Is it a good idea?

There is no question that plastic surgery is expensive and, in most cases, it isn’t covered by health insurance. Since the cost is coming directly out of your own pocket, it would be nice to save some money where possible, right? This has led many people to traveling to other countries to get their procedures done. However, is it safe? Are you more likely to have complications if you do this?


0311 Plastic Surgery Abroad TNAccording to the American Society of Plastic Surgeons (ASPS), cosmetic surgery is a $16 billion a year industry in the United States and 17.5 million cosmetic and minimally-invasive procedures were performed in 2017 alone. This means that more cosmetic surgery procedures are done in the US than in any other country. However, our plastic surgeons and hospitals are also the most expensive. This is driving people to find cheaper alternatives. If people travel abroad, they can save 40 to 80% depending on the procedure and the country they visit. Brazil, Japan, Italy, Mexico, Russia, India, Turkey, Germany, and France are the top ten destinations, according to the International Society of Aesthetic Plastic Surgery (ISAPS). This is a form of medical tourism, which is when you choose to have surgery outside the country for supposedly much less money than you might pay here in the US. This term covers all types of procedures, including elective plastic surgery, and is growing worldwide at an estimated rate of 15 to 25%, according to Patients Beyond Borders. Currently, estimations indicate that as many as 15 million US patients are seeking medical care abroad each year. In regards to plastic surgery, ISAPS states that women most often travel abroad for breast augmentation, liposuction, eyelid surgery, rhinoplasty (nose jobs), abdominoplasty (tummy tucks), and breast lifts. In addition, the number of women traveling for labiaplasty (reducing the length of the labia minora) and lower body lifts have increased. However, women aren’t the only ones traveling for surgery. Men represent 13.8% of cosmetic patients and their favorite procedures are eyelid surgery, gynecomastia (male breast reduction), rhinoplasty, liposuction, and hair transplant.

Due to the cost savings, more and more people are pursuing this avenue. There is no question that foreign travel is intimidating and so is the thought of any kind of surgery, so it’s easy to understand the stress involved with going abroad to have a procedure done. International plastic surgeons know this and try to make everything involved with traveling to their facility as streamlined and reassuring as possible. The new trend is to combine cosmetic surgery and luxurious vacations, usually at half the price of the same surgery here in the US. A typical package will include your pick of an operation or operations, tour itineraries and spas visits. In addition, it often includes airport pickup, pre- and post-surgery accommodations at four-star hotels and exotic meal plans. While this might sound like an awesome opportunity, plastic surgery is still surgery and it affects your body and health. This means that there are several things that you should consider before deciding to move forward with your plans.

Without the proper research, your surgery abroad can quickly turn into a nightmare at home. Regulations and standards in other countries for training, accreditation and safety protocols vary significantly and can be deficient or nonexistent. Due to these fluctuations, the number of patients reporting complications after treatment abroad is increasing. In the April 2018 issue of Plastic and Reconstructive Surgery (the official medical journal of the ASPS), a study found that patients traveling to developing countries for plastic surgery procedures may experience severe complications that require extensive and costly treatment after they return home. Several possible complications include hematomas (a pocket of blood that resembles a large and painful bruise), nerve damage, infection, blood clot (in legs or lungs), scarring, dissatisfaction with appearance, organ damage, anesthesia complications, blood loss and seroma (when serum from your blood pools beneath the surface of your skin causing swelling and pain). The most common complications are infections, wound healing problems and pain. Sometimes, if a person’s condition is severe enough, they need to be hospitalized. Unfortunately, this costly postoperative care isn’t always covered by your insurance, which can quickly turn your overseas bargain into a financial nightmare, in addition to threatening your health. Another study that was completed in July 2017 and published in Plastic and Surgery Reconstructive Surgery, followed 42 patients who had received cosmetic surgery abroad. The study found that the average cost of treating complications in this small group of patients was more than $18,000. The key thing to keep in mind is that this is only 42 patients out of the millions that get procedures done yearly. The study also approximated that the cost of treating medical tourism complications was about $1.33 billion in 2012 and Medicaid was the main funder.

If you do have complications, you might have difficulty finding a US surgeon willing to correct the bad surgery. There are numerous legal reasons that could make it impossible for them to correct any complications. Part of this problem is that there are no US laws that can protect you if you go to a doctor abroad. Here you’re able to sue for malpractice if something goes wrong with your surgery or your privacy rights are violated. However, the laws in other countries vary. So, the accountability of your foreign surgical center rests largely on your ability to stick around and determine the quality of your results. Since issues with plastic surgery don’t usually occur until several weeks after the initial treatment, this can be difficult. In addition, it’s near impossible for surgeons to track down exactly what was done, where the surgery was performed or which doctor did it. If you do find a willing surgeon, it’ll most likely be more expensive than your original surgery. Revision rates for patients who have traveled abroad for surgery and have had complications are much higher than those who have their surgery at home. So, your procedure could end up costing you more than double what you would’ve paid had you received proper care in the US from the beginning. It’s key to make sure you understand exactly what your legal rights are and what recourse might be available to you before you make an appointment in another country. You need to consider the worst-case scenario and have a plan in place in case something goes wrong.

In order to be prepared, check with your health insurance provider to determine if any of the costs of your plastic surgery abroad will be covered. Usually, it’s not because the surgery is elective. If not, you can ask about international medical coverage, which is becoming more common thanks to the increase in medical tourism. Insurance companies are aware of this trend, their own viability and the need to save money. They’re are actually telling patients that there are international destinations where they can be treated. This typically means paying much lower premiums than you would to receive treatment in the US. Another important consideration is travel insurance. Most people get this just in case something goes wrong while they’re traveling. However, it’s rare that a policy will cover you in the event of something going wrong during a planned surgery. Make sure you check that you have full coverage before going.

