After COVID-related lockdowns put medical tourism on pause, our desire for improvement came back stronger. The “Zoom Boom” that famously sparked countless cosmetic treatments also launched a thousand flights to exotic locales in search of a better deal, but at what cost?
BBLS AND BODY WORK
Bodies are a big business abroad, and when it comes to breast and body work like tummy tucks, Mommy Makeovers and curvaceous Jessica Rabbit-esque body contouring, experts say popular destinations include Mexico, Brazil, Colombia, and the Dominican Republic. “In general, medical tourism is risky,” says New York plastic surgeon Brad Gandolfi, MD. “To protect patients, there is significant physician oversight, training and credentialing in the U.S., which is not replicated in most foreign countries.” If something does go wrong, surgeons caution there’s a lack of recourse while abroad, and sometimes even when you return.
The most common destinations for facial cosmetic surgery include Turkey, Dubai and South Korea. “Because of the complex nature of these facial procedures, surgery can be more expensive. However, if a patient’s surgery fails to correct a structural problem, creates other anatomical issues, or looks aesthetically undesirable, then they will end up needing a revision,” says Miami plastic surgeon Paul Afrooz, MD, who has seen more than a few patients return home with complications. “A rhinoplasty performed by an unqualified surgeon can lead to excessive swelling, nasal collapse, breathing issues, infection, skin necrosis, and septum perforation.”
According to the Turkish Dental Association, 150,000 to 250,000 foreigners travel to Turkey each year for dental work. While it may seem appealing to book an exotic vacation alongside a smile makeover, patients often return with subpar results, says Chicago cosmetic dentist Nathan Hoffman, DDS. “Other countries typically do not have regulatory organizations to enforce a standard that has our well-being at its core,” he explains, noting that it’s a quality-control issue. “Other factors like poor materials lead to dental work that doesn’t last or looks totally unnatural, hence the term ‘Turkey teeth.’ Patients end up spending substantially more to correct, repair or replace their ‘cheaper’ smile makeover in the long run.”
The destinations with the most cosmetic patients traveling from abroad include Turkey (32%), Mexico (29%), Colombia (26%) & Thailand (23%).
SOURCE: I SAPS
In South Florida, where many people travel for affordable surgery, Miami plastic surgeon Sean Simon, MD says he’s seen hundreds of cases where unqualified physicians perform surgeries they’re not certified or trained to do. “You have surgeons or people that aren’t even trained in plastic surgery performing these procedures with higher risks, higher complication rates and a lack of follow-up.” Eugene, OR plastic surgeon Mark Jewell, MD adds that verifying a surgeon’s credentials with the International Society of Aesthetic Plastic Surgery is crucial. “There are many exceptionally qualified plastic surgeons worldwide that are great at what they do,” he says. “ISAPS is a good resource for vetting international providers.”
When it comes to facilities, many popular plastic surgery destinations don’t follow the same protocols we do in the United States. “The quality of hospitals outside of the U.S. varies tremendously,” explains La Jolla, CA, plastic surgeon Robert Singer, MD. “Some are accredited and inspected; others are not.” Here, our facilities are certified through the American Association for Accreditation of Ambulatory Surgical Facilities to ensure they meet strict safety criteria. In addition to vetting a surgeon, surgical centers and facilities abroad should also be researched. “The lack of regulations just scratches the surface,” says Dr. Simon. “The worst-case scenario isn’t an infection or complications, it’s death. Do your research before undergoing any procedure, anywhere.”
Westborough, MA facial plastic surgeon Min Ahn, MD says timing is also a concern. It’s generally considered safe to fly two weeks after a facelift and one to two weeks after a rhinoplasty. “Flying beforehand can negatively affect healing due to air-pressure changes, the physical strain of traveling, and potential exposure to illness,” he notes. For body work, surgeons advise waiting four to six weeks. There are major potential issues like “fatigue, dehydration, leg clots called deep venous thrombosis, and clots to the lungs, which may be life-threatening,” adds Dr. Singer.
Once patients are back stateside, there can be a lapse in care due to issues finding a local provider willing to take on a case done abroad. “I’ve seen patients have difficulty finding a physician or surgeon to help them should they need assistance once they return,” Dr. Simon explains. “Many plastic surgeons will not see these patients, especially during the early post-op period.”
Dr. Afrooz adds that almost all revisions procedures are more complicated than the original procedure, and this is something traveling patients need to consider. “The surgeon must address the existing incision, make every attempt to remove it or revise it, and then conceal the revision incision. These considerations add time, money and technical challenge to a revision,” he explains. Dr. Gandolfi recalls a cautionary case of a patient who traveled to Mexico for a cheaper tummy tuck: “She lost all the skin below her belly button and required multiple reconstructive surgeries over the course of a few years to be able to return to her normal life.” Stories like this one highlight the long-term concerns with “affordable” cosmetic surgery deals.