PSJOURNEYS.com has a forum dedicated to not only plastic surgery, but also dental and eye care abroad. Here is a good article on one person’s experience with eye in Mexico.

Crossing over to better vision
After a lifetime of misalignment, man’s eyes in focus

By Kristi L. Nelson (Contact)

Retired pharmacist Edd Bissell, 67, had crossed eyes all his life and wore bulky prism lenses, right, in order to be able to see. Last month, Bissell learned about a surgery that could “uncross” his eyes. Now, after surgery, Bissell is seeing things in a new way. “I can’t believe how light my glasses (at left) are,” he said.
WHAT IS STRABISMUS?

* Strabismus is a condition in which the eyes are not properly aligned with each other, usually because lack of coordination among muscles surrounding the eye prevents both eyes from focusing on the same point at the same time. It may prevent someone from seeing out of both eyes at the same time, affecting depth perception. Strabismus can be either a disorder of the brain coordinating the eyes or a disorder of one of more muscles and can affect just one eye, both eyes at the same time, or both eyes at different times. A person can be born with the condition, or it can result from trauma or some diseases.

For his whole life, Edd Bissell’s vision has depended on his ability to control a little set of muscles around his eyes.

The 67-year-old retired pharmacist has strabismus, or misalignment of his eyes. Born with it, Bissell - like many others with the condition - got used to controlling those muscles in his younger years by squinting. But as he aged, that grew harder and harder for him to do. Then Bissell’s eyes would appear crossed, and if he tried to use them both at the same time, he’d see double.

“You can look at the back of my car and tell by the bumper that I have no depth perception,” Bissell said. “I either looked out of my right eye or my left eye. … Throw me a pair of keys, and I don’t know where it is. I have no conception of where it’s coming to. I might reach here, and it might hit me there.”

For about 15 years, Bissell has worn “prism” lenses - big, thick curved lenses that draw his eyes together in the correct way, enabling them to focus. They’re a nonsurgical solution to milder cases of strabismus, said optometrist Gale Roberts of Tapp Optical Dispensary, who made Bissell’s prism glasses.

“He surprised me when I first put them on him; he immediately liked it,” said Roberts, who said most patients need an adjustment period, and some don’t really like the glasses at all.

“It was immediate,” Bissell said. “It was like snapping a finger.”

But last spring, Bissell returned to Knoxville from Mexico, where he spends part of the year, unable to uncross his left eye, even with the help of the prisms. At any rate, Bissell was already wearing such thick prism lenses that it was unlikely he could support a thicker lens on the bridge of his nose.

Not only was the crossed eye affecting his vision, but “it made me self-conscious,” he said. “Because somebody’s looking at you, and they don’t say anything, but you see them go … ‘His eye’s crossed.’ You know, it’s like being one-legged, or having a wart on the end of your nose. You know people are looking at you.”

He tried in vain to get an appointment with his regular ophthalmologist group but was told he would have to wait three months. Frustrated, he asked his internist for another recommendation.

“He said, ‘You know, your prescription’s as good as it’s going to get. You need to go to Gitschlag,’” said Bissell, who knew ophthalmologist Dr. Gary Gitschlag’s name from filling prescriptions for customers. “I said, ‘He’s a pediatric guy!’”

Like many older adults, Bissell had no idea there was a surgery available that could correct his strabismus - one that had been available for decades. In Knoxville, Gitschlag is the go-to guy for repairing strabismus.

About 80 percent of Gitschlag’s patients are children; his office is in the Koppel Plaza at East Tennessee Children’s Hospital. These days, most cases of strabismus that occur from birth are diagnosed during childhood. Strabismus can also occur as the result of some diseases, accident trauma, or stroke, Gitschlag said, and since he’s known among local ophthalmologists as someone who likes to do the surgery to correct it, and is experienced at it, he’s often referred adult patients as well. Gitschlag operates on adults one day a month.

Prism lenses are often a good solution when someone’s angle of misalignment is small, Gitschlag said, but larger angles would require lenses to be so heavy it would be difficult to support them. And for some, he said, it’s a question of lifestyle; they may not like wearing glasses at all. The surgery, common since the late 1960s, won’t fix existing near- or farsightedness, but someone whose only problem is misalignment wouldn’t need corrective lenses afterward just because of the strabismus.

“A lot of folks have the impression you can’t fix (strabismus),” Gitschlag said. “It’s actually very fixable, and has been for a long time.”

The $3,000-$8,000 surgery is also covered by Medicare and insurance companies; Gitschlag does not do cosmetic surgery, so all his surgeries are coded “medically necessary,” and his office will appeal if an insurance company denies it.

In the past, strabismus sometimes wasn’t caught until a child started school, Gitschlag said, but earlier screening through the state, day care centers and civic organizations like the Lion’s Club has meant strabismus is now usually caught before school age.

“That really makes our jobs not only easier, but a lot more pleasant, because you get good results,” he said.

There are six muscles - three sets of two - around the eye that control its movement. Surgery entails lengthening or shortening one or more sets of muscles to bring one eye into alignment with the other. The trick is to get the measurements exactly right, Gitschlag said.

“Some folks have greater or lesser elasticity,” he said. “It’s not like engineering, where you can cut and measure.”

Gitschlag does six to eight of the surgeries per week and has for years, so he has some experience in measuring. It’s rare that a patient needs more than one strabismus surgery, he said.

“The surgery has a pretty good success rate,” he said.

Bissell, who had plastic surgery six years ago in Mexico to correct the sagging skin around his eyes caused by a lifetime of squinting, couldn’t be happier with the results of the strabismus surgery he had last month.

“The first day, I was dizzy as Cooter Brown,” he said. “My brain could not figure out what was going on. But every day is a little bit better.”