Since you’ll most likely being paying for your procedure out-of-pocket, you need to calculate the total cost of it, which includes the cost of the actual surgery and pre-op/post-op consultation fees, lab work costs, medication costs, anesthesia costs, aftercare fees, facility and surgeon fees, miscellaneous fees that depend upon your surgery type, the cost of getting to and from your destination and the cost of accommodations and transportation. The price will depend on which country are going to and which procedure you’re having done. Keep in mind that costs are averages and can change at any time. It’s important to note that there is a common misperception about the inequitable cost of procedures at home versus abroad. A procedure that you think will cost $25,000 in the US might actually cost around $16,000 elsewhere. This is the result of providers not sufficiently explaining all the various fees and patients not doing their due diligence of fully investigating all the possible costs involved. Also, here in the US, many plastic surgeons offer cosmetic health insurance. This type of insurance covers costs up to a set amount in the rare event of a major complication that requires hospitalization. It helps to minimize your out-of-pocket expense in the event you have an issue. In order to have this insurance, you pay a small fee (typically around $150) up front. This type of insurance isn’t commonly offered abroad because you’re there such a short time, usually less than a week. When it comes to price-hunting, if that is the only thing that you’re focused on, you can find great deals, but they are often with non-board certified, inexperienced and potentially dangerous surgeons.

Before you select a surgeon, either abroad or at home, you should do thorough research about the procedure you’d like to have done, surgeons who perform it and their technique and the clinic they are working out of. By knowing the procedure, you’ll have a better idea of what to expect before, during and after. This will help you to fully prepare for what lies ahead and take appropriate precautions to avoid complications. The surgeon should display certifications and recommendations and have a clear license that allows them to practice. There are no medical programs specifically designed to train plastic surgeons. The Board of Plastic Surgeons has a rigorous training program that you must pass in order to be qualified as a plastic surgeon. Most plastic surgeons receive training and affiliate with organizations, such as ASPS or ISAPS. They don’t allow you to become a member unless you’ve passed the rigorous training program, which means they confirm that you’ve been well-trained and can safely practice plastic surgery. There are plenty of very qualified doctors around the world who can perform procedures. It’s especially important to look for them if you going outside the US for your surgery. Also, plastic surgeries don’t have to be performed in a certain location. This means that it can take place anywhere from an office to an actual operating room. Most medical tourism clinics are simply doctors’ offices and you won’t know if they have standards of infection control or equipment sterilization practices. This is why doing adequate research beforehand is essential. Since each country has different rules for governing plastic surgery, this task can seem daunting. To help, ISAPS has verified and certified over 3,200 surgeons in 103 countries who currently meet US standards. They make sure that their members have extensive training in the complete spectrum of surgical and nonsurgical aesthetic procedures, they’re members of a recognized national and international plastic surgery society, they and their staff speak English fluently (this isn’t always the case) and the surgical setting is accredited or certified. All of this information is available on their website. Nevertheless, this is no substitute for visiting the clinic prior to actually booking your surgery. A good tip to follow is to never pay to have a procedure done at a facility you’ve never seen with a surgeon you’ve never met without any real sense of what the surgeon can deliver. While visiting take a tour facility, talk to the staff and make a preliminary appointment to talk with the surgeon. When speaking with surgeon, ask about the procedure, their method for completing it, expected outcomes/recovery time, what complications are possible and their educational background (most highly qualified surgeons will be able to prove that they were trained in the US or UK).

Clear, open and uncensored doctor-to-patient communication is crucial for determining proper treatment plans and understanding what you truly need and want. Besides the information mentioned above, there are several other imperative things that you need to ask questions about in order to be as well-informed as possible. While you may be in a vacation destination, you’re not really on vacation. The typical vacation activities, like swimming, sunbathing or drinking alcohol, can actually slow the healing process. So, before booking any activities around your surgery, check with your doctor to make sure that it’s a safe thing to do. It’s also vital to check with your doctor about when you can travel because traveling too soon after a big operation can lead to complications. Flying isn’t usually recommended for at least ten days following surgery because sitting for long periods of time after surgery, like you do on an airplane, can increase your risk for deep vein thrombosis (blood clots in the legs) and pulmonary embolism (blood clots in the lungs). If you’re planning on going to a country where you don’t speak the local language, find out exactly how and who might be able to help you communicate with your surgeon and the other staff who will be caring for you. It can be helpful to bring your own translator in order to ensure that you don’t miss any key information. Since complications are possible, be sure your passport is valid for at least 6 months beyond your return travel date because if you need to spend extra time recuperating, you don’t want to have to worry about it expiring. If you do develop any kind of complication after your surgery, you should be prepared to go back to the surgeon who originally operated on you since it’ll be easier than trying to find another surgeon willing to fix the problem. It’s necessary to evaluate all the risks that could potentially be a problem, which means you need to do your homework so you know what you’re getting into!

It doesn’t matter where cosmetic surgery is performed, there are risks involved, but it’s more challenging to fix complications from procedures done abroad should they arise. When procedures are performed in developing countries, they can carry substantial risks of complications, which causes a burden on patients, surgeons and US healthcare system. The US needs to do more to reduce costs, improve efficiency and increase quality here at home in order to compete with medical tourism. Maybe, the sight of millions of Americans traveling thousands of miles for medical care will call attention to this need, especially when some of these individuals are coming back with complications that require treatment. The sad thing is that, most likely, if they had their procedure done here, they wouldn’t have had a problem to begin with. While it’s always important for patients to carefully evaluate and select reputable providers that have track records of successful outcomes, this is especially true for individuals who decide to travel abroad to have their procedures carried out. Before you make a decision, make sure you do enough research so that the clinic and surgeon you choose are ones you would trust completely with your life!