US plastic surgery vs Dominican Republic? I’m on the fence of having a TT and Liposuction.

Question

I’ve already had a breast reduction from a Doctor here in the US and I’m somewhat satisfied with my results (I’ll leave that to another review). I want to have SX sometime in April of 2019? I’m being very proactive in my research. So need some advise and insight.

Robert M. Tornambe, MD · Answer

Impervious81.  I recommend that you consider all options before traveling abroad for your cosmetic surgery. I practice in NYC, and I have seen far too many serious and harmful complications resulting from surgery in the Caribbean or over seas. Issues like serious wound infections, tissue loss and questionable operative techniques result in complications that are expensive and hard to fix. Please balance the risks and your personal safety against the perceived advantage of cheaper cosmetic surgery, because in the long run, it can cost you a lot more, both monetarily and in personal harm. Good Luck!

Paul Vitenas, Jr., MD · Answer

Thank you very much for your question, as this is a
common one. Unfortunately, while seeking cosmetic surgery outside of the United
States can sound like a bargain at first, the risk for potential post-op
complications is far too risky. Physicians and surgical centers are not
required to carry the same board certified or accreditation that is needed in
U.S., meaning they may not follow the same safety guidelines or restrictions.
If any complications should arise once you have come home from the Dominican
Republic, your operating surgeon cannot provide the necessary follow-up care.
It may also then be difficult to find a local cosmetic surgeon willing to pick
up your care. I suggest scheduling a consultation with a local, experienced,
board certified plastic surgeon to discuss your Tummy Tuck and liposuction choices.
At this time, the office can explain all of your payment options, including
healthcare financing, which may make the procedure more budget-friendly

Luis M. Rios Jr., MD · Answer

Thanks for the question.A tummy tuck is a very serious operation and can take several months before patient's feel back to normal. Other types of cosmetic surgery have less downtime and smaller incisions, so the recovery period is not too complicated.My opinion is that you should be close to your surgeon when you take on a bigger surgery like a tummy tuck or breast reduction. The recovery period is just as important as the actual surgery. Should complications occur, you will be happy you can call up your doctor at a moments notice and get advice or be seen in person.Don't underestimate the importance of the postoperative period after a tummy tuck. You will need a lot of support and reassurance.Good Luck.

Robert P. Schmid, MD · Answer

Thanks for your question! I can’t stress strongly enough my bias in answering this question. Of course you need to stay in the US! Good old fashioned patriotism aside, have your surgery performed by a US board certified plastic surgeon! If you go to the Dominican, there are relatively NO liablilty & malpractice assurances, your follow up will be sporadic at best, & Inc you have a problem, NO surgeon back home will have anything to do with you.  Don’t bargain basement shop with your body! Best of luck to you!

Robert Brueck, MD · Answer

Stay here because if you have complications it is a long and expensive journey to go to the DR every week.

Regina M. Fearmonti, MD · Answer

In general, this is a very bad idea. A key component of ensuring optimal results (and managing and preventing complications) is close followup with your surgeon. I see my tummy tuck patients weekly for the first month then at 3 month intervals for an entire year to monitor drain and suture removal, swelling, and then optimal scar appearance.  I have also cared for patients that have had similar procedures elsewhere and end of in ERs and wound clinics as their surgeon is unreachable, in another country, after their surgery. Don't do it.  It's your body and life at stake.

Thomas Trey Sands, MD · Answer

Thank you for your question. I practice in South Louisiana so many people consider going to Central America for their surgery because of the cost. Consequently, I end up seeing a lot of people with problems who are left with no one to care for them. I would strongly urge you if to find a board certified plastic surgeon who has a history of quality work with body contouring close to you. The amount of follow up with your PS is at least 6 months. Therefore being around your surgeon for only 2 weeks is not good enough. In my experience, we have people calling our office begging for us to see them because no other plastic surgeon around them will take care of them once they found out they went out of the country. My patients also tell me that they end up spending just about as much as if they would have just stayed in town with me and therefore elect to have their second stage of surgery locally. You also have to remember that social medial guidelines, society guidelines and faculty accreditation is not them same in other parts of the world as you have come to expect in the US. One of my patients who had a procedure in Central America showed me her before and after on the surgeons social media channel and then showed me her actual before and it was obvious that he before picture had been altered. There are many quality surgeons in Central America but the reality is it is harder for you know know your surgeon well before hand and hard to have them care for you after surgery. Good luck.

Andrew Gear, MD · Answer

While there are many fine surgeons in other parts of the world including the Dominican republic, Brazil and Columbia among others, there are many stronger reasons not to fall into the appealing trap of medical tourism. I tell patients if you know the lay of the land, if you know the surgeon and have family there and can stay there for an appropriate amount of time for postop evaluation, then by all means. If not, you’re playing Russian roulette. There is no real true preoperative screening. There is no follow up. Many US surgeons, including myself, see a lot  of complications in the aftermath of medical tourism. There have been recent hospitalizations in our area following medical tourism. This never gets highlighted in cyberspace or Instagram but it is a reality. Count the cost carefully.From a simple, physiological standpoint, getting in an airplane after having a TT is not a good idea due to the potential for thromboembolism in the context of atmospherIc changes and venous stasis from lack of movement

Ali Sadeghi, MD, FACS · Answer

Its best to stay near home and have your surgery done by a US Board Certified Plastic Surgeon in an accredited surgical facility to obtain the best outcomes.  If you are trying to save money by going overseas, you will pay much more when dealing with the complications of the procedure thats done out of the country.

Robert Singer, MD · Answer

While there are good surgeons in many countries including the Dominican Republic, having surgery at a reduced rate in a foreign country sounds
appealing, but there are many concerns that you should consider. Generally,
there is no preoperative direct discussion with the surgeon who is going to
perform the surgery in order to establish any reasonable doctor/patient
relationship. There are often language barriers that can interfere with your
care. Even if your surgeon speaks English, the ancillary personnel like the nurses
and the anesthesia provider who are involved in your care, may not. The quality
of hospitals outside of the U.S. varies tremendously. Some are accredited and
inspected, others are not. Even if the hospital has reasonable facilities and
the surgeon has training, which may not be up to the quality of training of a
plastic surgeon certified by the American Board of Plastic Surgery, the quality
of the nurses and others involved in your care may be very different from that
in the United States. They may have little or no formal medical education,
training or credentialing.
There
is usually little follow-up care. In addition, the general sanitary conditions
often increase the risk of infections, including some that are generally rare
in this country. There are major potential problems that may occur with traveling long distances
just before and after surgery, like dehydration and fatigue, but more
importantly complications including clots in the legs called deep venous
thrombosis and clots to the lung which may be life threatening.
In
most countries, if a problem develops, you will have little legal recourse and
no ability to file a complaint either against the hospital or about the
surgeon. If complications develop after you return home, it may be difficult or impossible to obtain care
from your local physicians. If problems do occur, the cost of subsequent care
can be far greater than the reduced cost of the original surgery. While there
are well-trained physicians in many other countries, I would suggest that you
travel for pleasure or business and have your surgery closer to home.
Robert
Singer, MDFACS
La
Jolla, California

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