He only wishes he’d known years ago that there was a surgical fix for strabismus.

“If it’s no better than what it is right now, it’s OK,” he said while still healing. “It’s 100 times better than it was before.”

“Hopefully, most people won’t end up thinking that they have to wait so long to get it fixed,” Gitschlag said. “He didn’t hurt his vision at all; it’s just that he could have gotten out of having those prism glasses.”

As plastic surgery goes mainstream, expressions of dismay more common

Mireya Navarro, New York Times

Sunday, January 6, 2008

(01-06) 04:00 PST Los Angeles –

Pity poor Ashley Tisdale. Riding high from her success as the scheming Sharpay in “High School Musical 2,” she seems to have come down with a minor case of Jennifer Grey syndrome.

After having surgery to fix what she said was a deviated septum on Nov. 30, she emerged two weeks later with what looked to many casual observers like a brand-new nose. Celebrity magazines and blogs piled on, questioning her for tinkering with the trait that many people say made her special.

Five-year-old fans said they no longer recognize her. She looks “plain,” “average,” even “Stepford,” according to some of the online comments.

“Any character her face once had is GONE!” says one of hundreds of opinions that poured into perezhilton.com after the first post-surgery pictures of the 22-year-old actress surfaced. “Bye Sharpay. Hello bland!”

As a celebrity, Tisdale might have expected scrutiny. (At least she still looks like herself, unlike Grey, the “Dirty Dancing” star whose rhinoplasty altered her face so much that her acting jobs dried up.) But anticipating and dealing with negative reaction to changed looks is not just for the boldface set.

Plastic surgery has become mainstream - almost 11 million procedures were performed in the United States in 2006, up 7 percent from the previous year. The vast majority were performed on women, with breast augmentation and nose reshaping leading in popularity.

Doctors say that anxiety about the response is common among patients and that they can expect comments that are not of the you-look-fabulous variety.

“As patients become more open about it, they should expect more open feedback, good or bad,” said Dr. Richard D’Amico, who is president of the American Society of Plastic Surgeons and practices in New York and Englewood, N.J. “There’s no question it adds some stress to the decision-making process.”

Plastic surgeons say rhinoplasty has the most potential to jolt the patient’s friends and loved ones. But any type of facial surgery can spark strong reactions, including silence, stares, gossip and confrontational remarks.

Sometimes people react as if mourning a loss.

“A couple of people said: ‘Where’s Pat? You don’t look like yourself,’ ” said Pat Casanova, 57, an asset manager in Los Angeles who had a face-lift two years ago. “They were just a little bit in shock.”

Lois Stern interviewed more than 100 women for “Sex, Lies and Cosmetic Surgery: Things You’ll Never Learn From Your Plastic Surgeon.” She said the women gave various reasons for less than ecstatic responses to their surgeries: Some said that looking better and feeling more confident unhinged boyfriends and husbands; a few had relatives who disapproved of the cost; and some said that friends became jealous and competitive.

Stern, who herself has had a face-lift, found that men became more attentive and complimentary, while women’s reactions ranged from thrilled to hostile. Her once-chatty hairdresser clammed up when she noticed the surgical scars on her scalp.

“I could feel something in the air, there was a different tone - and I left her because of that,” said Stern, who lives on Long Island, N.Y. “With some people, their value system says it’s a frivolous thing.”

Not all criticism is subtle, especially from those who believe surgery has robbed someone of an endearing feature or rendered him or her almost unrecognizable. Dr. R. Merrel Olesen, founder of La Jolla Cosmetic Surgery Center in La Jolla (San Diego County), recalled a case of buyer’s remorse in which a woman wanted her prominent nose back, after being shunned at a reunion for erasing a feature shared by many relatives. “The family almost made her suicidal,” he said.

Often, the harshest disapproval comes from children.

“My son was really sad,” said Jane Glenn Haas, the founder of WomanSage, a group for middle-aged women, and a columnist for the Orange County Register.

Haas said an inheritance from an uncle nine years ago allowed her to get rid of what she called her “walrus” look - a double chin and bags under her eyes. She went ahead with the surgery, though dreading the reaction.

“I thought people would make fun of me because I’m not a glamorous type of person,” she said. “I felt a need to justify it. I told everybody I used money that I had inherited.”

The face-lift was overwhelmingly embraced by everyone in her circle, she said, except her 31-year-old son. He told her she looked “like an Orange County woman,” which she said meant a woman with so much money she could buy herself a new face.

“I thought he was kind of kidding at first,” she said. “I felt very badly because I realized that there’s a ‘mother look.’ I didn’t look like that anymore.”

Haas told her son to get over it. “I was very pleased with the way I looked,” she said.

D’Amico said that what best equips patients to deal with the emotional consequences of cosmetic surgery is wanting to do it for themselves. If the motivation is something like needing to be liked by others or trying to fix something else that is wrong in their lives, “you refer them to a counselor,” he said.

Some patients, of course, hear nothing but compliments. Linda Rios, 50, a stay-at-home mother in San Diego who had a face-lift in July, said that if anyone made catty remarks, she is unaware of it.

“Everybody I’ve talked to is in awe,” she said. “Several of my friends have asked for my doctor’s card.”

And many patients say that after a while, the surgery is all but forgotten. Still, enough of a stigma lingers to make some people deny, fib or at least not advertise the reason they look different.

Sandra Miller, of Los Angeles, a 38-year-old writer, had surgery at 18 that included fixing a deviated septum and straightening the tip of her nose. Last year she again had a little work done on her nose.

She told no one about the first surgery and only a few close friends about the second one.

“You’re kind of embarrassed to say that there’s a problem with the way you look,” she said. “I wanted to look better but didn’t want people to know why.”

