Plastic Surgery Abroad Is an Operation, Not a Vacation

Americans unhappy with what they see in the mirror are looking past borders—and oceans—to save money on face-lifts, breast augmentations, and other elective procedures not covered by insurance. The Internet is littered with companies offering cosmetic surgery vacation deals to exotic locales like Costa Rica, the Philippines, Mexico, and Brazil. But experts caution that so-called cosmetic surgery tourism can wind up costing patients more—both in health and money—than they expect.

Many overseas surgery practices use specialized travel agencies to package their cosmetic procedures with vacations. A typical offer includes your pick of operations—say, liposuction and a tummy tuck, for as little as half the U.S. cost—plus tour itineraries, tony resort stays, and pampering at posh spas during recovery.

But shopping around for the lowest fee or the best destination is not the way to choose a cosmetic surgeon. The International Society of Aesthetic Plastic Surgery has vetted and certified about 1,500 surgeons in 73 countries who meet U.S. standards; isaps.org has a surgeon-finder tool. Surgeons who aren't on that list may be good, but their credentials, training, and prior disciplinary record can be hard to verify, says John Canady, incoming president of the American Society of Plastic Surgeons.

A long list of unknowns didn't stop Felicia Pappas, a Woodbridge, Va., medical assistant, from traveling to Bolivia in February for breast augmentation, liposuction, and a tummy tuck. She found her surgeon through a friend, never researched the doctor's qualifications, and had no communication with her until the day of the first surgery.

The operations went horribly wrong. An infection killed nipple tissue, and she required a blood transfusion. Back home, Pappas, 42, had trouble finding a doctor to perform corrective surgery and now regularly needs to have fluid removed by needle from her stomach.

Partly for legal reasons, U.S. doctors may be reluctant to correct complications incurred abroad, says isaps President Foad Nahai. Revision surgery for botched cases can end up costing far more than the original procedure. And U.S. malpractice laws don't apply in other countries. To hedge against unforeseen problems, Nahai says, "make sure there are doctors and facilities nearby that are equipped to manage any unexpected complications."

If you've done your homework and are confident you've found a skilled surgeon, treat the trip for what it is—surgery, not a holiday. While relaxing poolside with a piña colada may sound conducive to recovery, vacation activities like swimming, sunbathing, or drinking can slow down the healing process and contribute to infection or bleeding. Guidelines from the American Society of Plastic Surgeons suggest that patients wait up to 10 days, depending on the procedure, before flying. Even then, the post-op process can last weeks. "It's in the patient's best interest to have the same doctor who performed that surgery evaluate the patient's progress," says Canady. "That's simply not feasible when done abroad."

Still recuperating, Pappas blames her surgeon—and herself: "I should have been more educated, and I put too much faith in a doctor I didn't know enough about."