Advice for Multiple Procedures in Mexico?

I am going to have a tummy tuck, breast lift, and breast augmentation done at the same time with a board-certified doctor in Mexico. He says he can also do minor Liposuction and inject the fat in the buttocks to give me a more smooth look, he says this is included on all tummy tuck patients if they wish to do so, but I am a little nervous. Is it possible to have the three procedures done, along with the Lipo and Brazilian Butt Lift?

Doctor Answers 6

Be very cautious

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I would be very careful having multiple procedures in Mexico. We just finished filming an episode which will air in July or August about a patient who went there, had a complication,, came back to the Unites States and spent six months trying to find a doctor here who would take care of her. The complications from a botched surgery can be much more difficult and expensive to treat than the initial surgery. You should explore prices in your community - you might be surprised, especiall in thes economy! - the prices may not be that different than you will pay in Mexico. Finally, board certification is not equivalent to saying that you picked a surgeon certified by The American Board of Plastic Surgery. If you would like you could speak to the patient who had the horrific experience in Mexico by calling the office and we can arrange it. If you have already made your decision, best of luck!

NO! Your medical care should not be "Out-Sourced"

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I am sorry to pick on you "Housewife in San Diego," but your post is very concerning to me. Frankly, I don't think you are being safe.

First, a breast augmentation and a breast lift are 2 separate procedures. Dual-plane breast augmentations take me 90 minutes. Wise-pattern (anchor) mastopexies require another 3-4 hours, depending upon the "droopiness" of the breasts. So, for 2 procedures, you're already going to be under for 5 hours or so.

A tummy tuck would be a 3rd procedure. This takes me about 3 hours.

My math indicates that you're now up to 8 hours. Frankly, that's already pushing it.

I try to avoid operating on a cosmetic patient for longer than 6 hours at a time. If she is young and very healthy, then maybe I'll do 8 hours. If I think that the case is going to last longer than 8 hours, I never do the operation in an out-patient surgery center. I do these ultra-long procedures in a real American hospital with all of the safety precautions. The patient stays overnight for close monitoring by an excellent nursing staff.

OK, but now you want to add Brazilian butt lifting. This is not a 3rd procedure, but actually a 4th. Truthfully, I don't think BBL works. It has never produced long-term success in my hands, and so I don't do this procedure at all anymore.

Nevertheless, if you were to elect to do BBL, then I guess that it would add at least another 90 minutes to the operating room time. So, now you've been in the operating room for at least 9 hours. And that is way too long since I bet that you will not be having your surgery in a hospital.

Sorry. But this plan sounds unsafe.

I take care of 5-10 patients annually, whose aesthetic surgeries were botched during Mexican plastic surgery adventures. To me, the thought of obtaining medical care—especially surgery—outside of the USA is ridiculous. Many plastic surgery procedures come with significant risks. For example, most honest American/European/Asian research studies of breast reductions report 30-40% rates of complications! For tummy tucks, 25-35%! Many of these complications do not manifest themselves for 2-3 weeks.

So, what are you going to do if you have a complication? Drive back to Mexico? Who is going to take care of your complication at 3 am Sunday morning?

Well, in my community, I do. So, yes, I am bitter. I do resent going to the emergency room in the middle of the night to take care of a patient who had bad surgery done by a foreign doctor who had no intention of looking after her.

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? Almost never. Ultimately, my management of the patient’s complications is necessarily suboptimal because I do not have the specifics.

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 Mexico City.

But if you're going to get plastic surgery in Mexico, then do it right. Make sure that the surgeon is truly Board Certified. Which Board? The plastic surgery board or the general surgery board? Is the facility accredited? What's the policy for complications? Who do you call in the middle of the night? And, then plan to stay down there, so that you can follow-up with your own doctor.

In most cases, even some of my Mexican colleagues who are fantastic 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 across the border.

Moreover, a doctor needs to see his/her 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 cross-border 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.

Michael C. Pickart, MD
Ventura Plastic Surgeon

Surgery is team work

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Healthcare in general and plastic surgery in particular is a team work that requires a good surgeon but also a certified facility, a qualified anesthesiologist,nurse and The safest products!!

This combination is only present in very few places outside of the US. Also,followup will become extremely difficult. Think about it twice!!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Plastic surgery and multiple procedures

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While I have several friends jsut over the border from San Diego who are excellent surgeons, I would recommend staying close to home for multiple procedures.  First, I think that you may be having too many done at the same time.  Second, what if you have a problem? How easy is it going to be for you to see your doctor in Mexico. What if you need to be hospitalized?

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Multiple cometic procedures safety

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Patient safety first.

Multiple surgical procedures take their toll on the patient and the surgeon. Each surgical procedure takes a certain amount of time to do and excute properly to get the optimal result.

We have the best quality medicine in the world. If you get a complication you will have a hard time finding a surgeon to take over somebody elses liabilities, and will cost you much more. Or end up in an emergency room being taken care of by a non Plastic surgeon to save your life and not consider the cosmetic fial outcome.

Samir Shureih, MD
Baltimore Plastic Surgeon

Surgery in Mexico

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There are some excellent plastic surgeons in Mexico but I still wouldn't recommend going to a different country for cosmetic surgery. The question is not if you can have all the procedures performed simultaneously, or if a doctor there thinks it is safe or not safe to do, or what the cost is. When everything going right, everyone is happy. The question is, what if something goes wrong or not according to plan? Things can go wrong in the best of situations and you need to be prepared. If you are confident that things such as anesthetic problems, infections, prolonged recovery over weeks, deep vein thrombus and pulmonary embolism, pneumonia, as well as healing problems or capsular contracture of the implants can be handling while in Mexico then you might be fine. If not, it isn't worth the risk.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.