In Hollywood, where looks make or break careers, it is almost unheard of for an A-list star to own up to artificial enhancements. Tisdale told fans on her Web site that her nose surgery was for “health” reasons. But plastic surgeons say that fixing a deviated septum does not result in a changed nose.

Dr. Brent Moelleken, whose sees his share of celebrities at his practice in Beverly Hills, Calif., says some patients come at odd hours, wear disguises to throw off paparazzi, or pace their surgeries over several years “so you can’t put your finger on what’s happened to that person.”

Although he suggests that patients get a new hairstyle or admit to at least getting the eyes done as a way to explain away a new look, Moelleken said the best course is to come clean.

“The people who are the most open about their plastic surgery have the most positive experience,” he said. “If you’re open about it, you’re unembarrassable.”

Link: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/01/06/MNS3U6AGJ.DTL&feed=rss.news

These ladies met on our website, Plasticsurgeryjourneys.com
They were all plastic surgery patients in Costa Rica.
Watch the youtube video!

http://www.youtube.com/watch?v=fn9BfKSB19g

Another reason why research is sooooo importanat.

Breasts removed after botched surgery in Mexico

Updated Mon. Dec. 31 2007 9:47 AM ET

The Canadian Press

Updated: Mon. Dec. 31 2007 9:47 AM ET

GUADALAJARA, Mexico — Gabriela Sanchez always felt self-conscious about her small breasts, and at age 40 she decided to do something about it.

At 41, she has no breasts at all - they had to be surgically removed after implants inserted by an allegedly bogus plastic surgeon caused a severe infection.

The charges against Agustin Huerta, a sweet-talking, snappy dresser who zipped around town in a blue Jaguar, raise new questions about how easily untrained scam artists can pose as qualified doctors in Mexico.

At risk are not only the patients, but Mexico’s campaign to attract Americans with the promise of cheap and safe medical care.

Sanchez is one of 43 patients to file complaints since 2003 against Huerta, a medical doctor who allegedly branched into plastic surgery without a licence and botched dozens of facelifts, liposuctions, breast implants and other procedures.

“I can’t even look at myself in the mirror,” Sanchez said, fighting back tears. “I can’t be with my husband.”

Huerta, arrested Dec. 6, faces about eight years in prison if convicted on charges of fraud, medical irresponsibility, severe damages and professional usurpation, according to lead prosecutor Elsa Arias.

“He was operating left and right for easy money and didn’t perform the proper follow-up treatments,” she said. “He knew he didn’t have the seven years of training required for those surgeries. He was lying.”

Such cases are surprisingly common. That same month, authorities detained a man in the border state of Coahuila for working as a doctor for more than 30 years with nothing but an accountant’s degree. And Arias made her name prosecuting former stripper Miriam Yukie Gaona, dubbed the “Beautykiller,” for allegedly injecting industrial silicone and other substances into hundreds of women.

No one keeps records on how many U.S. citizens travel south for medical procedures, but anecdotal evidence suggests the number is growing.

In the border city of Tijuana, most patients in some hospitals are American. Most come from California for dental work and plastic surgery that isn’t covered by insurance. This month, Tijuana’s medical community announced an initiative to encourage even more patients to cross the border.

The U.S. Embassy warns that while elective surgery may be cheaper in Mexico, “facilities may lack access to sufficient emergency support.”

And when things go wrong, seeking redress can be next to impossible. Class-action lawsuits - a foundation of consumer protection in the United States - don’t exist in Mexico, and the judicial system remains plagued by corruption and bureaucratic inertia.

Huerta’s patients found an advocate in Arias because of her experience prosecuting Gaona, who still has cases pending against her five years after her arrest.

Arias said Huerta distributed business cards reading in English “Cosmetic and Aesthetic Surgeon.” Huerta, she said, would often pressure patients to undergo surgery immediately, boasting he could make them look like the Mexican pop star Thalia.

Many were left with severe infections, disfiguring facial scars, lopsided breasts or lumpy stomachs, she said.

Huerta declined to be interviewed, but his lawyer, Victor Varela, said he held a medical degree and had undergone postgraduate training in liposculpture in Europe. He said Huerta was well-qualified to perform “aesthetic procedures” but insisted none of them qualified as plastic surgery.

The doctor “only performed liposculpture, which encompasses breast and buttocks implants and liposuction,” Varela said. “It’s a question of aesthetics. It’s not plastic surgery.”

Dr. Alberto Smeke, who investigates medical misconduct for Mexico’s Health Department, called that rubbish. He said what Huerta did was clearly plastic surgery, and requires a licence.

Varela said the complaining patients are after money, and accused many of bringing on their own problems by failing to follow post-operation treatment and drinking or smoking after surgery.

But patients and their families denied that they were responsible for the outcome of the procedures, and said they simply want justice.

“I’ve given up,” said Montzerrat Ramirez, 21. “I’m not charging him with homicide - I just want my money back.”

Ramirez’s mother Lorena, 39, saw Huerta in July because her back was hurting. He recommended breast reduction, a tummy tuck and liposuction, even though she had diabetes and hypertension. Once she was under the knife, Huerta performed a full mastectomy, replacing her breasts with implants, the daughter said.

Following the surgery, Lorena Ramirez’s incisions repeatedly opened and became infected, and she spent 37 days in the hospital, racking up medical bills of more than US$23,800, her daughter said. She died of a heart attack in October.

Operating on a patient with diabetes and hypertension requires careful testing and monitoring, even when the most qualified plastic surgeons are involved, according to Dr. James Wells of Long Beach, Calif., former president of the American Society of Plastic Surgeons.

Gabriela Sanchez went to Huerta two days after the doctor inserted threads into the face of her mother Consuelo to lift her nose and help her breathe better, a procedure he performed in the hallway of his clinic.

