Colombia has become the fourth leading destination for foreigners seeking cosmetic surgeries, most of them Spaniards and U.S. citizens lured by the lower prices and the promise of maintaining a youthful appearance.
But behind the veil of a perfect body lie the risks of disfigured faces, lifelong scars, damaged organs and even death. Those are the high costs paid by dozens of patients, including foreigners who traveled to Colombia to undergo beauty procedures with scalpels that sometimes have a double edge.
The South American country has a reputation for quality cosmetic surgeries at lower prices than elsewhere. A breast implant costs $3,000 to $4,000 in Miami but $1,500 to $3,000 in Colombia. A liposuction that costs $4,000 to $8,000 in Miami costs $800 to $2,500 in Colombia.
More than 75,500 foreigners traveled to cities such as Bogotá, Cali and Medellín in 2016 to undergo cosmetic procedures, accounting for 15 percent of the total number of surgeries carried out that year, according to the International Society of Plastic Surgery (ISAPS).
But what many of the patients don’t know is that a lack of laws and regulations mean their surgery can wind up in the hands of a general physician or even a dentist. And that’s just one of the industry’s serious problems, which include the recent scandal of surgeons who were performing cosmetic procedures for years even though they had never studied the specialty.
The problems have set off alarms among authorities and physicians, especially because the number of fatal cases spiked by 130 percent in one year, from 13 in 2015 to 30 in 2016, according to the Colombian Institute for Legal Medicine. That’s much higher than the 11 deaths in South Florida since May 2016 reported by the Miami Herald.
“It’s not possible to have so many moralities. We need a law to avoid more victims,” said Diego Valencia, vice president of the Union of Colombian Plastic Surgeons.
The last woman who went from a surgery room to a morgue was Jessica Joan Catorrizo, 32, who traveled from the United States to Cali in May to undergo one of the famous “combos” — a combination of surgeries in one procedure. She suffered complications during the procedure and was rushed to another clinic but died, according to local news reports.
Surgeons with fake diplomas
The need to regulate the cosmetic surgery industry has been known for many years, but it was highlighted by a scandal in 2016 that involved renowned doctors around the country.
The scandal started when Colombian journalist Lorena Beltrán publicly accused Dr. Francisco Sales Puccini of malpractice during her breast surgery and of obtaining a diploma in cosmetic surgery from an “express” course at the Veiga de Almeida University in Brazil.
Beltrán went to Sales Puccini’s office, in a exclusive Bogotá neighborhood, in 2014 for breast reduction surgery. She had looked him up on Google and trusted that he had a diploma as a cosmetic surgeon.
“At that point I believed him,” said Beltrán, who paid about $1,700 for the procedure.
Complications from the surgery started one week later: “My breasts were purple. They hurt. One of my nipples was almost ripping away from the sutures. It was going necrotic,” said Beltrán.
When she went back to the doctor, he told her that “everything was normal” and that she should wait one year to correct the scars with another surgery. But Beltrán consulted with another specialist, who told her that she would probably never be able to breast-feed a baby and that her procedure had been performed by an obstetrician not a cosmetic surgeon.
“I was very surprised, so I looked into what was happening with the Veiga de Almeida University and found that it did not even have a medical school. Those courses … are not even valid for surgery in Brazil,” she added.
Beltrán and another reporter from Noticias Uno decided to investigate and uncovered a national scandal. Dozens of Colombian doctors had enrolled in universities in Brazil, Peru and Argentina for short courses on cosmetic surgery, many of them online, and then paid bribes to Colombian Education Ministry officials to register them legally in their home country.
The diplomas certified them as specialists in plastic, esthetic and reconstructive surgeries, a specialty that must be studied in person and can take up to six years.
Two years after the scandal exploded, Colombian justice system took action. A judge has sentenced former Education Ministry official Leonor Herreño to seven years in prison for validating 44 foreign “express” diplomas for doctors in exchange for about $10,000 per validation.
Prosecutors also accused Sales Puccini and five other doctors of using false documents and procedural fraud because they submitted manipulated documents to register their specialization diplomas. A judge ordered Sales Puccini to stop performing cosmetic surgeries, but his social network accounts continue to offer them.
Since Beltrán went public with her own botched surgery and launched a campaign under the title Cirugía Segura Ya (Safe Surgery Now), dozens of other victims around the country have publicly accused doctors of malpractice and joined the call to regulate the industry.
