When doing Lipo 360, why do doctors in the Dominican Republic remove more fat/better sculpture than doctors in the states?

Patients should remember that having a procedure performed in the US in a certified facility by a board certified physician guarantees adherence to the highest standards of safety. The governmental oversight which protects patients by establishing these standards cannot be overstressed. With respect to your specific question, large volume liposuction is a much higher risk procedure than many patients appreciate. The volume limits for office lipoaspirate is generally 4-5 liters (not pure fat). Any more than that usually necessitates overnight admission to the hospital for monitoring. This may explain the perception that aggressive liposuction is best pursued elsewhere. However, potential cosmetic tourists should be informed of the risks they may be taking. Understanding why “lipo-tourism” or cosmetic surgery tourism is an attractive option for those seeking plastic surgery is not difficult. Who would not be interested in combining what many believe to be “minor” surgery with travel to an exotic destination at a fraction of the cost of the equivalent procedure domestically? What is easily overlooked in the excitement of monetary savings are the potential physical and health costs associated with post operative complications (both in terms of the patient’s financial liability and subsequent morbidity).
Unfortunately no surgery is free of the risk of potential complications. Patients have complications here just as they do elsewhere. The difference…proximity to your operating surgeon.

In the case of lipo-tourism, complications can be magnified by multiple factors:

-Inadequately or unregulated foreign facilities and hospitals

-Inaccessible medical records or poor documentation

-Delayed post complication care due patient reluctance to seek medical attention after returning home (for financial reasons) or difficulty in finding a surgeon willing to deal with another’s complications

-Infections stemming from foreign and unfamiliar or resistant pathogens

It is unlikely that this phenomenon will come to an end, rather, trends demonstrate an increasing popularity. Yet it remains vitally important that patients are educated about the risks of “lipo-tourism” in order to minimize the likelihood of complications.  Patients are encouraged to check the credentials of any potential surgeon (foreign or domestic). To aid this, the International Society of Aesthetic Plastic Surgeons is developing a program to enact certification standards and recognize surgeons’ competency and dedication to patient safety (in a fashion similar to the American Board of Plastic Surgeons).  Patients and physicians should also be aware of the U.S. Joint Commission on International Accreditation which to date has accredited some 80 hospitals in 18 countries.

Seeking care through a surgeon certified by the American Board of Plastic Surgeons is always regarded as a prudent choice. However, for those patients seeking care abroad, they need to be well informed of the added risks to aid them in making safe decisions regarding their care.

It's inaccurate to say that doctors in Dominican Republic remove fat better than doctors in the US.  In the US, a board certified plastic surgeon performs liposuction very well, and does it to the highest safety standards in an accredited surgery facility.

the more fat you remove, the thinner the areas will look.  also, the more the area might show wrinkly or saggy skin.  many latino patients have skin that is more robust and elastic than most caucasian patients, so there's a big difference between what can be achieved in the two populations.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. 

It's hard to answer your questions without knowing what before/after pictures you have looked at or what surgeons you are referring to.  I think that is a very significant generalization and misrepresentation of surgery abroad vs here in the United States.  One of our biggest concerns here is patient safety, and we do not practice large volume liposuction in an ambulatory setting (where you go home after surgery instead of staying in the hospital) due to concerns of blood clots, dehydration and fluid shifts, and other post-operative complications.  We often also take care of many complications suffered by patients who have gone overseas looking for inexpensive plastic surgery.  In the end, this is your body, and you generally get what you pay for.  Be very careful where and by whom you chose to have your surgery! 

I think that is a gross misstatement. First, we have no idea whether posted before and after have been photoshopped.  Second, in the US, we have much higher standards of accountability in terms of governmental regulation and malpractice risk which protect patient safety.  Large volume liposuction is not permitted in New York based on morbidity concerns. Shopping for plastic surgery is not the same as shopping online for a dress that can be returned if you don't like the fit!