Consumer Brief: This is the second in a series of articles about the costs of plastic and cosmetic surgery. CosmeticSurgery.com takes a critical look at going overseas -- where costs are far less -- for your procedure. The guideline is about the same as selecting a U.S. surgeon -- homework counts for everything.
A retired North Carolina teacher, K.B., stopped wearing glasses after she had Lasik, the laser eyesight correction surgery. But then her sagging eyelids became very noticeable and she began looking for a surgeon to perform an upper and lower eyelid lift.
Yet, K.B. (who asked to have her name withheld) found a $5,000 quote hard to swallow on a retiree's budget, so she did more Internet research.
Eventually, she came to MedRetreat, an Illinois-based medical tourism company, which arranges plastic and cosmetic surgery procedures in 10 nations where surgical costs are vastly reduced -- from 40 to 70 percent less -- over U.S. costs.
But would traveling abroad for plastic surgery present a host of potential problems and complications for K.B.?
Two in Five Would Go
Several of the U.S. and English professional plastic surgery organizations, along with the International Society of Aesthetic Plastic Surgery (ISAPS), frequently issue warnings against people traveling from their home nations to a foreign country for rejuvenation surgery.
Nonetheless, a Deloitte consumer health report found that two in five Americans would travel abroad for a medical procedure if it cost half the U.S. price and the quality was at least equal.
The study also shows how firmly medical tourism is entrenched in the industrialized nations where all types of health care tend to be more costly. Moreover, the governments of some third-world countries are pouring massive amounts of money into building world-class medical facilities staffed by top surgeons to better attract more Dollars, Euros, and Pounds.
The nations leading the medical tourism trend: Argentina, Brazil, Costa Rica, India, Malaysia, Mexico, Panama, Philippines, South Africa, Thailand, and Turkey.
Iguaza Falls, Brazil (Brazil Tourist Board photo)
Recently, the American Board of Cosmetic Surgery (ABCS) spent $30 million to build a hospital at Dubai in the United Arab Emirates to make that nation a center of excellence for reasonably priced cosmetic plastic surgery.
Prices on a distant shore can be up to 70 percent cheaper because the cost of living is so much lower and because the medical professionals are not saddled with the huge malpractice premiums that must be provided for a U.S. doctor's office.
Sensible Foreign Plastic Surgery
The trend is so large that one of the world's most stringent hospital certifying bodies, Joint Commission International (JCI), reports it has certified 157 hospitals in 30 smaller nations to the same high standards enjoyed by American, Australian, and English doctors and patients.
As more people vie for all types of goods and services in an increasingly global economy, some firms have sprung up to arrange for more responsible offshore plastic surgery.
"..the doctor checked on me every day and it was all in a beautiful tropical paradise while my home state was shivering in winter."
For instance, Gorgeous Getaways, "an international operator of plastic/cosmetic surgery holidays," makes an unusual offer: in case of botched surgery, the company will fly the patient from his home back to its hospital in Malaysia, pay for lodging, the revision surgery or other procedures and then return him or her back to his native land -- all at no charge.
"In four years, we've never had a botched surgery but we do put the no-charge offer in writing," says Gorgeous Getaways founder Louise Cogan. MedRetreat makes a similar offer.
Botched Plastic Surgery
Nonetheless, the medical landscapes in America, England and Australia are littered with cases of botched plastic surgeries performed in foreign lands. Once the patient is back home, she often goes to another plastic surgeon for care. But in the absence of medical records, the surgeon is likely to be puzzled about where to start or what exact surgical approach the foreign doctor used.
The situation once reached epidemic proportions. A liposuction clinic in the Dominican Republic infected so many American women that the Centers for Disease Control (CDC) in Atlanta took over the investigation. The source of the problem was traced to unsterilized liposuction wands used in a Dominican Republic clinic.
A Beautiful Tropical Paradise
When K.B. first approached MedRetreat she found that a Malaysian surgeon who was born, trained, certified and practiced for 25 years in California would receive her photos, vital statistics, medical history, and other health records. He would then return a quote for the eyelid surgery. The charge for that service alone was $200.
