As soon as Lisa Sullivan came round from having a tummy tuck and breast-lift at a clinic in Istanbul, she knew something was wrong. 'I'd gone into shock; I was freezing cold and in so much pain,' she says.
Drifting in and out of consciousness, she was told she had required a blood transfusion during the operation. 'I never got a clear explanation about why, which made me feel scared and very vulnerable,' she says.
Then later, as she began to heal, came a devastating realisation. One of her breasts was significantly higher than the other, the implants were too big, and they had hardened, creating ridges at the sides near her armpits. 'They looked awful, even under clothes,' she says.
Lisa, 60, from Rochester in Kent, is one of a rapidly growing number of British people to undergo cosmetic surgery abroad. The most recent Office for National Statistics figures estimate that in 2024, 524,000 people travelled overseas for medical treatment, of which cosmetic procedures such as dentistry, rhinoplasty, breast implants and liposuction - the most common choices - form the largest share. Turkey is the most popular destination, with nearly 200,000 visits, while other cosmetic hotspots include Poland and Hungary.
The primary reason is financial: while an abdominoplasty, or tummy tuck, can cost as much as £10,000 and more, and a breast lift and augmentation around £8,000 in Britain, Lisa paid just £7,000 for both procedures. In many cases, the cost abroad is a third of the price it would be here.
Convenience is another selling point. A quick Google search returns a dizzying array of enticing holiday packages with a nip and tuck included. Flights, airport transfers, hotel stays and post-operative care are all sorted, part of an experience marketed as stress-free, even luxurious. 'Girls' trips' and 'Mummy makeovers' are frequently used terms. So popular are these packages that visitors to upmarket hotels in Antalya and Istanbul have had to get used to sharing the breakfast buffet with heavily bandaged post-op patients. 'Watch out for other guests if you have a weak stomach... you get to see people with bandages, open wounds,' warns one Tripadvisor review.
But earlier this year, an audit published in BMJ Open warned that the boom in surgical tourism is placing a significant burden on the NHS due to the vast number of botched cosmetic procedures. Each patient who needs care back in Britain after surgery has gone wrong - some of whom are left requiring intensive care - costs the NHS up to £20,000.
The analysis has shone a light on the risks of cut-price surgery abroad. At least 28 British people died after undergoing surgery in Turkey between 2019 and 2024, among them Kaydell Brown, 38, who died in Istanbul during a 'Mummy MOT' involving liposuction and a Brazilian bum lift. A further seven deaths were recorded last year. Far larger numbers return to Britain with serious complications or work requiring extensive revision.
'This is a growing and very concerning problem,' says Dr Nora Nugent, president of The British Association of Aesthetic Plastic Surgeons (BAAPS). 'Almost every colleague I know has treated patients who have returned to the UK after cosmetic surgery and needed to seek urgent medical attention.'
Consultant plastic surgeon Mo Akhavani, co-founder of The Plastic Surgery Group, has revised many botched procedures, both in his private practice and in the NHS, at London's Royal Free hospital. 'We often see abdominoplasty and breast surgeries, in particular, which have gone wrong,' he says. 'Normally, there will be quite severe infections that can cause the wound to open up.' In some cases, these can lead to sepsis or necrosis, in which the flesh dies and must be cut away.
The NHS always provides urgent care for patients with life-threatening conditions, including infections. 'We'll do everything we can to save them,' he says. However, it has no obligation to repair substandard cosmetic work that does not pose a significant health risk, as in Lisa's case. When she had her surgery in Turkey in 2024 the low cost was the main appeal. Yet, following successful revision surgery at The Ghanem Clinic in London, she admits, 'I've ended up spending more to correct it.'
Lisa was drawn to the idea of cosmetic surgery after losing a vast amount of weight following a gastric bypass, which left her with loose, sagging skin. 'I did a lot of research and chose a company someone I knew had been to, which had great reviews,' she says.
Where many clinics dispatch patients to hotels the day after their operations, this one offered a five-day stay in the hospital. 'It was beautiful there and everyone was very friendly,' she says. 'My surgeon spent seven hours operating on someone else before me, which worried me, but I handed over the money - in cash which they insist on - and went ahead.' Lisa spent the days after her operation 'crying, thinking "What have I done?"'
Her experience underlines the major drawback of surgery tourism: 'It's much harder to know what you're getting,' says Dr Nugent. In Britain, patients typically meet a surgeon face-to-face long before going under the knife. It's easy to check they are listed on the General Medical Council specialist register and affiliated with professional bodies such as BAAPS. 'It's very hard to know that you're going to a fully affiliated surgeon in another country; what that means there; and what your rights are if things go wrong,' she says.
Revising poorly performed work is expensive and challenging.
Dr Yannis Alexandrides of 111 Harley Street who was previously a trauma surgeon in Miami recently performed revision surgery for a young woman who had gone to Turkey for a rhinoplasty. Once there she had also been talked into buccal fat removal in her lower cheeks. 'It was not done properly and had left her with obvious scarring indentations in the middle of her face,' he says. 'It was very difficult to revise.'
'Often a disastrous outcome requires more than one revision surgery,' adds Mr Akhavani. 'It is classed as complex work so the fee is always higher and it's not always possible to get a perfect result at that stage.'
BAAPS says it is 'very disturbed' by the aggressive advertising of cosmetic surgery from companies in other countries which do not fall under the oversight of any clear regulatory body. It is in discussion with the Advertising Standards Authority to address misleading adverts.
Dr Nugent advises anyone considering surgery abroad to research their surgeon's credentials thoroughly; for instance checking they are a member of TSPRAS (the Turkish Society of Plastic Reconstructive and Aesthetic Surgeons)); as well as checking the clinic's aftercare arrangements. 'Read the fine print about what exactly is covered and think about the what-ifs so you're prepared if anything goes wrong,' she says.
She also strongly advises against combining surgery with a holiday; saying: 'Many of these procedures are major surgery and nobody should be in a pool or sunbathing when recovering.'
Lisa is finally happy with her appearance but says; 'I wish I'd never been to Turkey.' Her warning to others like her? 'If what they're offering seems too good to be true; it probably is.'