"One disadvantage of having surgery abroad is follow-up," says Somsak Lolekha,
president of Thailand's medical council.
He says that while the surgery may initially look good, complications can arise
when the patient returns home, and with the operating hospital hundreds or
sometimes thousands of miles away, patients could be at risk.
Somsak urges doctors to tell patients about both the advantages and
disadvantages of heading abroad for treatment.
"A lot of times they say the advantages but don't mention the side effects and
adverse reactions that might occur after surgery," he tells AFP.
But these concerns have not stopped millions of foreigners flocking to Thailand
for medical procedures, making the kingdom a center for medical tourism.
Last year, 1.28 million international patients visited Thailand and the number
is expected to increase by 10% in 2006, according to Thailand tourism agency
figures.
Thailand has 33 internationally-accredited hospitals, including Yanhee
Hospital, the most famous plastic surgery clinic for sex change operations.
Patients like Van Der Merwe make up just a small percentage of the people
coming to Bangkok for plastic surgery, most of whom are hankering after a new
nose, larger breasts or less cellulite.
And while Bangkok has long been known as a center for male-to-female
operations, Yanhee has seen a sharp rise in the number of women wanting to
become men.
So far this year, they have done 75 female-to-male operations compared with 47
male-to-female.
"The service is remarkable," says Van Der Merwe, a designer for a newspaper who
says he wants to get married and have children. "You get spoiled here."
But in a few days, armed with a kit of supplies, Van Der Merwe will have to go
back to South Africa and take care of himself, before returning in six months
for his final surgery.
The plastic device currently in his arm is used to stretch the surface so new
skin will grow. After six months, the skin will be removed and shaped into a
penis.
Of Yanhee's cosmetic surgery patients, 30% are international, with most coming
from other parts of Asia, followed by Western Europeans, Americans and Middle
Easterners.
The hospital has translators for 10 different languages to help the more than
2,000 international patients who have come to Yanhee for plastic surgery so far
this year.
"The result is good and it is a very cheap price when compared to home," says
Greechart Pornsinsirirak, head of plastic surgery at Yanhee, as he finishes up
a nose implant on an Asian woman and walks across the hall to remove the Adam's
apple of a man from New Zealand.
The hospital teams up with travel agencies in the United States and Europe that
help patients with flights, accommodation and transfers in addition to the
surgical procedure.
Breast enlargements at Yanhee cost $2,200. Phalloplasty - the procedure that
constructs a penis from a skin graft, takes about four to eight hours, and
requires a two-week stay at the clinic - costs $5,500.
Doctors say similar procedures in the United States cost five to 10 times as
much.
"For our patients, nearly 100% say the service is very good when they compare
it with their country," boasts Greechart, as nurses decked out in tight
uniforms, short skirts and high heels walk past.
As well as the hospital's quirks - which include staff on rollerblades zipping
through the hospital delivering records - patients get the amenities of a
luxury hotel, including top quality cuisine.
"After all the food, I need liposuction," Van Der Merwe says, only half-joking.
With an expected 20% rise in revenues and patients per year, Yanhee is
expanding with a new 15-storey building. This expansion will mean more room for
patients like Norwegian Helge Jan, 58, who is recovering from a facelift.
Although his bandaged face is swollen and bruised, Jan manages a smile when
talking about his reasons for coming to Thailand for surgery.
"It is very expensive in Norway and I don't think they are as good in Norway as
they are in Thailand," he says. "The treatment here is 10 times better than in
Norway. This is like a seven-star hotel."
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