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A British mum-of-three died after being offered a cut-price Brazilian butt-lift with just five minutes’ notice at a Turkish clinic, an inquest has heard.

Hayley Dowell, 38, died at BHT clinic Istanbul Tema Hospital on October 3, 2023, from complications during liposuction – fat removal surgery.

She had originally booked in for a tummy tuck and liposuction but was offered the BBL as an add-on by a surgeon who suggested the fat from her stomach could be used to enhance her ‘flat’ bottom.

Her husband, Neil Dowell, told the inquest at Winchester Coroners’ Court she was ‘quite happy with that’ but added: ‘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.

‘I don’t recall seeing a consent form at all.

‘It was just in the moment it was so quick. We had to make a quick decision – it was a mad rush.’

Area coroner Nicholas Walker raised concerns that offering the ‘risky’ procedure in such a way could lead to future deaths.

‘Although on evidence Hayley did not die from BBL, this was offered to her and can be offered to others,’ he said.

‘I’m satisfied upselling in such circumstances and lack of time to reflect on consequences will create a risk of future deaths.

‘Hayley was marked up and ready to go to theatre when presented with a choice and given a card machine to complete that transaction.’

He added that such upselling would not happen in the UK as a patient would have a 14-day cooling off period, as heard in evidence by expert witness, consultant plastic surgeon Elaine Sassoon.

‘Moreover, the operation itself would have been discussed likely well in advance of the operation by the surgeon who was going to conduct the operation,’ he said.

Ms Sassoon told the inquest that cosmetic tourism had become ‘a conveyor belt’ in Turkey, with no sense of patients as ‘a human being, as a doctor should view the patient’.

Giving evidence at the inquest, Mr Dowell said his wife decided to get a tummy tuck and liposuction done abroad because of the cost, and that it was a ‘kind of trend’ having heard stories and friends who had done it too.

‘I didn’t trust surgery abroad, thought it should be in the UK,’ he said, where Hayley previously had breast implant surgery.

‘I tried to persuade her not to, but she was very persistent, she’d done her research.’

She found medical broker Qunomedical on the internet, who organised the hotel, clinic and surgeon for about 7,000 euros while the couple arranged for their own flights.

Mr Dowell had also booked to get his teeth done while they were away together.

The couple, from Eastleigh, Hampshire, arrived in Turkey the evening before the operation and were taken to the clinic to have blood tests and sign paperwork, which included a list of risk factors.

Mr Dowell said Hayley was not given a copy of the signed documents to take back to the hotel room with her before the procedure the next day.

The inquest heard that Mr Dowell was initially advised, after four hours of surgery, that everything was OK.

But, as it got towards midnight, he was told by the surgeon that his wife was very unwell, had suffered two cardiac arrests and ‘you should say your goodbyes’, he said.

The coroner said he made no findings about the surgery or the competence of the surgeon, and that further questions from the family may be answered in litigation currently ongoing in Turkey.

The clinic was an interested person in the inquest but did not give evidence.

Hayley was described as a fun-loving girl who adored her children and was training to be a dental nurse.

Her family told the inquest: ‘She’s a big loss, she had everything to live for, especially her children, she’s greatly missed.’

The coroner will write to the Health Secretary and General Medical Council in a prevention of future deaths report including to raise concerns over a lack of database on evidence on the extent of this problem.

He added: ‘I cannot be involved in what happens in any other country, but I have to look at this with the focus of this country and how those in this country are informed so that their eyes are open when they (get) on a plane.’

Asking Ms Sassoon of her view of being offered additional treatment at a discount price around 15 minutes before surgery, the expert witness said: ‘My professional view is, oh dear, this is a conveyer belt, there is no sense as the patient being viewed a patient, a human being, as a doctor should view the patient.

‘It’s become just a transaction and you just think, because he had no contact with Hayley before, he had no idea of who she was.’

In her evidence she added that cosmetic tourism is ‘not going to disappear’ and it contributes billions to the Turkish economy.

‘You have political aspects to it, you also have people want to do it. It’s not going away and more people do it,’ she said.

‘We can’t stop it but what we need to do is set baseline things that will make it safer.’