No controls for “garage clinics”
Colombia has long been one of the countries that reports the highest number of cosmetic surgeries. More than half a million procedures were reported in 2016 alone, and the most popular were tummy tucks, breast augmentation and liposuction, according to ISAPS figures.
But the real number may be much higher because of clandestine procedures performed in “garage clinics” and those performed by doctors who do not specialize in cosmetic surgery. Colombia does not have any laws that forbid doctors without specializations to perform cosmetic procedures, a practice known in the field as “intrusiveness.”
That means that a general doctor, a dentist and even a nurse can perform procedures such as breast augmentations, nose jobs and liposuction, among many others.
“It is always safer to undergo surgery with a specialist, but there are no controls or regulations for the specialty. The attempts made to regulate this have not prospered” in Congress, said Valencia, of the Union of Colombian Plastic Surgeons.
Cosmetic surgeon Ricardo Lancheros said “intrusionism” has been in part responsible for the boom in procedures. “People don’t know that any doctor, gynecologist, ophthalmologist or nose doctor can perform this kind of procedure,” he said.
Although Colombian officials have been trying for years to control the “garage clinics,” they are still luring clients with prices as low as $100 for various procedures — but at the hands of unlicensed personnel (which have included hair stylists and masseuses) and under risky conditions.
The price difference between a legal and a “garage clinic” can be as much as 50 percent. A butt augmentation can cost as little as $100 to $300, but the substances injected have included cooking oil, industrial silicone, glue and shark cartilage. All can cause deformations and even death.
That was the case of Leidy Johanna Leyton, 34, who died last year in Cali after paying less than $100 for a butt augmentation in a “garage clinic.” Local news media reported that she was injected with liquid silicone and suffered a heart attack.
Although the regional health authorities have closed dozens of these clandestine places, many reopen under other names. Bernardo Guerra, a councilman of Medellín, has waged a battle against what he has called a “criminal gang of white coats associated with garage clinics that capture and cheat foreign patients in social networks without having the capacity for procedures.”
Attempts to regulate the industry
The wave of complaints led the government of President Juan Manuel Santos to endorse a proposed law to regulate cosmetic procedures, but it has failed passage in Congress several times.
The bill, submitted by Sen. Jorge Iván Ospina, requires that all cosmetic surgeries be performed by specialist doctors, and only in clinics with qualified personnel and the proper technology. The bill carries fines and criminal sanctions for those who violate its requirements.
“This industry has been gaining ground in the country and requires more protection to avoid more victims or a loss of standing around the world,” said Ospina, a surgeon and Green Party member.
For Beltrán, who has become an activist for safe cosmetic procedures, the legal gap can only be filled with a law.
Ospina says his proposed legislation has been rejected by Congress three times because of “the lobbying by general doctors who own clinics that would be in danger of closing under this type of regulation,” the senator said.
What patients should know
Lack of information is one of the key problems when it comes to making a decision on cosmetic procedures. The Colombian Society for Plastic, Esthetic and Reconstructive Surgery has these recommendations:
▪ Be aware that all surgeries carry risks, and that cosmetic surgeries are no exception.
▪ The number of procedures performed in one surgery increases the risks. Avoid the famous “combos.”
▪ Confirm that the surgeon is a specialist. Google the diplomas. If they are from universities abroad, verify that they have been registered with the Colombian Education Ministry.
▪ Pick a surgeon who is accredited with the Education Department’s Health and Social Protection Secretariat and belongs to an industry group such as the Colombian Society of Aesthetic and Reconstructive Plastic Surgery.
▪ Do not trust recommendations from friends, relatives or famous people in advertisements. Verify all information on your own.
▪ Make sure that the clinic where the procedure will be performed also has emergency, hospital and intensive care facilities. This is key in the case of complications. The clinic must be authorized to perform the type of procedure planned.
▪ Ask the surgeon if you are healthy enough to undergo surgery, and whether you need prior physical, medical or psychological exams. Ask for the details of the preparations for the surgery, the procedure and the recovery.
▪ Follow the surgeon’s recommendations to ensure a proper recovery. If complications develop, contact the surgeon directly. Ask the surgeon if the procedure will be walk-in or require hospitalization for one or more days.
▪ Resolve any doubts you may have about the surgeon and the medical team. Don’t trust the experience of someone else. Every patient is different.
▪ Verify the quality of the materials that will be used. They must be approved by the National Institute for Monitoring Medicines and Food.