Flickr, Arturo de Albornoz

As healthcare costs rise in the United States, many patients are lured by the lower cost of medical care abroad. But is a less expensive procedure in a foreign country the best option when it comes to surgery? This month, we will address cosmetic surgery travel. In November, we'll explore major elective procedures.

All-inclusive cosmetic surgery vacation packages have been cropping up all over, generally offering private hospital services and highly trained medical staff. Since elective cosmetic surgery procedures are not covered by insurance, price is the major selling point. Popular destinations offer everything from exotic safari and surgery to tropical tour packages.

Josef Woodman, author of Patients Beyond Borders, a guide to medical tourism, estimates 2-3 million people travel beyond their own country for surgery each year. The majority of cosmetic surgery patients seek breast augmentation, liposuction, facelifts, tummy tucks, eyelid surgery and nose reshaping.

Although there are many skilled physicians practicing all over the world, it may be difficult to assess the training and credentials of surgeons outside the United States. Look for foreign surgeons who are board certified in the United States or Canada.

Proper administration of anesthesia, sterile technique and modern instrumentation are all key safety issues. Devices and products used abroad may not meet U.S. standards, and U.S. law does not protect patients or mandate the qualifications of physicians outside of the country. There may be no legal recourse in cases of surgical negligence.

The Joint Commission International sets accreditation standards for hospitals abroad factoring in quality, standards of practice, outcomes and patient safety. To date, more than 120 healthcare facilities in Europe, Asia, India, the Middle East, South America and the Caribbean are JCI-accredited.

If you choose to pursue surgery abroad, your surgeon should welcome questions and answer them thoroughly. He or she should readily provide information about qualifications, experience, costs and payment policies, and be well-versed when it comes to explaining the procedure, its risks and possible outcomes.

Cosmetic surgery is real surgery and requires the same recovery as other surgeries. To properly heal and reduce complications, patients should not sun-bathe, drink alcohol, swim, snorkel, water ski, jet ski, parasail or exercise strenuously in the days immediately following surgery. Infections are the most common complication seen in patients who go abroad for cosmetic surgery. Other complications include unsightly scars, hematomas and unsatisfactory results.

Even routine post-operative care such as changing dressings and monitoring for healing may continue for several weeks, long after your vacation is over. Patients generally need assistance for at least the first two post-operative days. Pain management may be an issue.

Taking a long flight after surgery can increase the risk of developing a pulmonary embolism or blood clot. Do not fly for five to seven days after procedures such as liposuction and breast augmentation, and seven to 10 days after facial procedures including facelifts, eyelid surgery, nose jobs and laser treatments. Limit the number of procedures done at any one time, since multiple surgeries increase the risk of complications.

Be aware that cosmetic surgery vacation packages provide limited, if any, follow-up care once you return to the United States. If you experience a complication, you may find it difficult to locate a qualified plastic surgeon at home to provide treatment or perform revision surgeries.

A relatively new organization, the Medical Tourism Association, is a non-profit group of the top international hospitals, healthcare providers, medical tourism facilitators, insurance companies and other affiliated members established to assist global healthcare consumers. The MTA's goal is to promote the highest quality healthcare in a global environment and to provide transparency in both
quality of care and pricing. The association's Quality of Care Project will change the way we look at the reporting of global healthcare statistics and the quality of care available at hospitals around the world. 

Checking Up

Use these sources to determine credentials and qualifications of surgeons and facilities abroad.

All Medical Tourism

American Society of Plastic Surgeons

International Medical Travel Association

International Society for Quality in Healthcare

Joint Commission International

Medical Tourism Association