Gabriela Sanchez woke up the morning after her breast surgery with a gaping wound in her abdomen. Huerta, she said, told her he had inserted the implants through her belly - and even given her “a bit of lipo” as a gift. Eventually, she had to have both breasts removed because of an infection, and scars now stretch across her abdomen.

Her mother’s nose, meanwhile, became so infected that doctors had to remove the entire bone, leaving her disfigured.

Face lift, luxury safari — bargain price

By Neil Edward Schlecht

(LifeWire) — Colleen Hiltbrunner spent two years researching her dream trip to South Africa. But she wasn’t looking for the perfect safari lodge. She was hunting for the right cosmetic surgeon.

When she told her family, it wasn’t an easy sell. “South Africa? You’re going to get some kind of witch doctor,” she recalls her father saying.

“But I told him they perfected some of the first heart surgeries down there. To me, South Africa had the most reputable surgeons.”

Hiltbrunner, of Colorado Springs, Colorado, traveled to Johannesburg in 2004 for a face-lift, upper arm lift and eyelid surgery. And she and her husband — who hadn’t taken a vacation in 20 years — went on a luxury safari, included in the package by medical-travel agency Surgeon and Safari.

“Medical tourism” may sound strange, but patients are discovering they can get some cosmetic surgeries abroad for less than the U.S. price. And many surgeries include sightseeing packages.

The roster of countries in which hospitals and surgeons are marketing their services to foreigners is growing. South Africa, Argentina, Thailand, Brazil, Costa Rica, India and Singapore have become major players.

Robert Painter, a travel writer from Albuquerque, New Mexico, journeyed last year to Argentina for dental surgeries — and tango lessons: “If I’m going to be stuck somewhere for two weeks at a time, twice, Buenos Aires has got to be the best possible place,” he says

Painter’s procedures were organized by Plenitas, a medical-travel facilitator in Buenos Aires, which booked him at a hotel with a dance studio in the back.

He wasn’t the only guest getting surgery: “While I was there, there was a young lady who was also having implants — though not of the dental type.”

Cost-cutting pros and cons

Cosmetic, or elective, procedures aren’t covered by insurance, so cost remains the motivating factor for most medical tourists. Surgeries in many countries cost half or even one-fifth what they would in the U.S. — including airfare, hotel and excursions. “A full face-lift that would cost $20,000 in the U.S. runs about $1,250 in South Africa,” a 2005 article in U-Daily, the University of Delaware’s online news service noted.

Faith Richter, of Hope Sound, Florida, got a face-lift in Bangkok, Thailand. Her trip was organized by New York City’s Med Journeys.

“In the U.S., it would have cost $20,000 for the procedure alone, with no time in the hospital,” she says. In Bangkok, Richter was in the hospital four days, and the total cost of her 19-day trip, including sightseeing and airfare for two, was $10,600.

Painter estimates he saved $18,000 on his surgeries. “Cost was the primary factor,” he says. “The only factor.”

Medical costs abroad are less than in the U.S. for many reasons — favorable exchange rates, lower salaries and fewer medical lawsuits, which means lower malpractice-insurance costs.

But the International Society of Aesthetic Plastic Surgery warns against low-cost surgery. “Get bargains on your shoes and laundry detergent, not on your face,” says spokesman Tony Staffieri.

“Researching the quality of doctors should be a patient’s primary consideration, but it isn’t always,” he says. “Some people think ‘tummy tuck and shopping.’ This is not makeup; it’s somebody cutting you.”

Some medical professionals fear that patients will overlook the severity of invasive surgeries and fail to ask the right questions. More casual attitudes toward plastic surgery — spurred by lunch-break Botox treatments and same-day liposuctions, paired with temptingly cheap alternatives and vacation packages — increase the risk of bad outcomes.

Even stateside, cosmetic surgery can have tragic results. “First Wives Club” author Olivia Goldsmith died during a chin-tuck in 2004, and this year Kanye West’s mother, Donda, died after a tummy tuck and breast reduction. However, a 2004 study published in the official medical journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery, found that “deaths occurring at office-based surgery facilities (in the U.S.) are rare — less than a quarter of a percent.”

Quality surgeons

Medical tourism experts counter criticism by saying that cheaper prices don’t necessarily mean lower quality of care.

“In general, it is the hospitals and facilities that have justifiable claim to ‘world-class’ status or to meeting or exceeding U.S. standards that are competing for patients from the United States and other countries,” says Jeff Schult, author of “Beauty from Afar: A Medical Tourist’s Guide to Affordable and Quality Cosmetic Care Outside the U.S.”

The authors of a 2006 “New England Journal of Medicine” article confirm the high standards of internationally accredited hospitals: “We doubt (…) that the average U.S. hospital can offer better outcomes for common complex operations.”

“Almost 80 percent of the doctors we use have been trained in the U.S. or U.K.,” says Tim Wallace, vice president of sales and marketing for Med Journeys. “It gives the American consumer a degree of confidence.”

Richter, a registered nurse, agrees that standards are high abroad. “After the surgery, the nurses were there for me 100 percent,” she says. “At home, we’re so understaffed and overburdened, and inundated with paperwork.”

When Painter visited U.S. dentists, “I felt like I was being processed for a home loan,” he says. “In Argentina, I had three dentists working on me at once.”

While medical tourism continues to increase in popularity, it’s still not mainstream. When Richter left for Bangkok, she “didn’t tell a soul, not even my seven children, who are almost all in the medical field. They would have had a stroke.

“At Thanksgiving, though, they were all saying, ‘You really do look good.’”

Here is my version of some things to think about when planning plastic surgery abroad.

