The Dangers of Medical Tourism: Buyer Beware

Author: Dr. Richard Chaffoo
Medical care in a foreign country is a bad idea. Hear from San Diego's Dr. Chaffoo on why it's best to stay at home.

Several times a year I see patients in my practice who are interested in cosmetic surgery, but travel south of the border to Tijuana or some other third world destination to have plastic surgery. These unsuspecting patients mistakenly feel the savings justifies traveling outside of the country. To some people all plastic surgery and all plastic surgeons are created equal. Many San Diego-area residents ask, “What does it matter if I have my breast augmentation, hair transplant, mommy makeover, or rhinoplasty in a foreign country?” Read on to find out why.

It’s difficult to assess surgeon qualifications.

First of all, there are many good surgeons in other countries. The problem for Americans is knowing how to find qualified surgeons in other countries. It is relatively easy to find qualified American plastic surgeons. Most patients recognize that competent plastic surgeons are certified by the American Board of Plastic Surgery (ABPS). They are also members of the American Society of Plastic Surgeons (ASPS), which is the largest organization of board-certified plastic surgeons in the world. Many plastic surgeons who focus on cosmetic plastic surgery are also members of the American Society for Aesthetic Plastic Surgery (ASAPS). However, it may be very difficult for potential patients to find plastic surgeons who meet equivalent standards in other countries.

It’s difficult to assess the safety of surgical facilities.

There are other important considerations for people who are contemplating undergoing cosmetic surgery in a foreign country. What is the facility like where you will undergo surgery?  In the U.S., outpatient surgery centers must meet the same strict safety standards as accredited hospitals. They must be licensed by the state and a national accreditation organization like the AAAHC (the Accreditation Association for Ambulatory Health Care) or the AAAASF (the American Association for Accreditation of Ambulatory Surgery Facilities). Safety protocols are in place to protect patients in the event of an emergency. Strict sterility standards exist in the U.S. to protect patients against infections that can be acquired in a surgery center or hospital. It is very difficult for patients to compare our certified surgery centers in the U.S. with those in other countries in terms of safety and overall quality care.

Anesthesia providers are not always qualified.

Who will administer your anesthesia in a foreign country? It is just as important to consider who provides your anesthesia care as who performs your surgery. Complications from elective plastic surgery can be the result of the surgical procedure itself. However, complications can also occur as the result of anesthesia. Board-certified plastic surgeons in the U.S. are required to perform any cosmetic surgery in an accredited outpatient surgery center with a board-certified anesthesiologist or nurse anesthetist. Our safety standards for recovery rooms and intensive care units in America are seen as the “gold standard” across the world. Don’t expect the same level of care across the border.

There are additional risks to consider.

There are numerous cases of Americans who have undergone cosmetic plastic surgery in a foreign country and developed serious life-threatening infections upon returning home. Many of these infections are the result of rare and unusual bacterial or fungal organisms that patients are exposed to in foreign countries. Such rare infections can be difficult to treat often requiring:

  • Hospitalization
  • Intravenous antibiotics
  • Further corrective reconstructive surgery

Unfortunately, the final results of the initial cosmetic procedure are often compromised and less than ideal.  In addition, some insurance companies will not pay for complications of cosmetic surgery, especially as a result of surgery performed in a foreign country. These costs to a patient can be considerable, much greater than the money saved by undergoing surgery in a foreign country.

On a personal note, I remember caring for a young Hispanic woman who had traveled to Tijuana for a tummy tuck to save money. She developed a serious, life threatening infection after her surgery in Mexico. She tried to travel south of the border to see her surgeon after returning home, but it was very difficult. She waited hours at the border crossing to visit his office. He tried to treat her infection as an outpatient. Eventually, she became very ill and was admitted to a local hospital here in San Diego and placed in the intensive care unit. I was consulted to treat her. I had to perform emergency surgery to remove the infected tissue. She spent weeks in the hospital. I spent the next 2 years performing reconstructive surgery on several occasions to repair the damage which had been created. Ultimately, she had an acceptable outcome. In fact, she became a vocal spokesperson to the public warning Americans about the danger of medical tourism and having elective plastic surgery in a foreign country.

Plastic surgery is real surgery.

Remember that all surgery and anesthesia carry inherent risks even with qualified American physicians. Cosmetic plastic surgery is real surgery, not a “spa treatment.” Do not compare buying a retail item with paying for plastic surgery. If you are unhappy with your purchase overseas, you can always buy a new item; there are no “returns” for a new you!

What is your legal recourse if your plastic surgery goes wrong in a foreign country? Do you know the laws in that country that protect the public? Don’t assume that our laws regarding malpractice apply in a foreign country; in fact, they probably don’t. It may be impossible to recover the costs of your plastic surgery and especially the costs from a prolonged hospital course back home.

Many people travel to the U.S. for plastic surgery.

Each year, I have the privilege of caring for many patients who travel to La Jolla from all over the world for elective plastic surgery. Many of my patients are from Mexico, Central America, and South America. They have the financial means to have plastic surgery in their own countries or anywhere else; instead, they prefer traveling to the U.S. for plastic surgery with board-certified American plastic surgeons. They understand that we are among the best trained and most qualified plastic surgeons in the world. It is a matter of trust; these patients are indeed educated “consumers” of health care.

U.S. plastic surgeons are highly regarded worldwide.

Why risk the outcome of cosmetic plastic surgery by traveling overseas? The plastic surgery world considers aesthetic (cosmetic) plastic surgeons in the U.S. to be the innovators and leaders of the specialty. Our national conferences are regularly attended by plastic surgeons from across the globe. American university programs train the best and brightest medical students to become plastic surgeons. Our research centers lead the way in developing new technology for the specialty. I always advise patients that it is best to undergo cosmetic plastic surgery when you can afford it. It is much wiser to save a little money and save your life!

The American Society of Plastic Surgeons (ASPS) has created a very useful document for Americans considering cosmetic surgery in a foreign country.

If you would like any further information on elective plastic surgery, please feel free to contact us online. We are happy to answer your questions or schedule a consultation at your convenience by calling 858-623-6333.

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