cosmetic surgery tourism. Their surprising results are prompting a re-think of the industry and the risks involved in undertaking a nip and tuck overseas.

Most of us remember a time when cosmetic surgery was a weird, dangerous indulgence reserved for Hollywood stars and the severely vanity-inflicted. But in the last 20 years it has become something many people think of as part of good grooming; another option in the suite of self-improvement procedures that include hair dye, teeth capping, dieting and gym work.

Cosmetic surgery is apparent on faces and bodies everywhere. It is now, for many, simply not a big deal. There are complex reasons for its popularity, and they show no signs of waning. Firstly, ageing baby-boomers, the richest generation that has ever lived, have money to spare and are unwilling to age in the ways their parents did.

Secondly, throughout the 20th century, the ways we viewed our bodies changed: the body morphed from being something ‘God-given’ into something we own and have the right to modify. A few years ago, reality television programs such as Extreme Makeover and The Swan made cosmetic surgery seem easy, necessary and glamorous.

There is an increasing focus on the importance of personal appearance, and our exteriors have come to signify our values and our senses of control: our bodies now help us to demonstrate we are ‘good citizens’ who are always undergoing self-improvement.

Last, but not least, cosmetic surgeons have been shamelessly dedicated in the promotion of this new and lucrative industry. Like other consumer items connected with ‘living well’, cosmetic surgery is now highly desirable, and if prices are restrictive in Australia, then some people are prepared to travel in order to get it.

Scalpels on a benchScalpels, photo by Joanne Saad

I am part of a multi-site, multi-disciplinary international team examining cosmetic surgery tourism. The Sun, Sea, Sand, Silicone project is funded by the UK’s Economic and Social Research Council. Colleagues at Leeds and Leicester universities are looking at Britons who go to Poland, Spain and Tunisia, as well as Chinese people traveling to South Korea for surgery. Researchers at UTS and Sydney University are looking at Australians who travel to Thailand and Malaysia.

Statistics are scarce for cosmetic surgery in general and for cosmetic surgery tourism in particular. However, my own (extremely conservative) estimate shows 15 000 Australian residents seek cosmetic surgery overseas annually, amounting to spending of at least AUD$300 million.

Thailand is the most popular destination for Australian cosmetic surgery tourists (Malaysia comes in second), offering cosmetic surgery services at half or even a third of what they cost at home.

When I first visited Thailand to interview Australians who were there for cosmetic surgery, I expected unhygienic conditions, poorly qualified surgeons and desperate customers. I could not have been more misguided. Most of the hospitals that foreigners visit in Thailand cater especially for internationals and are highly accredited and world class. Many of the people I’ve interviewed over the last few years have spoken about how much cleaner, well equipped, and better staffed they think Bangkok hospitals are than Australian ones.

Understandably, Australian cosmetic surgeons are not happy with the rise of cosmetic surgery tourism. Their businesses are being threatened and they stand to lose customers and money. They like to contribute to scare campaigns about cosmetic surgery abroad, often saying they are constantly fixing up botched jobs done by foreign surgeons.

What they fail to mention, however, is they are also constantly fixing up botched jobs done by each other. Again, statistics are not recorded, but I strongly suspect the possibility of cosmetic surgery ‘gone wrong’ is just as likely whether you have it in Sydney or in Bangkok.

However, people do not just travel for surgery. Cosmetic surgery tourism is often a luxury package that includes sightseeing, shopping, and spa-type pampering.

A new breed of entrepreneurs, who call themselves cosmetic surgery tourism agents or consultants, have helped to create this seemingly incongruous combination of holiday and surgery.

Most agents are middle-aged women without tertiary qualifications but with a huge amount of experiential expertise – that is, they have been cosmetic surgery tourists themselves. These small businesswomen usually operate from home, often via the internet and online social networking, organising everything from flights to hospital bookings to wildlife park visits. Most never meet clients face to face.  

Clients’ profiles are hugely diverse, but there has been an increase in the last couple of years in one particular demographic group: women in their early 20s. They usually are travelling together, either with friends or in a group made up by an agent, and most of them have breast augmentations.

One of the fascinating things about this group is that it’s very highly socially networked, making huge use of Facebook, texting and YouTube. These young women are a new breed of cosmetic surgery recipients, who, unlike many older recipients, make no apology for their decisions to have cosmetic surgery.

They do a lot of research and are far from secretive, often posting post-surgery images of themselves online, writing about their experiences and even uploading videos that document their experiences. They form a very strong and knowledgeable community that knows what it wants and sees cosmetic surgeons as skilled technicians.

As a cultural studies researcher and ethnographer I think these groups are doing far more than changing their bodies at cheap prices. They are performing ritual bonding of a type that has been observed by anthropologists across many cultures and in many time periods. That is, they travel away from home, in a group, often with an older and more experienced guide, in order to undergo physical and emotional change.

They do this at an age of transition, when they are moving from being children to being adults, and the surgery they choose – breast augmentation – is a physical marker of this. In other words, cosmetic surgery tourism for these young women is an initiation or a rite of passage: a demonstration of maturity and independence.

While personally I can think of far better ways to show that one has become a woman, such as being well educated and financially independent, what these people get out of cosmetic surgery tourism is important and deserves the sort of understanding that can only come about through deep research. The results of our research will be fully disseminated at two conferences to be held in Sydney and Leeds in June 2013 and a full report will be released at the same time.

need some information

Hi Meredith,

Our business, "The Cosmetic Institute" is offering affordable cosmetic surgery options for patients seeking out alternatives to the high prices ordinarily charged here in Australia and the overseas options. We do this without compromising on quality or service to our patients. Your colleague Emily Hunter visited our clinic a few months ago to assist with her research and also interviewed our surgical director and plastic surgeon "Dr Eddy Dona" www.thecosmeticinstitute.com.au
In addition, I wish to address one of your comments "What they fail to mention, however, is they are also constantly fixing up botched jobs done by each other. Again, statistics are not recorded, but I strongly suspect the possibility of cosmetic surgery ‘gone wrong’ is just as likely whether you have it in Sydney or in Bangkok."
Whilst I agree with this statement, I feel you have left out a critical piece of information. Yes, complications are experienced by all surgeons however, its how those complications are dealt with and in what time frame which are equally as important.
If a patient experiences a complication post-surgery from procedures carried out overseas, having a follow up visit or post care treatment from their surgeon is not easy, and of course would carry additional travel expenses and inconvenience. It’s also worth noting that some post-surgery complications can manifest long after the procedures has been carried out, a prime example of this would be capsular contracture.
I would welcome the opportunity to discuss this topic with you further given the opportunity.

Regards,

David Segal

Dear David,
thanks for this. Yes I agree with you and it's a good point. I was thinking more of patients who are dissatisfied with their surgeons and don't want to return to them so seek someone else out to remedy the work. I agree that ideally the surgeon who has done the initial work should be available to address any problems. Hopefully that is something that your new clinic will be able to do!
All the best, Meredith

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