I had a short trip back to Istanbul this June. When I last visited in 2016 I had cause for concern. My concern was, it seems, ill-founded and poorly judged and my hopes that things would improve were granted. In 2016 there had been an attempted military coup and since then things generally have gotten worse; an economic crisis in Turkey created by the financial ignorance of its for-life president Tayyip Erdogan, the proximity to a tragic war in Ukraine and the creep of more extreme elements of Islamic culture and values. The liberal ideals of Ataturk are sadly being eroded. Yet the crowds have returned, the bazaars are doing great business and the mood is very optimistic. On my previous visit to Istanbul in 2016, I got five lire to the pound, this time I got 20.
For me, the stand-out feature of this trip was the explosion in medical tourism. On the Turkish Airlines flight out from Dublin, I talked with two thirty-somethings from Belfast who told me they could not eat or drink on the flight as they were due to have “a procedure” a few hours after their arrival. They were both having breast augmentation and the price “was a bargain” compared to UK clinics. Their stay was only a few days “if all goes well” and there would be little time to experience the delights of the historic city. They weren’t friends meeting for the first time at the airport having found each other in an online support group set up by the Turkish clinic. They looked so alike I thought they were sisters when my better-informed wife pointed out that their lips, eyebrows, and cheekbones had all been “done” in a standard design that risks dull conformity to an idealised beauty. They identified two men at the back of the plane who were also getting procedures but were unsure what.
We arrived at the new Istanbul Airport (İstanbul Havalimanı) on the Black Sea coast opened in 2019 and now one of the World’s biggest and busiest. It is impressive by any standards and certainly compared to the old Istanbul Ataturk Airport on the Aegean Sea coast. İstanbul Havalimanı is planning to be a major travel hub and already is a medical hub.
In Sultanahmet, the historic part of the city, the level of medical tourism is starkly obvious. Men arrive at cafes with untidy bandages across the nape of their necks where hair follicles have been harvested and inserted into the skin on their hairlines and which is still stained iodine-brown with disinfectant. There are many males and females sporting neat bandages on their noses. These are the obvious ones and hair transplants are the most popular procedure listed on advertisements posted by the city’s surgeons. This is followed by rhinoplasty (nose jobs), then breast augmentation, dental implants, bariatric surgery (stomach cutting) and IVF (fertility). We met a Swedish couple in the Grand Bazar looking for cheap Gucci luggage and passing a few hours before each getting a nose job. The female was strikingly beautiful and I did wonder why.
I’ve no doubt that the clinics in Istanbul are properly regulated but I have concerns that some of these procedures might need after-care which cannot be provided in the short time the patients spend in the city. All surgical procedures have risks and it is likely some will end up being dealt with on return by the NHS. Indeed Mr Allister Brown, consultant in plastic surgery at Ulster Hospital, has warned about the dangers.
Relating my Istanbul observations to work colleagues I was given a long list of alleged botched operations linked to Istanbul including a twenty-something female in Belfast City Hospital with severe stomach complications. Dentists too are concerned with the procedures that produce the ultra-bright Turkey Teeth. They feel Turkish clinics are much too aggressive in cutting back good teeth leaving only residual stumps that often fail after a short time.
We need to be realistic. Cosmetic procedures are becoming more common and are big business so they are not stopping anytime soon. What we need to do is protect patients who decide to get surgery in regions where standards are perhaps more difficult to assure. We also need to ensure that such procedures do not become a major burden on our over-stretched health system. If I were waiting for a procedure with Mr Brown, which funny enough I just happen to be, and waiting for nine months with a red flag, then it seems unfair that his valuable time and considerable skill is spent dealing with botched cosmetic procedures performed by his colleagues in Istanbul. Ok, Dupuyteren’s Contracture is hardly life-threatening, it’s sometimes painful and it impacts to a small degree on my work but makes my right hand look like a grotesque claw which makes me think perhaps I’m just being totally vain and bloody selfish complaining about the wait. Maybe I should not be so mean and go privately. I wonder can it be dealt with while I enjoy another trip to my beloved Istanbul?
I am a pharmacist in Belfast.