Many factors need to be taken into account when looking at varying costs of cosmetic surgery. One of the primary determining factors is local average fees. Surgeons will generally cost their surgeries relatively similar to those in practice in the same area. This is to stay competitive in the local market while also accounting for the relative cost to practice in a certain area. Office real estate costs vary tremendously depending on the region and certainly factors into costs. Additionally, some physicians charge more due to years of practice, reputation, and specialization. It's very hard to compare prices in the US vs the rest of the world. Costs here in the US are generally higher due to: real estate costs, cost of materials, salaries for the physician and ancillary staff, malpractice costs, anesthesia costs, OR costs/fees, and many more factors. I am generally not a proponent of going abroad for surgery due to the difficulty in adequately assessing the surgeon and building a relationship with that surgeon. Follow-up may be challenging and is an absolutely imperative aspect of surgery. What happens after can be just as important as what happens intraoperatively. Furthermore, should complications arise and you are unable to return abroad for assessment, you may have significant challenges finding a local surgeon to address your issues. If you do, they are not going to incur the risks of managing someone else's complications without significant costs. Such fees are generally far more than you paid to go abroad in the first place. I've seen many patients "botched" abroad and desperately look for someone in the US to then assume their care. They often end up at an academic medical center and try to get their insurance to pick up the costs of salvage repair. I'm not saying that all surgery performed abroad is bad or botched. I have seen some good work too, but the risks are higher than seeking a reputable surgeon in the US.