Phuket Plastic Surgery Institute

This policy and procedure applies to PPSI clients who have booked a plastic surgery procedure through our affiliated agencies or directly through our reception or online channels.

Our Commitment and Promise – Terms and Conditions

At PPSI we stand by the service that we offer, believing in quality, client satisfaction and that we have a responsibility to our clients long after they have returned home. PPSI provides our clients with the assurances that they are not putting themselves at unnecessary risk by travelling overseas for surgery.

Clients are advised that risks are inherently associated with any surgery, and that clients should be fully informed of those risks prior to electing to undertake surgery at PPSI. Information on surgical, anaesthetic and other risks are detailed in PPSI Procedure Information pamphlets and consent forms. Clients should also fully discuss these risks with their attending surgeon.

If clients are healthy without prior medical conditions, have realistic expectations, follow their surgeon’s advice and recovery instructions, then they should be pleased with the outcome of the surgery. If a problem arises as a direct result of the surgery or hospital admission may require corrective surgery, PPSI has set up a review process. Notification of a client’s dissatisfaction should be made in writing to postop@phuketpsi.com within 12 months of the surgery.

Review Process

Clients are advised to report a complication or dissatisfied with the outcome to their agency or directly to PPSI. In order for the tending surgeon to review and advise on a case, PPSI request that the client or agency:

Contact PPSI coordinators immediately in the case of urgent complications
Provide recent photos in accordance with PPSI photo guidelines
State the concerns in writing, including a description of symptoms and concerns
Submit any other relevant information, such as GP’s or medical notes, ultrasound results, etc.
Notify PPSI within 12 months of surgery for the client to be eligible for consideration for revision surgery by the PPSI Surgical Review Committee

Initially the case will be reviewed by the attending surgeon. More complex cases will be referred for a review by PPSI’s Surgical Review and Risk Management Committee, which consists of at least 2 Senior Plastic Surgeons and a Hospital Risk Management Doctor. The committee will review the evidence presented and determine if revision surgery or other action is warranted on a case-by-case basis. This determination will essentially be:

That the complication is related to surgery, hospital treatment or admission
That the complication is related to unrealistic expectations of the client, previous medical or pre-existing conditions, the client not fully following post-operative or surgeons instructions
That the complication is not related to surgery, hospital treatment or admission

After a determination of the above, the amount and extent of responsibility between PPSI and the client will be allocated. In some cases, responsibility will be 100% allocated to PPSI, in others, 50% to PPSI and 50% to the client (percentage may vary), and in others 100% responsibility to the client. Allocation of responsibility will be made based on the evidence presented in each case.

PPSI will notify the client or the client’s agency of the determination in writing. If a client disagrees with the determination, they should immediately notify PPSI, in writing, providing the reasons or evidence why they disagree with the determination.

Conditions

Clients should be aware that:

All post-operative advice provided by surgeons, including medication recommendations, restricted activities, follow up care must be followed.
Compression garments, where recommended, must be worn according to the surgeon’s instructions.
In cases that a client considers to be an emergency, such as acute pain, acute swelling or infection, the client should seek immediate medical assistance from a licensed medical practitioner. The client should obtain a medical report or notes detailing the diagnosis, treatment provided and forward this information to PPSI. Failure to notify PPSI within a reasonable amount of time that emergency assistance has been sought, may result in limited post-operative support.
PPSI will not reimburse treatment costs abroad.
PPSI does not reimburse the cost of the initial surgery in Phuket.
Generally, except in the cases of emergency or acute complications, no determination will be made by PPSI for 6 months following surgery. This is to allow ample time for the minimization of any swelling and scar healing, etc.
No procedures, except in emergencies or acute complications, may be performed by another surgeon without the consent of PPSI. Failure to pre-notify PPSI may result in the client being ineligible for review of their case.

