Plastic Surgery Tourism

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Plastic Surgery Abroad & What To Consider

By Steve R. Fallek, M.D.

There is a wonderful commercial on television on how certain products or services don’t go well together.   For example, car wash and teeth whitening, divorces and carpeting, and baby-sitting and cesspools. The company states that they do one thing, and they do it right.  I thought about this in regards to plastic surgery and vacations.  In my opinion, these are two services which should almost never go together and ultimately may lead to disaster.

I am continually amazed by how many people make bad decisions regarding plastic surgery.  Hopefully, I can give you some insight into how this occurs and how to avoid serious risk.  The best way is to compare the two.  Since most plastic surgery tourism takes place in the Caribbean or south of the border (either Mexico, Central or South America), we’ll use it as an example.

Meet your doctor

Plastic Surgery Stateside:

Just to give you an idea, what does it take to become a practicing plastic surgeon in the United States?  For me it was four years of college, four years of medical school, and a five-year general surgery residency followed by a 2-year plastic surgery fellowship. All of these have to be accredited by the state and national government.   To become board certified, oral and written examinations as well as a periodic review of your cases performed.  To operate in a hospital, evaluation of your training as well as peer review to determine whether or not you are capable of performing the procedures which you want to perform.  Don’t forget malpractice coverage.  I won’t even go into the government regulations necessary.

Let’s say you want to check up on me.  First step now, online research.  Website looks nice, a bunch of articles and belongs to a few hospitals.  Let’s dig a little deeper.   Hey look, I can check with the state medical board or national societies to see if he’s a member in good standing.  No malpractice suits.  All checks out.

Plastic Surgery Abroad:

Now let’s check in on our foreign doctor.  A friend of mine had a friend who said you can get cheap plastic surgery.  Website looks very enticing. Great pictures, nice setting.  But who do I call to check up on his schooling?  How about any of his credentials?  Is there board certification?  Is this person really a plastic surgeon?  Has he had any problems, deaths, complications?  Who do you call?  Where do you get any information?  I haven’t the slightest idea.  Just to make sure it wasn’t me, I checked with one of my hospital medical directors.  She said the same thing.  In fact, she told me of a notorious cosmetic surgeon who has been kicked out of New York, New Jersey, and Florida who just opened a clinic in the Dominican Republic.

Don’t get me wrong; there are many excellent plastic surgeons abroad.  Some are world famous.  However, many of them are honorary members of American societies as well as authors of articles published in reputable journals.  They usually work in big hospitals and charge just as much as their American counterparts.  They are known.  They are not running plastic surgery mills trying to squeeze every last dollar out of you.

The Consult

Plastic Surgery Stateside:

I spend at least 45 minutes to an hour with my cosmetic consultations where we discuss your operation, anesthesia, risks, recovery, costs, back-to-work issues, and any other concerns.  You can sit with my patient coordinator for as long as you like, and you’ll come back again prior to surgery.  We will discuss preoperative blood work or any other tests necessary.  I operate at both hospitals and surgicenters so we will discuss that, too.  If you want, you can check out the facilities or speak to the anesthesiologists.   We want you to be as prepared as possible so you know what to expect and get the best result.  Never forget that it is still surgery.

Plastic Surgery Abroad:

As for your foreign doctor, many of them come to town for a day or two and try to cram as many patients in one day as possible.  That is, if they even come, for many times a representative of the doctor will come alone and try to recruit as many patients as he or she can. You may have to go to a different country to actually see the doctor. I know of a hair salon which hosts a Dominican doctor once a month, and he and his assistant see consults in a space behind the hair dryers.  Maybe it’s just me, but I want to feel confident and comfortable with my surgeon.

A consultation in a nail salon or empty storefront doesn’t do much for privacy, professionalism, or confidence.  Good luck getting all your questions answered before you’re shoved out of there. Oh, and cash up front; no deposit and no refund.

The Operating Room

Plastic Surgery Stateside:

It would take me ten pages to document all the regulations, requirements, protocols, etc. for every single person or piece of equipment which is in a hospital or surgicenter.  The accrediting process is unbelievable; and it goes on and on, including periodic unannounced inspections.   For anything put in the body, you can triple the regulation and add the FDA.  For the most part, that is not important.  You live in an area and you know the local hospitals and their reputations.  You will go to the one with which you are most comfortable.  If you are traveling to another part of the country for surgery, most hospitals are the same and meet the same regulations by the government.

