British surgeons have issued a stark warning regarding individuals travelling overseas for leg-lengthening procedures, highlighting the significant burden placed on the NHS.
Hospitals across the UK are increasingly encountering patients who require extensive follow-up care, including complex corrective surgery, intensive physiotherapy, and long-term rehabilitation, following operations performed abroad.
Experts have detailed the "challenging" complications observed, such as implant failure, inadequate bone healing, and severe limb deformities.
This alert comes as MPs are set to debate medical tourism, alongside other cosmetic procedures like liquid Brazilian butt lifts, in a committee hearing this week.
The Royal College of Surgeons of England noted that these findings underscore a growing trend of patients seeking surgical and cosmetic treatments outside the UK.
A study led by specialist limb reconstruction surgeons at the Royal National Orthopaedic Hospital NHS Trust calculated that addressing complications from just seven such cases has already cost the NHS over £36,000, with warnings that the true financial impact is likely far greater.
Writing in the Annals of the Royal College of Surgeons of England, the team said they had seen a “recent increase in patients presenting for rehabilitation and treatment of complications following limb lengthening”, such as implant failure, poor bone healing and severe joint stiffness.
They found:
– Of four men and three women studied in depth who went abroad for leg-lengthening in the last five years, five had travelled to Turkey for surgery, one to Russia and one to South Africa.
– Six of those studied said they wished to be taller to “improve their feeling of wellbeing and quality of life”, while one went to Russia to correct a congenital lower limb deficiency.
– The patients typically needed 10 NHS hospital appointments, with all requiring physiotherapy and some needing extensive follow-up care.
– Two patients “required major surgery for complications”, including knee surgery and removal of broken nails holding bone together, “with re-nailing for poor bone regenerate”.
– Patients said they had decided to go abroad mostly due to cheaper costs and the availability of the surgery.
The experts wrote: “The desire to become taller is gaining popularity, driven by the internet, social media advertising and affordable treatments based around the world.”
They added: “There has been a recognised rise in people choosing to undergo surgical procedures abroad in the last decade, the incidence almost doubling from 230,000 patients in 2021, to over 430,000 in 2023.”
The team said the “reasons for medical tourism” are multiple, including distrust and dissatisfaction with local services, low costs and “perceived excellence from targeted advertising on the internet demonstrating specialist clinics offering surgical services, combined with low air fares, (which) produces a very appealing concept of surgery combined with a holiday”.
Peter Calder, lead author of the study and consultant paediatric and limb reconstruction surgeon at the Royal National Orthopaedic Hospital, said: “Anecdotally, we have seen an increase in patients presenting to our hospital following lengthening surgery abroad.
“All required intensive physiotherapy and, in many cases, surgical intervention for serious complications.
“This resulted in both an increase in burden on staff and financial costs for the NHS. It is unclear whether this is a localised problem or more widespread throughout the UK.
“The findings provoke debate on health tourism and patients returning to the UK with poor outcomes, especially with reference to cosmetic procedures.”
Professor Frank Smith, vice president of the Royal College of Surgeons of England, said: “This study shines a light on a growing patient safety issue.
“People considering surgery, such as leg-lengthening, may be drawn overseas by lower costs or persuasive marketing, but when things go wrong, the complications can be serious and, at worst, life-changing.
“Patients can then return to the NHS needing complex treatment, placing pressure on already stretched services.
“While many providers overseas offer high-quality care, this research underlines the importance of people fully understanding the risks, the standards of care they can expect, and what aftercare arrangements are in place before undergoing treatment abroad.
“RCS England has long called for better public awareness of the risks associated with medical tourism, and we would also like to see the NHS collect robust data on patients presenting with complications after treatment abroad.
“That is essential to understanding the true scale of the issue and its impact on NHS services.”
