A mother of three died from complications during liposuction surgery in Turkey after being offered a discounted Brazilian butt-lift (BBL) procedure just minutes before going into theatre, an inquest has heard. Hayley Dowell, 38, died on October 3, 2023, at the BHT clinic in Istanbul.
Dowell had traveled to Turkey for a tummy tuck and liposuction. During an initial meeting with her surgeon, she was offered a third procedure as an add-on at a £1,000 discount. This offer was presented with a card machine moments before she was scheduled to begin surgery.
Coroner Nicholas Walker stated that while Dowell did not die as a result of the BBL itself, the practice of upselling additional procedures with little time for reflection poses a risk of future deaths. "Upselling in such circumstances and lack of time to reflect on consequences will create a risk of future deaths," Walker told Winchester Crown Court. He noted that Dowell was already prepared for surgery when presented with the choice and the payment option.
Dowell's husband, Neil, was with her when the surgeon suggested using fat from the liposuction for a BBL. He stated his wife was agreeable but unaware of the additional cost. "As soon as he left the room, a young lady came in with a card machine, we had a five-minute window to decide to have the procedure or pay for it or not," he said, adding that he did not recall seeing a consent form. He described the situation as a "mad rush" requiring a quick decision.
The coroner emphasized that such upselling would not occur in the UK, where patients have a 14-day cooling-off period, and procedures are typically discussed well in advance. Dowell reportedly chose to have the operations abroad due to cost and a perceived trend among friends.
Medical broker Qunomedical arranged the hotel, clinic, and surgeon for approximately €7,000 (£6,000). Dowell and her husband arrived the evening before the operation on October 1. After initial tests and paperwork, including a list of risks, Dowell underwent surgery. Her husband was initially told she was well, but later informed she had become critically unwell and suffered two cardiac arrests.
At a previous hearing, Neil Dowell testified that the surgeon reportedly left the operating theatre midway through the procedure, leaving the anesthetist to complete the surgery. What was expected to be a six-hour operation concluded in one hour and 45 minutes.
The coroner made no findings regarding the surgery or the surgeon's competence, suggesting that ongoing legal action in Turkey might address the family's outstanding questions. Representatives from the BHT Clinic did not provide evidence at the inquest.
Data from the Foreign Office indicates that at least 35 Britons died following elective medical procedures in Turkey between 2019 and the previous year. In 2023, the same year Dowell died, 31-year-old Melissa Kerr also died in Turkey during BBL surgery due to a fatal blood clot.
Coroner Walker indicated he would be writing a report to the Health Secretary and the General Medical Council, recommending measures to improve patient awareness regarding cosmetic tourism, even if he cannot directly intervene in overseas practices. He noted a lack of comprehensive data on the extent of the problem.
Elaine Sassoon, a consultant plastic surgeon and expert witness, described the situation as a "conveyor belt" where patients are treated as transactions rather than individuals. She acknowledged that cosmetic tourism is unlikely to cease and contributes significantly to Turkey's economy. Sassoon suggested that while the practice cannot be stopped, safety standards can be improved.