Do go where you know you’ll get excellent medical treatment.
Research medical standards, facility, doctor background, and talk to past patients. Make sure you are safe - this is your biggest and most important responsibuility.

Do plan ahead, especially if you’ll be traveling at peak tourist times.
You’ll be competing for treatment with other medical travelers and for hotel space with regular tourists. Get your passport ASAP if you are planning to fly into countries such as Costa Rica, the DOminican Republic, Brazil, Colombia, etc. If you are driving into a Mexico bordor town you only need a birth certificate and ID.

Use all available resources. Don’t rely only on the Internet or the kink memebers of plasticsurgeryjourneys.com for your research.
Get on the phone and call the places you are researching. Call a past patient. Call the board that certifed your PS. Consult on the phone. Talk to PSes in the US.

Do ask a surgeon about his fellowships or specialized training.
Does he regularly attend international professional meetings? How recently has she practiced in the U.S. or Canada? How many years of experience does he have in the specialty?

Do invest a few dollars in a telephone call.
Your conversation with the surgeon’s representative or with your medical travel planner will be a good indicator of the attention you’ll get later.

Don’t be stingy with your vacation time.
Take advantage of the medical attention that’s available to you during recovery so that your return home is uneventful. Better to spend an extra day or two in recovery than to start traveling too soon.

Don’t cut costs by going with the “lowest bidder”.
Keeping down the cost of surgery or staying at a budget hotel may sound like a good idea at first, but experience shows you may be sorry later.

Do get everything in writing.
Before you go, know your costs, procedures, dates and times of the consultation and surgery, number of nights in the hospital and contact names and telephone numbers your family can use to reach you. Know your pre and post-op instuctions including diet and how to manage draining and bandages.

Don’t take stupid chances.
There is always some doctor somewhere who will agree to anything you want. This may be the only time you will travel for medical treatment. Do it right and put your safety first.

If you have second thoughts, don’t be afraid to simply walk away. Have a back-up plan and listen to your instincts.

At PSJ, we often refer to one’s plastic surgery event as a “plastic surgery journey.” We chose this for 2 reasons:
1. The Physical Journey - The actual research, traveling to another country, logdging, having the surgery performed, and physical recovery.
2. The Internal Journey - The emotional journey with oneself and loved ones, self evaluation, and friendships incurred through this passage, along with the emotional recovery and acceptance of the results.

Let’s look into the internal journey.

In the book “More Than Skin Deep: Exploring the Real Reasons Why Women Go Under the Knife” (HarperCollins), San Francisco plastic surgeon Eskenazi denies that most of her female patients who undergo breast enlargements, face-lifts, liposuction and other cosmetic operations are insecure dupes of an ageist, “female-hating culture.” Instead, cosmetic surgery is a “rite of passage that celebrates life stages” and not as much superficial, manipulated, or orchestrated.

Quoting an article on the subject:

“I just had a patient 10 years post-cancer who had no breasts but wanted a face-lift because she said she looked so old relative to parents of her kids’ friends and, she said, ‘I’m 10 years alive and I want to celebrate that,’ ” Eskenazi said.

After performing about 10,000 reconstructive and elective procedures over the past 25 years, she says there are myths and misconceptions about cosmetic surgery. Eskenazi says the desire for transformation through surgery is connected to psychological and spiritual change, what she calls a chosen rite of passage to have outer selves reflect an inner reality.

She goes on to say that all surgery can be very spiritual. At key points in our lives, something changes internally, there is psychological shifting and we want to mark that time, like a tattoo.

It is important to understand ones reasoning for plastic surgery. Questions like, Why did you decide on surgery now? What do you hope to gain from this surgery? You cannot use this surgery as a substitute for dealing with other pressing issues in your life.

I think every PS patient should commit to the understanding of their journey. Its different for each of us: in the post weight loss surgery patient who needs to complete the last part of thier transformation by ridding herself of the excess baggage; the divorsee who found the courage to leave an abusive relationship and wants to mark this new beginning with a face lift; the girl who was teased and after alot of self evaluation wants to move on.

Yes, there is a mind-body connection that should not be ignored. The journey inward is a spritual event.

Anderson Cooper’s motto is “Be honest about what you see, let the story reveal itself, and get out of the way.”

Recently, a feature on plastic surgery in Mexico was aired on Mr.Cooper’s CNN news magazine.
The question asked was “Would you have plastic surgery in Mexico?”Here are some veiwer comments taken from the show’s blog:

Umm, no. Surgery is risky enough without letting someone who is most likely not even a trained professional do the job. There are things you can get away with buying cheap (like Q-tips) and things that you must splurge on if you want to be sure of what you’re getting (like surgery!). My advice to anyone considering discount plastic surgery over the border: Seek a second opinion - from a psychiatrist.
Posted By Al, Long Island, NY : 4:16 PM ET

Girlygirl’s response: Yes, surgery is risky - noone will disagree with that. However, to describe a plastic surgeon in Mexico as someone “who is most likely not even trained to do the job” is far from the truth. Many of the surgeons discussed on PSJ are known for their artistic talent, have extensive educations, and are even certified with American organizations. The bottom line is patients need to do thier research.