She eventually discovered the foreign surgeon could lift her upper and lower eyelids -- along with her entire face and neck -- for the price of the eyelid procedure she was quoted in her hometown, North Carolina. She decided to go ahead with the surgery and spoke on the phone with the distant surgeon before leaving.
"In Malaysia, a driver picked me up at the airport, I stayed in a five-star hotel I could never afford at home, the doctor checked on me every day and it was all in a beautiful tropical paradise while my home state was shivering in winter," says K.B.
Jamaica (National Tourist Board Photo.)
The $6,000 Rule
"If your procedure costs $6,000 or less in the U.S., you probably would not save anything by going overseas for surgery," says Patrick Marsek, the MedRetreat founder. "The surgery itself may only cost about $1,500, but by the time you add in airfare, hotels, and other costs you would realize no savings."
Working on her own, K.B. was able to find airfare to Maylaysia and back for only $800. She also spent $600 for an MRI while there to help her U.S. surgeon diagnose a pesky back problem.
Requirements for Overseas Plastic Surgery
Robert Kotler, M.D., a board certified Beverly Hills plastic surgeon, is the author of three books for consumers about various areas of plastic surgery. He suggests seven smart questions for patients interested in offshore rejuvenation surgery.
- Is the surgeon board certified by one of the recognized American boards like the American Board of Plastic Surgery (ABPS)?,
- Is the offshore surgery facility a hospital, an outpatient surgery center or the surgeon's office? Ask what safety accreditation the facility holds and if it is licensed by its government.
- Who does preliminary physical exams and lab tests to make sure I am healthy enough for surgery and undergoing anesthesiology?
- What happens if I don't like or feel comfortable with the foreign doctor or the hospital. Can I get a refund?
- If I go ahead with the surgery, is a board certified anesthesiologist in attendance during the procedure?
- How long must I remain in the host nation before going home? How often does the surgeon check on me after surgery? Will the stitches be taken out before departing?
- What happens if a complication or problem crops up after I return home? What doctor will handle it and who covers his fees?
Adds Catherine Foss, executive director of the International Society of Aesthetic Plastic Surgery (ISAPS) in Hanover, New Hampshire: "Board certification varies by nation; the more western nations, like those in Europe, have certifying bodies similar to the ones in the United States. But the training and certification policies in nations like China and the former Soviet block nations are less well known.
K.B. before her surgery (left), offshore; and 3 years after her procedure (right). (K.B. Photo)
"So we generally advise patients to be sure the foreign surgeon is a member of the national society of plastic surgery in that country," Foss says.
Says Doc: Don't Fly Too Soon!
"Traveling in a plane is pretty much out of the question the first ten days after surgery," says Dr. Kotler. "The long incisions associated with a tummy tuck may even require more than ten days before safely flying."
Recently, a U.S. citizen who went to Mexico for a low-cost tummy tuck literally stumbled into Dr. Kotler's office. He found the woman was suffering from a raging wound infection in her incision. The doctor asked why she chose him and she replied: "Because your office is the closest to the elevator and I couldn't walk much farther."
"…we generally advise patients to be sure their surgeon is a member of their national society of plastic surgery in that country."
"Nonetheless, I have seen excellent plastic surgery performed in smaller nations like Costa Rica," says Dr. Kotler.
The global economy can also work in Americans' favor. Many more European citizens, attracted by a weak dollar that buys 50 foreigner's percent more, are arriving in New York City, Beverly Hills, and other centers of plastic surgery excellence. They also spend money on other services, goods, and entertainment.
One Italian male patient explained during a phone call to Dr. Kotler's Beverly Hills office that it was cheaper for him to fly there, have a rhinoplasty, wait for recovery, and fly back home than it was for him to go to Switzerland -- a scant 600 miles away -- for the procedure from a surgeon with comparable training and qualifications.
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