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.

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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.