___________________________________________________________

There are some good doctors who do excellent work and can help with the financial burden, however, it requires much due diligence on your part to find the right ones.
Posted By Matt, Los Angeles : 5:44 PM ET

4 years ago, I traveled to a small town of Acuna, Mexico. I had a lap band done. I research My Dr. for over a year. The care that I received at the small hospital was great and keep in mind I had the language barrior with most of the nurses. My Dr. before I left gave me his cell phone number if I had any problems. He was going on vacation the next. When back in Colorado I had some questions and called him while he was on vacation. He happily told helped me. I could not have been happier. The Mexican Dr.s had been to doing the lap-band surgery 10 years prior to it being approved in the US. They taught many of the American Dr.s the procedure. The sad thing is that it took several years until I found an American Dr. to make adjustments on my band. Do your home work before you make the decision.
Posted By Donna Pueblo, Colorado : 6:28 PM ET

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I had breast enlargement surgery in Mexico back in 1992. The experience was a little un-nerving because I ended up with an infection in one breast and capsules formed around both implants making the breast appear a little harder then normal. The infection was treated with antibiotics and the capsules that formed were torn apart and worked out by my medical doctor who happened to have some experience with this type surgery. When I first went in for a consult to have the breast enlargement surgery I explained to the doctor that I wanted my breast to be a small C (I was a small B) and he tried to talk me into getting a D because he said with my height and bone structure I could handle D cup. I explained that I would not feel comfortable with such large breast and told him I wanted to go with a small C. I wish I would have had trusted that little voice inside that told me to look for another doctor because as it turned out
I not only ended up with an infection, and capsules that surrounded each implant but I also ened up a D Cup.
If I ever choose to go out of the country again for plastic surgery I will be sure to do the research required and I will not doubt the little voice inside.
It is 14 years later and while my implants have held up well, I really have never gotten use to my large chest size.
Posted By W. Owens Mansfield, Ohio : 6:36 PM ET

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One of the main problems with seeking unecessary medical attention outside of your home country is that it is more difficult to check references and get the opinions from previous patients/customers. With that said, why anyone would risk putting themselves in the hands of a stranger thinking their money buys trust and assurance is beyond me. How far would I go? As far as credibility, reliability, experience and good feedback from others would take me. For now I’ll stick with the gym as my health and beauty regimen. That way I only have myself to blame if I look and feel worse instead of better.
Posted By Sarah Anne, Toronto, ON, Canada : 6:45 PM ET

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As with most things, fools who shop on price alone get what they deserve.
Cheap people know the cost of everything but the value of nothing.
No sympathy here.
Posted By Jack,Tampa,FL : 9:08 PM ET

Girlygirl’s Response: I don’t think anyone should decide on PS because of price alone. They should choose it because they trust that they will be safe, have a satisfactory outcome, and enjoy the seclusion of going away for PS a0ong other things. Of coarse, saving a few thousand dollars is an added bonus.

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I’m a bargain hunter, but I don’t think I’d go to Mexico or any other country for plastic surgery. My main reason is that if the patient has complications down the line, he or she might have to board a plane to be examined by the surgeon. Bottom line - there are shady surgeons in every country. Judging cosmetic patients and trying to change society is not the answer. Doing your homework is.
Posted By Michelle G., Land O’Lakes, FL : 10:06 PM ET

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as an American who lived in Mexico for years and had several surgeries there, I can tell you that the facilities are as modern and doctors as trained as they are here. You just have to do your homework as others have stated. Those of you on here who believe that some television report you saw on some exploitative (yes, CNN, ABC, NBC etc are all exploitative) show is representative of the majority of cases are the ones who need to have your head examined. These attitudes are also for the most part based on ignorance and even racism. The average life expectancy in Mexico is very much comparable to the US so where do you think Mexicans are getting their medical work done?? THINK, PEOPLE!
Posted By Jesse, Charlotte, NC : 1:04 AM ET

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I think the story does reveal itself - do your homework and surgery abroad is a viable option.

Here is a list of the # of plastic surgieries performed in 2002.

#1 United States: 90,992
#2 Mexico: 52,956
#3 Brazil: 47,957
#4 Japan: 42,842
#5 Spain: 40,164
#6 Germany: 23,140
#7 France: 21,170
#8 Argentina: 17,698
#9 Switzerland: 16,073
#10 Italy: 14,784
#11 Australia: 13,305
#12 South Africa: 11,140
#13 Canada: 11,102
#14 Taiwan: 10,048
#15 Korea, South: 9,560
#16 Greece: 8,300
#17 Ecuador: 5,979
#18 Hong Kong: 5,096
#19 Turkey: 4,865
#20 United Kingdom: 4,668
#21 Sweden: 4,326
#22 Lebanon: 3,270
#23 Colombia: 2,772
#24 Finland: 2,277
#25 India: 2,259
#26 Jordan: 1,620
#27 Norway: 1,611
#28 Cyprus: 1,449
#29 Russia: 1,200
#30 Singapore: 1,092
#31 Slovenia: 1,052
#32 United Arab Emirates: 783
#33 Saudi Arabia: 550
#35 Romania: 239
Total: 476,339
Weighted average: 14,010.0

DEFINITION: Corrected number of procedures per country 2002.

SOURCE: International Society of Aesthetic Plastic Surgery

Time Magazine published an artilce on Outsourcing Medicine and provided a price comparison.

Procedure —– U.S. Insurer’s cost — U.S. Retail price —India Thailand Singapore
Angioplasty—- $25,704 to $37,128 — $57,262 to $82,711- $11000 $13000 $13000
Gastric bypass -$27,717 to $40,035 — $47,988 to $69,316 - $11000 $15000 $15000
Heart bypass — $54,741 to $79,071 — $122,424 to $176,835 - $10000 $12000 $20000
Heart-valve replacement (single) - $71,401 to $103,136 –$159,326 to $230,138 - $9500 $10500 $13000
Hip replacement - $18,281 to $26,407 — $43,780 to $63,238 - $9000 $12000 $12000
Hysterectomy - $9,591 to $13,854 — $20,416 to $29,489 - $2900 $4500
Knee replacement -$17,627 to $25,462 — $40,640 to $58,702 - $8500 $10000 $13000
Mastectomy –$9,774 to $14,118 — $23,709 to $34,246- $7500 $9000 $12400
Spinal fusion –$25,302 to $36,547 — $62,778 to $90,679 - $5500 $7000 $9000

It is no wonder while people are swarming to India and Singapore for medical treatment.