Significant risk factors that may be taken into account when making a determination on high risk surgery cases

Patients with any of the following risk factors should ensure that this information has been provided to their surgeon before undertaking any surgical procedure and declared fully and truthfully on the pre admission form, including but not limited to:

Patients who smoke or are alcohol or drug dependent.
Patients outside a healthy BMI range.
Patients with diabetes or thyroid disease.
Patients with blood pressure disorders including hypertension, limb ischemia, varicose vein or hemorrhoids.
Patients with heart conditions including valvular disease or ischemia.
Patients with renal conditions including chronic renal failure or stone.
Patients with urinary conditions including benign prostatic hypertrophy, stricture of the urethra.
Patients with liver conditions including cirrhosis or hepatitis.
Patients with lung conditions including COPD, asthma or TB.
Patients with gastrointestinal conditions including peptic ulcer.
Patients with marrow conditions including dysplastic marrow.
Patients with nerve conditions including sensory, motor or autonomic disturbance.
Patients with muscle conditions including weakness, myasthenia-Gravis or Guilain barre syndrome.
Patients with uterine conditions including dysmenorrhea and endometriosis.
Patients with joint conditions including arthritis.
Patients with eye conditions including glaucoma.
Patients with psychiatric conditions depression, schizophrenia or anxiety.
Patients with systemic conditions including autoimmune disease allergy or cancer.
Patients with degenerative conditions to the spine, bone, joints, eye or brain.
Patients with keloid scarring problems.
Patients with vascular or heart problems.
Patients who take medications which could interfere with recovery.
Patients who are allergic to medications or other non-disclosed allergies.
Patients who are HIV positive, or have hepatitis or syphilis.

Exclusions

Clients should be aware that the following exclusions will not be considered by the review committee:

Non-surgical procedures, laser or dental procedures.
Inherent risks associated with surgery which are not a result of surgery error, including but not limited to: capsular contracture and skin rippling (in the case of breast implants), numbness and changes in sensation, minor asymmetry.
Changes associated with weight gain/loss or pregnancy after the surgery.
Clients who have not stayed the minimum recommended amount of nights in Phuket required for their procedure, except if the client received written permission from their tending surgeon approving a shorter stay in Phuket.
Clients who have been identified and advised that they are high risk.
Surgical outcomes that may not be fully attained as expected by the patient.
Prior to surgery, the surgery technique used, or any other factor provided to the patient which may result in a complication. This particularly applies to patients who insist on having a procedure, when they have been informed by the surgeon that the results may not be optimal.
Any revision surgery or secondary surgery not originally performed by PPSI, or any corrective surgery originally performed by a non-PPSI surgeon.
Smokers who do not cease smoking 4 weeks prior to, and 4 weeks after their surgery.
Clients who drink alcohol 1 week prior to their surgery and for the complete post-operative period, until they have ceased their course of antibiotics or as advised by their surgeon (except if they receive permission from their surgeon).

Determination

After taking into consideration the conditions and exclusions above, the PPSI Surgery Review Committee will make a written determination that may or may not include an offer for revision or touch-up surgery.

On a case-by-case basis, the determination may include the following:

No offer. The client is advised that no further surgery is advised or recommended.
Surgery at a Courtesy Price. The client is offered revision or touch-up surgery at a costs-shared basis. The cost and allocation of responsibility of the payment for hospital, admission, surgical and other costs associated with the surgery will be made based on the evidence presented in each case.
Complimentary Surgery. The client is offered complimentary revision or touch-up surgery and PPSI will take responsibility for all ground transfers, hospital, admission, surgical and other costs associated with the corrective surgery. The client will be responsible for the cost of travelling to Phuket and for accommodation before and after discharge from the hospital.
Complimentary Surgery and Travel Expenses. The client is offered complimentary revision surgery and a refund of the cost of travelling to Phuket. PPSI will take responsibility for all ground transfers, hospital, admission, surgical and other costs associated with the corrective surgery, and the client will be able to claim a refund of one return airfare from the nearest capital city or international airport in economy class (for non-residents of Thailand). The cost of the flight must be pre-approved by PPSI and any additional airfare costs or companion fare must be paid by the client.

Refund of the cost of hotel accommodation for the time required to be in Phuket for corrective surgery may be offered at a rate of THB 1,200 per night. Any additional hotel costs, including upgrades and meals, must be paid by the client. PPSI will not be responsible for any expenses for the patient’s companion or family.

Note: PPSI must be notified within 1 year of the original surgery and corrective surgery must be completed within the time period specified in the written determination.