Hello and thank you for this question. Medical tourism is a sensitive subject. We all understand the reason for it.
In the Dominican Republic plastic surgery cost is significantly less than having this done in the United States. The problem with doing this is that you are taking considerable health risks traveling abroad. In a country that has intermittent electrical blackouts on a regular basis, I would make sure that the facilty you are using has taken steps to ensure that is not a risk factor ( ie back up generator )
Although there are well qualified and safe plastic surgeons in the Dominican Republic there are also many who are not. A simple Google search will reveal a scary number of complications and deaths in the Dominican Republic from plastic surgery.
Furthermore should you have a complication I think it would be difficult to find a plastic surgeon willing to take on the liability of dealing with someone else's complications
If you factor in the cost of travel and the potential cost of having additional fees dealing with post-operative care the total cost savings is probably not as significant as you might think.
Best to you.