Breast implants in Thailand

Breast augmentation is the procedure Thai plastic surgery hospitals do most for international patients, which is why the packages are so standardised and why a surgeon in Bangkok or Phuket may have placed more implants in a year than many surgeons at home place in several. The hospitals are used to patients who arrive with photographs and a return flight booked, they stock the implant brands Australian and British surgeons use, and the price of the whole package is usually known before you travel.

The things to weigh sit on the other side of the ledger. You are choosing a surgeon from photographs and a video call rather than a consultation you can walk out of. You will fly home with wounds that are still fresh. Aftercare falls to a doctor who did not operate on you, and a revision, if you need one, means either a second trip or paying full price at home. None of that makes Thailand a wrong choice; it makes it a choice that has to be planned as a medical trip rather than a holiday with surgery in it.

A Thai package normally covers everything that happens inside the hospital, from the pre-operative tests to the last check-up before you fly. What it rarely covers is anything that happens after you land at home. Get the contents in writing before paying a deposit, and ask specifically about the items in the second and third groups below.

• Usually included. Consultation, blood tests and a chest X-ray or ECG where the anaesthetist wants one, the implants, the surgeon and anaesthetist fees, the theatre, one night in hospital, medication, the surgical bra, dressing changes and the follow-up visits until you are cleared to fly.
• Sometimes included. Hotel nights near the hospital, airport and hospital transfers, a nurse visit at the hotel, and a mammogram or ultrasound before surgery for patients over a certain age.
• Rarely included. Flights, travel insurance, a longer stay if healing is slow, drains left in beyond discharge, treatment of complications after you are home, and revision surgery, with or without the flight back.
• What the deposit buys. A date and a surgeon. Ask whether it is refunded if the examination in Thailand changes the plan or the price.

Instalment options for the whole trip are described on the payment plans page. Manufacturer programmes for Motiva and Mentor replace the implant in defined cases such as rupture and may contribute to surgical costs for a limited period; they never cover the flight, so ask the hospital what happens in practice for a patient who lives abroad.

Silicone gel implants are what almost every Thai hospital places; saline implants are available but rarely chosen. Within silicone, the choices are the brand, the shape, the surface and the profile. Motiva implants, with a smooth micro-textured surface and a softer gel, are the brand Thai packages most often name and have been in routine use in Thailand for years. Mentor is the other brand you will see everywhere. Both are the implants surgeons at home also use, so a Thai implant is not a different product.

Round implants give fullness at the top of the breast and cannot rotate; anatomical or teardrop implants mimic the natural slope and can rotate if the pocket allows it, which is why many surgeons now reserve them for reconstruction or thin patients with little breast tissue. Heavily textured implants were linked to a rare lymphoma, BIA-ALCL, and one manufacturer's textured range was withdrawn worldwide; Thai hospitals stopped using it at the same time. Ask the surgeon in plain terms which surface they are proposing and why.

Size is chosen in the consultation with sizers under a bra, not from a number you bring. A surgeon who agrees to any size without measuring your chest width and skin is not the one to choose. The implant card you receive after surgery lists brand, model, volume and serial numbers; keep it with your passport.

The differences between shapes are covered on the round breast implants and teardrop breast implants pages, and the brand on the Mentor breast implants in Thailand page. If you want a modest increase without an implant, breast fat transfer in Thailand is the alternative, and a breast that has dropped rather than emptied belongs on the breast lift in Thailand page.

Thailand licenses doctors and facilities separately. The surgeon should hold a licence from the Medical Council of Thailand and the Thai Board of Plastic and Reconstructive Surgery, the specialist qualification issued through the Royal College of Surgeons of Thailand; membership of the Society of Plastic and Reconstructive Surgeons of Thailand or the Society of Aesthetic Plastic Surgeons of Thailand is a further sign of a surgeon trained in the specialty. This is the counterpart of checking a specialist plastic surgeon's registration with AHPRA at home.

