Medical Tourism: "Should I Go to Mexico for Plastic Surgery?"

Probably NOT.

Medical tourism has become increasingly popular.  A few recent newspaper articles have even praised "medi-tours."  However, as an American Board Certified Plastic Surgeon, I am firmly opposed.

Since I practice in Southern California, I take care of 5-10 patients each year, whose aesthetic surgeries were botched during overseas plastic surgery adventures.  After paying for the cost of secondary management (hospitalizations, prolonged antibiotics, wound care, etc.), each recognizes that her plastic surgery would have been performed much less expensively in the US.

To me, the thought of obtaining medical care—especially surgery—overseas is ridiculous.  Plastic surgery is real surgery.  It is not at all similar to the TV programs.  Plastic surgery really hurts.  It requires real recuperation.  Real complications happen frequently.

For example, most honest American/European/Asian research studies of breast reductions report 30-40% rates of complications.  For tummy tucks, 25-35%.  Yes, most of those complications are minor, but how does the "medical tourist" know what's minor and what's major?

And many of these complications do not manifest themselves for 2-3 weeks.  When the patient returns home from her one-week “medi-vacation,” who looks after her?  Who takes care of complications that occur in 1 out 3 patients—a week or two after arriving back in the USA?

Well, I do.  But I charge for my services.  So, does she really save any money?  Doubtfully.

And, frequently, my hands are tied because I do not know the details of the surgery.  Is the patient supplied with information regarding antibiotic usage?  Suture type?  Implant size and manufacturer?  The answer is always, “No.”  Have the patients and I ever been able to obtain this information from the foreign surgeon?  Never.  And, believe me, I try.  Ultimately, my management of the patient’s complications is suboptimal because I do not have the specifics.

Despite the fact that I rant and rave about this topic dozens of times per year, many Americans, particularly Hispanic women, continue to be duped by Mexican physicians who have little training and even less oversight.  Commonly accepted surgical practices, such as not reusing disposable instruments and such as maintaining strict sterile technique, are not always adhered to.  I have discovered that one Mexican “hospital” where a number of patients have suffered horrendous complications is actually a veterinary facility!

I certainly admit that not every physician in the United States is outstanding.  In fact, while there are approximately 60,000 American physicians performing cosmetic procedures, only 6,000 of us are certified by the American Board of Plastic Surgery.  Certainly, we need to clean up our own backyard.

Likewise, I am more than happy to refer patients to any number of outstanding Mexican plastic surgeons.  Many of the world’s leaders in plastic surgery come from Mexico, particularly Mexcio City.

Nevertheless, even these fantastic Mexican surgeons are not right for my Californian patients.  Follow-up is a crucial part of any surgery.  Surgical care does not end when you leave the operating room!  Patients need to be nursed through complications.  Patients need reassurance; they must have the opportunity to come to see me, any day of the week and any time of day, to make sure that their experiences are “normal.”  Patients need continued compassion.

And a doctor can’t do any of those old-fashioned duties from thousands of miles away.

Moreover, a doctor needs to see his results.  How can I make improvements in my technique if I don’t get to see my results after complete healing?  This might be the biggest flaw of the medi-vacation surgeons.  They don’t even know that they are continuing to make mistakes, because they never see their own complications.

Some things just shouldn’t be “out-sourced.”  Medical care is one of them.

Comments

[Affordable Cosmetic Surgery]

Because cosmetic surgery isn’t normally covered by health insurance, why not go for the most affordable option available? With medical tourism to India, Thailand, or Brazil, you can spend a fraction of the money without sacrificing on quality.

[Prakash Arige]

Cheap Cosmetic Surgery You can pay a lot of money to a cosmetic surgeon in the States or you could go to medical tourism destinations like India, Argentina, or Thailand and received the same treatment for a fraction of the cost. Medical tourism provides you with affordable options for face lifts, Botox, liposuction, and breast implants - http://www.healthmedicaltourism.org

[Michael C. Pickart, M.D., F.A.C.S.]

Dear Mr. Arige,

Did you neglect to read the content of my post? Traveling overseas for medical treatment does NOT entail the same treatment.

While many foreign physicians are outstanding, how can a potential patient from the USA research that doctor? The doctor's facility? How does the American know that the surgeon and the operating room have been appropriately certified? How does the American interview other patients to find out about their experiences--especially since the American doesn't necessarily speak the local language and the other patients don't likely speak English? How can the American really be sure that his/her concerns are adequately addressed, given likely language barriers between him/her and the physician?

Most importantly, who looks after the patient when he/she returns to the USA? Given that complications for some procedures occur in 1 of 3 patients (such as with breast reductions), who will nurse those unfortunate few through their prolonged healing?

Mr. Arige, I can't help but feel your posts are just an attempt to redirect readers to your website. The purpose of this blog is to address the questions which I hear every day while I take care of my patients. Education is the goal, not commerce.

Sincerely,
Michael C. Pickart, M.D., F.A.C.S.