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The medical tourism industry is booming, and plastic surgery and cosmetic procedures are not immune from the trend. Patients are more willing than ever to cross borders in search of healthcare services and medical care. These so-called medical tourists seek treatment abroad for a variety of reasons — ranging from affordability and healthcare costs to the availability of medical procedures and quality of care that may or may not be available in their home country. As it relates to plastic surgery and cosmetic procedures, medical travelers may find that they prefer the style or aesthetic of the results of healthcare providers in other countries.

But there are undeniable risks associated with having surgery abroad. In the long run, these complications can result in expensive and, in some cases, dangerous consequences. Here, The AEDITION explores what to consider before seeking treatment overseas.

## __Why Do Patients Travel For Procedures?__
First things first, it's important to understand why and how medical tourism destinations have come to exist. According to the International Society of Aesthetic Plastic Surgeons, the [United States performs more surgical and non-surgical cosmetic procedures](https://www.isaps.org/wp-content/uploads/2019/03/ISAPS_2017_International_Study_Cosmetic_Procedures_NEW.pdf) than any other country in the world. In 2017, the organization reports that there were nearly 4.5 million procedures performed, representing about 18 percent of the global total. Brazil came in second with about 2.5 million, and Japan, Mexico, and Italy rounded out the top five.

While it should come as no surprise then that the United States welcomes a large contingent of foreign patients annually, plenty of Americans choose to leave the U.S. for aesthetic treatments and surgical procedures in different countries.

[Patients Beyond Borders reports](https://www.patientsbeyondborders.com/media) that the global medical tourism market is growing at a rate of 15 to 25 percent, and cosmetic surgery tops the list of specialities medical travelers are most interested in. The organization, which specializes in medical tourism, estimates nearly two million Americans traveled abroad for healthcare in 2019.

## __What to Consider Before Traveling Abroad for Cosmetic Surgery?__
Sure, cost savings and the allure of new technologies can be appealing, but patients should be cautious when seeking medical treatment in a foreign country. The potential risks of traveling abroad for cosmetic surgery are multiple and varied, says Beverly Hills-based board certified plastic surgeon [Johnson Lee, MD](https://aedit.com/provider/johnson-lee-md-710). And while it is possible to receive quality care around the world, patients should take the necessary precautions before opting for medical travel.
 
1. __Safety First__: Needless to say, safety should always be your top priority when seeking treatment both domestically or abroad. Researching how cosmetic procedures are regulated in other countries, what the education and certification process is for doctors and surgeons, and how medical centers and international hospitals function can help to ensure the proper safety protocols are in place.

2. __Do Your Homework__: If a procedure is not FDA-approved in the U.S., you may want to consult with a board certified plastic surgeon or dermatologist prior to traveling to understand the potential safety risks of the treatment or technique. Viewing before and after photos and asking to speak to local patients who have undergone the procedure can provide additional insight into what to expect. 

3. __Money Matters__: Make sure you have explicit documentation about the price of the procedure (including pre-op lab work and post-op recovery fees) from the onset. While healthcare costs can be significantly less outside of the U.S., it is important to remember that a low-cost treatment that sounds too good to be true probably is. 

4. __Insurance Intricacies__: Insurance companies rarely cover elective cosmetic procedures, but you may be able to take out an insurance policy before traveling abroad for a procedure. While some health insurance plans can be designed specifically for medical tourism, you'll want to be clear on exactly what is covered by the policy. For example, coverage may be provided if you have to delay your return home for medical reasons.

5. __Communication Is Key__: Consider potential language barriers when choosing a provider. Be sure to ask whether the entire medical team (nurses, doctors, etc.) are fluent in your native language. During both the pre-op and post-op care process, you will need to understand everything that is being said, so communication is a vital part of choosing a provider.

## __Risks Associated With International Medical Care__
Whether you're being treated at home or abroad, there are always risks associated with undergoing a procedure — especially an elective one. With that said, there are certain things to pay special attention to when considering healthcare services in a foreign country. Below are five of the most common risks pertaining to medical tourism for cosmetic procedures:

### __1. Anesthesia__
The increased risks associated with anesthesia when having surgery abroad are often in relation to the resources available in the clinic where the procedure is taking place. To mitigate this risk, it is worth asking what safety protocols are in place and how the surgeon’s team is prepared to react in the event something goes wrong. Dr. Lee advises patients to ask the following:

- *What safety measures are in place before, during, and after surgery to make sure there are no unnecessary risks?*
- *If there is a complication, are the providers or medical facility knowledgeable and equipped to handle it?*

### __2. Unsatisfactory Surgical Results__
Another common concern when traveling abroad for cosmetic procedures? The potential for unsatisfactory results and the lack of recourse in such cases. Dr. Lee has seen patients in his practice who are looking for revision procedures in the aftermath of a surgery done abroad. “Most of these procedures are larger surgeries that have larger incisions or tend to require a longer recovery period, such as [tummy tucks](https://aedit.com/procedure/abdominoplasty) or [mommy makeovers](https://aedit.com/aedition/the-mommy-makeover-how-to-bounce-back-after-a-baby)," he explains. "The problem is that most patients return home shortly after their procedure and are no longer properly managed.”

