A CORONER has urged authorities to warn Australians about the dangers of medical tourism after investigating the death of a Melbourne man after a $35,000 cosmetic surgery trip.
Leigh Aiple, 31, travelled to Malaysia in May 2014 with a view to changing his life.
The self-conscious Melbourne man signed up for a trip organised by New Zealand-based medical travel agency Gorgeous Getaways.
The plan was to travel to the Beverly Wilshire Medical Centre in Kuala Lumpur for a marathon of surgeries years of bullying had convinced Mr Aiple he needed.
The former Australian Defence Force member had been obese for most of his life. He weighed 124.6kg and had a body mass index that classified him as having Grade III Obesity.
He'd been bullied during his time in the army over his weight, his snoring, and the excess skin he developed around parts of his body after losing significant amounts of weight during his recruit training.
His mother said when he quit the ADF he returned "so depressed, there was nothing we could say or do to pull him out of this deep hole".
Mr Aiple had wanted to have surgery to remove excess skin from his chest, but couldn't afford the operation in Australia.
For about a third of what he would have to fork out to have the surgery back home, he underwent a tummy tuck, liposuction, an upper eye lift, a chin tuck, lip filler, a thigh lift and some chest sculpting at the Beverly Wiltshire clinic in two marathon surgery sessions.
The surgeries were life changing, but not in the way the optimistic patient had hoped.
Within 24 hours of returning to Melbourne, Mr Aiple was dead.
CLINIC BOASTED 'INTERNATIONAL STANDARDS'
The medical centre Mr Aiple visited was described by Gorgeous Getaways as "a boutique medical centre, offering surgical and non-surgical procedures using state-of-the-art equipment and highly-skilled, experienced specialists".
Of hospitals in Kuala Lumpur, the travel company said the surgery destination boasted "private and certified to internationally recognised standards with the same or higher as you would expected at home".
Mr Aiples surgeries took place days apart and lasted about 10 hours for the first surgery and just under five hours for the second.
According to the coroner's report, Mr Aiple was left with several open wounds that were oozing fluid. After leaving the hospital, carers provided by Gorgeous Getaways would find him in pain with the room "in a mess with bloodstained robes, towels, bedsheets".
An email to his mother, Grace Muscat, days after the surgery said: "For the last four days I have been losing fluid at a dangerous level. And I haven't been able to replenish it fast enough. I fainted on two different days when the girls were doing my dressings. I've been short of breath and my heartbeat has been beating rapidly, like crazy," he wrote.
Two days later he described "another bad day" where he blacked out and "woke up on the bathroom floor".
"When I got off the floor ... I started hyperventilating and couldn't breathe. My chest was tight and heartbeat was dangerously rapid," he told his mother.
"Just letting you know, in case this behaviour continues when I get home. They don't seem able to solve my issue here, they just say 'I've never seen your kind of case before'. It's a little scary hearing that."
It was May 11, 2014, when Mr Aiple was able to return to Melbourne. Ms Muscat picked him up from the airport and noticed "horrid" wounds. She said he was in "a lot of pain" throughout the day.
The next morning she heard a crashing sound from her son's bedroom to find that he appeared to have collapsed by his bed, and was struggling to breathe.
She called emergency services, but they could not recover Mr Aiple.
SURGERY SHOULDN'T HAVE HAPPENED
Australian Society of Plastic Surgeons president Professor Mark Ashton told the coroner Mr Aiple's multiple surgeries would never have been carried out in Australia.
He said Mr Aiple would have been considered a "high-risk" patient in Australia, and noted that if the surgeries were performed in Australia, Mr Aiple would have been treated with a higher level of anti-blood clotting treatments.
Mr Aiple died after a blood clot that had occurred while he was at the clinic had moved from his leg to his lung.
Despite assurances from the clinic that it was certified to "internationally recognised standards", Prof Ashton noted that such international standards did not exist.
"The pre-operative consultation, and the scope and spacing of the individual operations are NOT of an international standard," he told the coroner.
Prof Ashton said if the surgeries had been carried out in Australia, they would be done in separate hospital admissions, and some months apart.
In handing down her report, coroner Caitlin English noted it was important for Australians be made aware of the risks associated with opting to travel for surgery.
"The standards of medical practice in Australia are among the highest in the world and those Austrians who seek medical services such as plastic surgery overseas may not be aware there may be a difference in standards," she said.
Following her investigation, she urged the Chief Health Officer to publish a health advisory warning that the quality of medical care provided in other countries may not be of the same standard as that provided in Australia.