Plastic Surgery Abroad:

Hopefully your biggest concern will be following the right signs in the hospital.
If the odds aren’t stacked against you yet, here’s where it gets really dicey.  First of all, if you are still ready to go abroad, make sure you speak the language.   I have enough problems in a foreign country asking directions; I can’t imagine if I had a real emergency.

Don’t ask for directions to the local hospital because many times the surgery is not done in a hospital but in an operating room/clinic somewhere.  Accreditation is a joke.  Sterility non-existent.  Anesthesia iffy.  Materials re-used as many times as possible. There is no such thing as a disposable.  Disposables cost money; and remember, it’s about making money.

Just to give you an idea, here are some items I’ve removed from patients who’ve had plastic surgery in another country: numerous infected breasts implants, regular cotton threads instead of sutures, liquid silicone, metal plates, wires, and sponges left in during surgery.

The Recovery

Plastic Surgery Stateside:

After surgery we call you up to make sure everything is okay.  Stay at home, relax with loved ones, and take it easy.  Watch television with your feet up.

Plastic Surgery Abroad:

But here’s where there is the supposed pay-off for a plastic surgery vacation.  Beautiful island. Sun, surf, frosty drinks.    But wait a minute.  You need to stay out of the sun after surgery.  Can you go out? Sure, but you think you’re sitting out on a lounge chair?  What about the garment or bandages which you have to wear? No chance.  And forget about tennis, golf, a massage, and the pool.  I’m sure your spouse is going to feel great playing golf all day while you’re stuck inside with CNN International.  I hope you’re staying at a ritzy place where they’ll carry your luggage and speed you through customs.  If not, enjoy a crammed bus or van to the airport, followed by waiting in line for an hour, and a fun plane ride home.  You think that’s bad after a regular vacation.  Try it after an operation.  You’ll be ready to lie in bed for another week.

The Follow-up

There is nothing to compare here.

Plastic Surgery Abroad:

On a plastic surgery vacation like any other vacation, once it’s over, it’s over.  No follow-up, no phone calls, nothing.   I can’t tell you the number of times patients have had plastic surgery in another country, and they follow- up with me because that’s what they are told.  “If you have a problem, find a local plastic surgeon or go to the emergency room.”  If I did this, I’d be out of business.  If you are unhappy with the surgery, tough luck.  Call and complain?  Good luck speaking to the doctor.  Think you’ll get a refund?  No chance. Get a copy of the operative report?  There isn’t one. Sue for malpractice?  Doesn’t exist outside of the U.S.

What if there is a serious complication?  If you have insurance, it’s of no help because most of the time they will not cover complications arising from foreign plastic surgery.  If you have to be hospitalized, you are looking at a bill in the tens of thousands of dollars.  As for corrective plastic surgery, it is much harder to perform, costlier, and not always 100% restorative.

The Bottom Line

Congratulations on your foreign plastic surgery.  Best case scenario, you’ve saved yourself $1,000.00.  Worst case scenario, take your pick.  I always tell my patients there are times to save your money and other times to spend it.  Spend it on surgery and safety.  If a hospital costs a little more and it gives you peace of mind, that is money well spent.  I don’t want to be a downer; but if I’ve scared one of you out of going abroad for surgery, I’ve done my job.  It is my job to inform you and give you the right information.  I hate it when a patient comes in and wants me to correct a botched operation.

There is no guarantee to surgery; and there is no guarantee that even here there won’t be a less than optimal outcome, but you do want the odds in your favor. I do my best, but with no knowledge of the operation, the surgeon, what’s in there, or whether it can come out, it makes my job very difficult, and I want a happy patient population.  When I can fix these problems, patients are very grateful and some of my happiest patients.  Good luck.

Steve R. Fallek, M.D.
Board Certified Plastic and Reconstructive Surgeon
Englewood, NJ; New York, NY

Dr. Fallek obtained his B.A. degree from the University of Pennsylvania, cum laude, in 1987, and received his M.D. from Mount Sinai School of Medicine New York, NY in 1991.

After medical school, he completed a general surgery residency at the University of Medicine and Dentistry of New Jersey, where he then received fellowship training in Plastic and Reconstructive Surgery.

For more information please visit www.fallekplasticsurgery.com.

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