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  "The problem is that most patients return home shortly after their procedure and are no longer properly managed."
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There is also the risk that a provider will rely on patients not being local to cut corners, which can lead to long-term financial, physical, and emotional concerns. Dr. Lee recommends patients who choose treatment abroad find a doctor in their home country (prior to leaving!) who would be willing to treat them if something were to go wrong upon return.

### __3. Implant and Device Safety__
Ever since the [silicone implant scandal](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676226/) involving French manufacturer Poly Implant Prothèse (PIP) in the early 2000s and the more [recent recall of Allergan's textured breast implants](https://aedit.com/aedition/heres-what-you-need-to-know-about-the-allergan-breast-implant-recall), patients are increasingly aware of the need to discuss implant safety prior to surgery. This is especially true abroad, as clinical testing, medical standards, and regulation varies by country. 

“The FDA in the United States is particularly stringent. Most larger companies with FDA-approved implants and medications in the United States will have the exact same or similar products abroad,” says Dr. Lee, who encourages patients to ask their surgeons in other countries what types of products they use. If you are uncomfortable with what is offered, consult with another provider. The same due diligence is necessary for medical devices (think: lasers and body sculpting treatments), too.

### __4. Post-Op Travel Concerns__ 
Long-distance travel soon after surgery is one of the biggest differences in the recovery from a procedure carried out locally versus abroad. Surgeons who regularly operate on patients traveling from another country often have tried and tested protocols in place that will dictate when and how you will be allowed to travel home to prevent injury and complications.

“With air travel, you may be expected to stand or sit for prolonged periods of time or carry heavy luggage. This can be harmful to your surgical sites, in addition to being uncomfortable," Dr. Lee explains. "One of the most serious risks of flying is developing a deep vein thrombosis (DVT). This is usually a blood clot that forms in the calf area of the legs and happens because of prolonged sitting and poor circulation. Blood clots can travel through your vessels and cause damage to the lungs and even death.”

Ideally, patients would travel with a companion who can help navigate the post-op process and return trip home. Coordinating with your airline can also help to get you through the airport with less walking and standing. Regardless, Dr. Lee says surgeons should be able to provide "exercises and tips" that will help minimize the risks, "if you are traveling shortly after surgery."

### __5. Recovery and Aftercare__ 
With many procedures, patient care during the recovery process is as crucial to a good outcome as success in the OR. One of the biggest risks of having surgery in another country is the potential lack of follow-up care. Dr. Lee advises that patients try to find a doctor close to home who is willing to help them through the recovery process, if they do choose to have surgery abroad.

Scar revision, for example, is a common request of patients returning to the U.S. after having a cosmetic procedure abroad. The scarring can be due to the stress put on the surgical site while traveling home, poor post-op care, or doctor error. Larger revision or corrective surgeries (which are both financially and physically costly) may also be needed if patients are unhappy with their results.

To avoid such disappointments, make sure you ask your surgeon to outline their standard recovery practices (including when normal activity can resume and what symptoms to be on the lookout for) and how they can be carried out when you return home.

## __For Patients Traveling to the U.S. for Cosmetic Surgery__ 
Just as Americans looking to travel abroad for cosmetic surgery should take all of the potential concerns and risks outlined above into consideration, patients planning to come to the U.S. for treatment should exercise similar care. 

As in any country, finding a reputable reliable surgeon, who specializes in your desired procedure is paramount. It is important to consider his or her board certifications, aesthetic, and patient satisfaction. You will want to discuss how long you will need to remain in the country after the procedure for follow-up appointments and when it will be safe to travel long distances again. Additionally, be equipped with a list of medications and supplements you currently take and any relevant medical records to ensure things operate as smoothly as possible.

## __The Takeaway__
Regardless of where you choose to have it done, deciding to undergo a cosmetic procedure is a big decision. There are, of course, added risk factors to take into account before choosing to have a procedure abroad. Doing proper research to understand healthcare system in the country you are traveling to can help mitigate the risks and ensure high-quality care. 

Prior to leaving for your trip, you’ll want to line up a doctor close to home who is willing to treat you if side effects or complications arise post-op. Traveling with a friend or loved one is also recommended, as is securing appropriate insurance. And, if you take nothing else from this piece let it be this: The true price of a cosmetic procedure is about a lot more than dollars and cents.

“The cost of the procedure is just the tip of the iceberg,” Dr. Lee says. “When deciding to travel abroad, you should do your research and speak with your surgeon or other patients about their experiences. This is your body, not a car or a piece of jewelry. Don't shortchange yourself!”

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