A recent article in some british papers suggest that the trend toward plastic surgery vacations continues to get stronger. Link: http://www.dailymail.co.uk

According to the article, British tourists sought treatment on 50,000 health and wellness holidays last year. Popular destinations include South Africa and Thailand.

Why the trend despite the decline in vacation holidays?
1. Baby Boomers are open to PS
2. The Information Age gives us more options to seek healthcare abroad and reveiw options. Before the Internet, we relied only on phone book ads or reccommendations from “friends of friends.”
3. The value of the pound (and Dollar) abroad
4. The luxury the seclusion for nip and tucks

Often I receive emails inquiring how does one go about finding the best country and/or surgeon for a particular procedure?
“Best” is hard to define as everyone opinion of what “best” is varies. In my opinion, one should look for “best” plastic surgeon who consistently produces results to fit thier goals.
While there is no clear answer, here are some ideas on how to go about this:

1. Before and After Pictures - Go through the PSJ gallery or PS-sponsored websites and look and before and after pictures. Look for trends and consistencies. I think member-posted images are best because they show real work in sevral stages that has not been touched up.
So, let’s say I’m looking for a good face lift PS - I would look at every and any face lift abroad pic I could get my hands on and examine the work for the type of result I am looking for.

2. Ask around - For example, go to PSJ (or other PS related discussion forums) and ask members who they think is the best butt doctor. No doubt you will an array of responses as “best” looks different to everyone but you may see a trend in opinions that will send you in the right direction. Next to images, personal experiences are the best way to find out about the quality of a PSes work.

3. RESEARCH - Check certifacations. I have seen certifacations that do not exist or who are made up by the doctors themselves. Be proactive in your research and make sure you understand who your prospectivve PS is and what his/her strengths and weaknesses are.

4. Interview - Get a calling card and actually talk to your PS abroad. Email. Is this someone you think would be responsive if something went wrong? Will the post-op communication be satisafatory to meet your needs? Are you getting your questions answered? Are you confident in the surgeon’s skills and knowledge?

5. Follow your instinct - After enough research you will know what you need to have a successful PS Journey. Follow your instinct and choose the best PS to meet those goals. But if for any reason, something does not “feel” right, be prepred to walk away and turn your PS Journey into just a plain ole vacation.

Hi all,

I just wanted to share a new book out in stores about plastic surgery abroad called “Beauty from Afar.” This book is written by Jeff Schult, who is a well-known and respected member of the PSJ community. This book offers insight into the WHY of PS Abroad and offers much detail into how to research and plan.
I highly reccommend this book for any American who is considering plastic surgery outside the US.

Here is a note from Jeff:

My book on traveling abroad for cosmetic surgery, dentistry and other medical care is now available wherever books are sold in the U.S. and Canada and online. Beauty from Afar: A medical tourist’s guide to affordable and quality health and cosmetic care outside the U.S., was first conceived of more than two years ago when I went to Costa Rica for major dental work I could not afford to have done in the United States.

The publisher is Stewart, Tabori & Chang of New York.

Of particular interest to PSJers is that Plastic Surgery Journeys is (of course!) in the book. I singled it out as the best patient forum about traveling overseas for cosmetic surgery and dentistry.. In no way could a book do for patients what this web site does, and I did not try. Instead, the book consolidates all my research on the subject of traveling abroad for medical care. It is a more general resource and I filled it with information that is perhaps not so easy to find out for one’s self. The book is about the phenomenon of medical tourism and is also a consumer guide on where to go and how to research and choose doctors, surgeons and medical facilities. The book takes a reader around the world to the various countries where surgeons and hospitals are pursuing the U.S. market for medical care. Why is it less expensive? Is it safe? Where are the best places to go? Beauty from Afar has the answers.

From the back jacket:

“Jeff Schult’s “Beauty from Afar” is the first step to what so many of us have been praying for: how to match our bodies to the years in front of us and how to do it safely, inexpensively and exotically!” — Frances Kuffel, Author of Passing for Thin: Losing Half My Weight and Finding My Self.

“Having read Beauty from Afar, I believe that seeking health care from abroad may be one solution to America’s current health-care dilemma … it could be the tidal wave of the future.” — Felicity Harley, Executive Director, World Affairs Council, Connecticut

“I thought I knew a lot about medical tourism, having lived it for 10 years. Jeff has opened a whole new world of possibilities and he has made me a student again.” — Curtis J. Schroeder, CEO, Bumrungrad International hospital, Thailand.

There is a web page for the book at www.beautyfromafar.com where I will update information about the book as time goes on. It is easy to find the book for sale at online booksellers by searching for the title. In fact, Google the title or my name and you will trip over me or it.

There was a full-page article on the book in the New Haven (CT) Register on 6/17 with a picture of me! LOL … and I will be doing radio and TV interviews in coming weeks … and perhaps even visiting book stores in various cities. I’d love to meet some PSJers if and when that happens.

I look forward to hearing from readers as I continue to research and write about health care around the world. I’m hoping to have Lasik this year, if I can afford it. Where will I go? I haven’t decided yet … so many options. Costa Rica, India and Thailand are top of my list for that procedure, at the moment.

-jeff

Check out this Auction:

http://cgi.ebay.com/ws/eBayISAPI.dll?ViewItem&item=9520577567&fromMakeTrack=true

I really hope whoever is bidding here - is researching options…. The idea of buying breast implants and tummy tucks on EBAY is scary… Decisions like this should not be made on price alone and I hope people have sence enough to research this further…

Plastic Surgery Journeys (Plasticsurgeryjourneys.com) is mentioned in an article in the June/July issue of Jane Magazine.
It says that my experience was in Brazil. This is not true. My expereince was in Mexico.

