Colombia has one of the busiest and most profitable cosmetic surgery industries in the world.

In 2015, the most recent year for which figures are available, Colombians and foreigners signed up to over a third of a million procedures of one sort or another, with liposuction and breast implants being the most popular choices.

These may seem surprisingly large numbers to other cultures and parts of the world not so bothered by the necessity for body augmentation, but either way, with some people spending many thousands of dollars per operation and demand on the increase, it is clearly a very lucrative business to be in.

And therein lies a problem. While most of the procedures in Colombia are carried out by suitably knowledgeable and experienced surgical specialists, others are not. Such is the money to be made from performing aesthetic surgery that it's attracted medical practitioners who haven't necessarily achieved the relevant and required qualifications.

As a result, patients - who can find it hard to distinguish between the validity of one set of professional diplomas and another - are being put at risk of horrible complications: disfigurement, disability and even in some cases, death.

For this episode of Latin America Investigates, filmmaker Miguel Soffia joined up with reporter Martha Soto, an award-winning investigative journalist at Colombia's most widely-read newspaper, El Tiempo.

They set off in search of one group of doctors, now being investigated by the country's state prosecutor, who obtained their cosmetic surgical qualifications via a less-than-reassuring part time course at a Brazilian university - a course that has now been discontinued.

How was it, our team wanted to know, that this was deemed sufficient by the regulatory authorities back in Colombia to allow the doctors to wield their scalpels in such a specialist field? And why was the experience of one woman patient so disturbing that she began a national campaign to name and shame those she held responsible for her own plight and that of other victims?


By Miguel Soffia

Colombian women are known worldwide as icons of Latino beauty: Voluptuous curves, a flawless nose, full lips and perfect skin. People like actress Sofia Vergara, from the popular sitcom Modern Family, are the ideal for many young women in the country.

Thousands of Colombian teenagers save for years to have their first surgery when they are legally allowed to, at 18. Yet the desire for a perfect body has led to a public health crisis: According to reports from the ministry of health and the Colombian newspaper El Tiempo, cosmetic surgery-related accidents have been rising over the past 10 years, reaching alarming figures in 2015.

Most patients get procedures through proper surgeons, but others try to save money by using less-qualified medics or amateur aesthetic centres. Some leave with undesired scars, others haven't survived to tell their stories.

Doctors in Colombia perform surgery. It is typical for young women - even in their teens - to begin saving up large amounts of cash in the hope of affording multiple operations [Al Jazeera]

As a father of a three-year-old girl, I was instantly motivated when invited to direct a documentary on the issue. I wanted to figure out why women are willing to take big risks to have their bodies modified and how is it that so many are having unwanted consequences. This is how I met El Tiempo's investigative unit director, Martha Soto. A senior and much-respected journalist in Colombia, she helped us explore what has gone wrong with this Caribbean country's beauty fixation.

Official records from the International Society of Aesthetic Plastic Surgery show that over 375,000 such operations take place a year in Colombia, of which about 75,000 are medical tourists from other countries.

Colombia is second in the world per capita in its pursuit of cosmetic medical procedures, beaten only by South Korea. This represents a tempting market for doctors and is the starting point of our investigation.

A group of 39 trained Colombian doctors from different specialisations wanted a share in the business, but Colombian universities don't offer enough vacancies in the plastic surgery speciality.

Determined to get into the market, these doctors found a way of avoiding the long queue to take their country's four-year qualification course in the specialty. Instead, they signed on for a brief course at a Brazilian university which only took them a few months. Later, they validated those titles back in their country thanks to a legal loophole in the Colombian education law which allowed them to present their diplomas as full medical specialisations.

Now apparently legal, the group of doctors started operating. A member of another plastic surgeons' association has claimed that these doctors want to disrupt the market, like Uber has disrupted taxis, by offering lower prices and finding cheaper ways to deliver results.

Unfortunately, everything comes with a cost, and some of their patients say they started to suffer the consequences.

Lorena Beltran has become the face and voice of a group of women demanding better regulation of plastic surgery in Colombia. She shot to fame after a popular newspaper printed pictures of her disfigure breasts [Al Jazeera]

One dissatisfied customer of these doctors took a determined step to change the story. Lorena Beltran appeared topless, showing her scarred breasts in a national newspaper, and by sharing her intimate testimony she inspired many other victims to join her. They are seeking the attention of the authorities via a successful social media campaign using the hashtag #CirugiaSeguraYa (#SafeSurgeryNow).

But are the authorities reacting too late to this problem? How come doctors without the country's established specialisations can practise plastic surgery? And ultimately what do victims seek in going public with their ordeal?

Colombia: Under the Knife takes you on a quest into the world of Latino beauty. We question those involved to figure out what is not working between the operating rooms and the ministries and find out what is being done to help patients get safer surgery.

Editor's note: After this film was completed, we received a response from Dr Francisco Sales Puccini, one of the medical practitioners about whom various questions are raised in our report.

He had declined our numerous offers to interview him on camera, but chose subsequently to issue a statement. His position is accurately and fairly reflected in the film but his full statement - with some necessary redactions for legal reasons - can be found here

Source: Al Jazeera News