The facility should hold a Ministry of Public Health licence for surgery under general anaesthesia. Private hospitals in Bangkok, Phuket and Pattaya commonly carry Hospital Accreditation from Thailand's Healthcare Accreditation Institute, and several also hold Joint Commission International accreditation. A small cosmetic clinic may be licensed only for local anaesthetic procedures; breast augmentation belongs in a facility with a physician anaesthetist, recovery staff and a ward.

• Ask for the surgeon's full name and licence number and look them up in the Medical Council of Thailand register before paying anything.
• Ask who gives the anaesthetic. A named physician anaesthetist in a theatre with monitoring, not sedation from the surgeon.
• Ask for healed photographs of patients built like you, at a year rather than at weeks, from the front and the side and with arms raised.
• Ask how many augmentations the surgeon does in a year, and how many revisions. A surgeon who also does revisions understands what goes wrong.
• Ask what happens if you need a revision, who does it, whether the surgeon's fee is waived and what you would pay for the hospital and the flight.
• Ask for the implant card and an English operative report in writing before you leave, with the pocket, the incision and the implant serial numbers on it.

1. 1

   Online consultation with photographs

   Front and both sides, in a plain bra and without, with your height, weight, bra size, any pregnancies and whether you plan more. The surgeon should reply with a plan for pocket, incision and implant range, not only a price.
2. 2

   Arrival and examination

   Most hospitals want you in Thailand a day or two before surgery for the in-person examination, sizing, blood tests and the anaesthetic assessment. This is where the plan and the price are confirmed and where you can still walk away for the cost of the deposit.
3. 3

   The operation

   Under general anaesthesia, usually an hour or two, through the fold, the areola or the armpit. Some surgeons leave drains for a day. You wake in a surgical bra and stay a night on the ward in most packages.
4. 4

   The first days

   Tightness, swelling and a sore chest that settles over the first week. Sleep propped up, walk often, do not lift, keep the incisions dry and do not raise the arms above the shoulders. Most patients move to a hotel near the hospital after the first night.
5. 5

   Check-up and clearance to fly

   Around a week after surgery the surgeon checks the incisions, removes any drains or sutures that are not dissolvable and clears you to fly. If healing is slow you stay longer, which is why the return flight should be changeable.
6. 6

   Home and the long tail

   Implants sit high and firm at first and settle over months. Send the surgeon photographs at the agreed points, see a doctor at home the same day for fever, spreading redness, sudden swelling of one breast or a wound that opens, and book the imaging and check-ups your surgeon recommends for the years ahead.

• Anyone who cannot stay until the surgeon clears them to fly, which means at least a week and sometimes longer.
• Anyone who is pregnant, breastfeeding or planning a pregnancy soon, because the breast will change and the result with it.
• Smokers who will not stop, because wound healing is slower and the infection and contracture risks are higher.
• Anyone with an untreated breast lump, a strong family history of breast cancer that has not been discussed with a doctor, or a bleeding disorder or blood thinners that cannot be paused.
• Anyone who wants a size the surgeon says the skin and chest will not carry. Very large implants bring more contracture, more drooping and more revisions.
• Anyone travelling alone with no one to help for the first days, or under pressure from someone else to have it done.

• Medical Council of Thailand, register of licensed physicians.
• Royal College of Surgeons of Thailand, Thai Board of Plastic and Reconstructive Surgery.
• Healthcare Accreditation Institute of Thailand, hospital accreditation standards; Joint Commission International, accredited organisations in Thailand.
• Australian Society of Plastic Surgeons, guidance on cosmetic surgery overseas and on breast implants.
• Therapeutic Goods Administration, breast implant hub: BIA-ALCL, textured implant recall and patient information.
• US Food and Drug Administration, breast implants: risks, labelling and screening recommendations for silicone gel implants.
• British Association of Aesthetic Plastic Surgeons, breast augmentation patient information.
• International Society of Aesthetic Plastic Surgery, guidance for patients travelling for surgery.