It also mentions Candy’s experience (which I talked to the reporter about). If you want more info on Candy - which PS and where - log into PSJ and check the “Complications board.” I have noticed that there is not an equal amount of complications to successful experiences on PSJ. In fact, the majority of our members have had positive experiences. Check it out for yourself.

According to the article below, Lebanon is now competing with Brazil for plastic surgey tourists.
Link to article.

The person featured had a nose job and facelift for $5000 US.

Looking at Lebanese women on the streets these days, you would be forgiven for thinking they were clones. Why? Because cosmetic surgery has become common and is a booming business in the country.

In the past few years Lebanon has earned a reputation as a place for Arab tourists as well as Lebanese expatriates and locals to come to for plastic surgery. The cosmetic enhancements vary from nose jobs to facelifts to body sculpting.

“During the war there were mainly six or seven plastic surgeons in Lebanon, nowadays you can find more than 100 surgeons with well established names,” plastic surgeon Elie Chamas told Deutsche Presse- Agentur (dpa).

“We are now competing with the famous Brazilian plastic surgeons,” he said.

While I doubt AMericans will travel to Lebanon for surgery, it is pretty interesting to see that this is a world trend.

If you can’t afford a Mercedez, don’t buy a car.

This statement seems absurd to me.

But that is what I am hearing when I hear statements like “If you can’t afford plastic surgery in the United States, save your money or don’t do it.”
No - I am not saying plastic surgery in the US is the Mercedes of Plastic Surgery (although some people seem to beleive it is.)

Sure, I agree that people who are using thier life savings to have plastic surgery should consider setting aside some extra cash in case something goes wrong. And financial priorities should be in tact.

But if I can get a quality procedure and equally great care for a fraction of the cost of the US by going to Mexico, then why not? If I can research a plastic surgeon, meet patients, review before and after pics, consult in advance, and verify that the location is at the same level of cleanliness of that of LA plastic surgeons - then why shouldn’t I? Before I chose plastic surgery in Mexico, the alternative to having plastic surgery in the United States was not having plastic surgery at all. Now I know there are options. And I can be empowered with information and make the best decision for me.

With my financial priorities, I can’t afford PS in the US. I had a great experience in Mexico and saved over $12,000. I am glad I did it.

A well known plastic surgeon in Orange County, CA is being investigated for illegally importing Cohesive Silicone Gel Breast Implants from Tijuana, Mexico. These implants are not approved by the FDA and can be obtained in the USA only through clinical trials. Link: http://www.latimes.com/news/nationworld/world/la-me-breasts12apr12,0,1510009.story?coll=la-home-headlines

Silicone implants were taken off the market in 1992 over concerns they might cause autoimmune diseases if they leaked. The ban has spurred a black market for the implants, which some would say are considered more natural in appearance and feel than saline-filled ones approved for use in the nearly 300,000 U.S. women who have cosmetic breast surgery every year. Moreover, many women feel that they are much safer because in case of rupture, they maintain thier shape because of thier “gummy bear - like” feel.

What this article did not mention is the exudus of women who cross the border into TJ every year for breast augmentations for silicone gel implants. Plastic Surgeons in Mexico do not have to wait for the FDA to lift the ban on Cohesive Gel Implants. Mentor and Inamed, the two leading makers of silicone implants, each have demand in countries such as Mexico, Brazil, and Costa Rica. The average cost of a BA in TJ is $3500.

For more info on SCGI: http://www.implantinfo.com/breast_implants/silicone_gel_breast_implants/silicone_gel_breast_implants.htm

One of our members, Jodi, is suffering from complications after plastic surgery in Argentina with Dr. Lodolo (once worked with Plenitas).
As I write this she is in a hospital bed, with an IV hooked to her heart. She has Septicemia, otherwise known as blood poisoning. Her husband Marcello reported that the doctors have given Jodi a 50% survival rate and that she is delirious.

The forum is truly devastated as this is the worse complication one of our members has ever expereinced in our 3 years of our support forum’s life. Her story and contact info can be found on the Argentina forum on the PSJ board.

Please pray for Jodi and keep her family in your thoughts.

Updated Sunday, April 9th.

New Update April 11th: Jodi is doing much better! She is up and posting… Fully conscious! Thanks for all your prayers… will keep you posted…

In reading through the last year’s NBC article on Lipo-Tourism, when I realized that there is a difference between “lipo-tourism” and “lipotourism.”

The NBC article defines “lipo-tourism” as “foreign doctors who offer cut-rate surgery and Americans who are willing to go overseas to go under the knife.”

“Lipotourism”, however, is apperantly copywrited, and according to the website http://www.phudson.com/TOURISM/lipotourism.html , it is a term owned by Dr. Hudson in Alberquerque, NM.

Dr. Hudson’s website says it is the combination of vacation and surgery at the same time. In the link above, Dr. Hudson describes his tips for reasearching lipotourism. My favorite is “a good vacation spot is not always the same as a good place to have surgery.”

I have my own definition of this phenonmena - the plastic surgery journey. Because, god knows, it is not a vacation. And god also knows, there is very little tourist activity going on through these journeys.

We call it a journey because it is descriptive of both the inward, emotional journey and outward physical journey. Yes, we phisically arrive to a destination, but for those of us who go abroad for plastic surgery know, the journey by no means ends when we return home, as the recovery and learning to get used to the new us is also part of this journey.

Whatever you call it, I think it is unanomous, that one should research in detail, reveiw the risks, and understand that this may not be for everybody.