The medical tourism industry sells world-class surgery for half the price, followed by a recovery “vacation” at the destination. And while this statement is not completely false – some of the best surgeons in the world are practicing outside the USA and Europe – it is the consumer’s responsibility to make sure they choose one of them.
Understand what a medical license means
Here comes the catch. General medical licenses mean that the person has attended medical school and completed their residency training. In many countries, this also gives the physician the right to perform any type of surgery – including cosmetic surgery – regardless of whether this person has any experience with a plastic surgery residency.
When searching for a cosmetic surgeon, you are not looking for someone with a medical license. You are looking for a board-certified plastic surgeon, whose qualifications have been assessed by the relevant national governing board.
In Korea, this is KAPS; in Brazil, SBCP; and in the UK, BAAPS. These institutions are responsible for setting standards of surgical training, qualification exams, and continuing education, which makes a specialized surgeon different from any other MD with a cosmetic practice. A title “cosmetic surgeon” does not necessarily mean “plastic surgeon”; in most cases, it is not even a protected title.
ISAPS maintains a database of verified board-certified plastic surgeons by country. It is far from being comprehensive, but having a name on this list means that this surgeon’s qualification was evaluated according to a national standard. Use it as a starting point for your research, not as your only source.
Don’t just check the surgeon’s credentials, verify the facility
Plastic surgery board certification proves the surgeon’s training and experience. It does not tell anything about the place where you will be operated on.
Facility-level accreditation is another story. Joint Commission International (JCI) is probably the most reputable accreditation agency for medical facilities worldwide. JCI’s standards are recognised as the closest thing we have to global standards of healthcare safety. Among other things, JCI’s standards are particularly strong in patient safety, infection control, medication safety and medical emergency preparedness.
The Korean government has established its own system of evaluations, similar to JCI, carried out by the Korean Institute for Healthcare Accreditation. Clinics that have passed this evaluation display the seal. Make sure to ask your prospective facility if it has any national or international accreditations, and make sure you can verify them in the relevant registry. If you encounter any evasiveness or cannot find your facility there, this is a red flag.
Additionally, you should find out if there is an on-site anaesthesiologist (more qualified than a nurse-anaesthetist), resuscitation equipment and the clinic’s emergency procedure in case of a surgical complication. Being able to stabilise the patient and transport him/her to the nearest trauma capable hospital in a matter of minutes can save lives.
Match your surgeon’s results to your anatomy
Before-and-after pictures are not marketing materials. Think of them as surgical records that show potential patients what type of results the surgeon achieved with previous patients. This way you can learn more about the surgeon’s experience with patients who have similar anatomy or desired surgical outcomes.
It is especially important for facial surgeries and, in particular, blepharoplasties. Blepharoplasty principles used for Western patients do not always match those used for Asian patients. Whether a person has natural eyelid folds or not, quantity and distribution of the orbital fat, the position of the upper eyelid relative to the tarsal plate – all these factors are significantly different between distinct population groups.
Time and again, we see that a blepharoplasty result that turns out “too obvious” or uneven may reflect a mismatch between the surgeon’s experience and the patient’s anatomical characteristics. Even small mistakes in blepharoplasty technique can result in an overly prominent or under-corrected result and an unnatural appearance. This is probably the main reason for most reported complications of double eyelid surgeries.
According to statistics, blepharoplasty is the most commonly performed cosmetic surgical procedure worldwide, with more than 1.4 million eyelid procedures performed each year. At the same time, South Korea is the country with the highest number of plastic surgeons per capita, with specialisation in blepharoplasty surgery. Prospective patients seeking double eyelid surgery Korea should focus on evaluating surgeons’ portfolios for results on patients with similar anatomy, looking at crease height, symmetry and the overall natural appearance of the result.
When reviewing surgeons’ portfolios, pay attention to consistent results achieved on multiple patients, and ask how many procedures of this particular type your surgeon performs. 100 procedures are not the same as 10.
Require a personal consultation with your surgeon
This is the non-negotiable requirement, and the one that many patients skip.
Medical tourism patient coordinators serve a purpose – booking, translation, transport arrangements, etc. Some are very good at this job. But they are not doctors, and their business model is focused on booking patients, not on providing a proper surgical consultation. Discussing your medical history, procedure options and goals, and receiving answers through a patient coordinator and translator is not the same as a direct consultation with the clinician.
Before you even book anything, you should have a personal consultation with the surgeon who will personally operate on you. Not the surgeon’s colleague, not the assistant – this surgeon. Such consultation should cover your medical history, the surgical technique chosen by the surgeon and his/her rationale for using it, realistic expected outcome and risks associated with your case, and revision plan, if necessary.
If the clinic doesn’t allow you to discuss all of this before you travel, walk away. A clinic that values its patients will accommodate this request.
Plan your recovery time before booking your plane tickets
Returning home too soon after surgery is not just inconvenient. It is a dangerous mistake.
Traveling long distances after any surgery performed with anaesthesia increases the risk of formation of deep vein thrombosis (DVT), i.e. blood clots in legs. In addition, the pressure changes in the cabin affect the healing process of the tissues.
For facial surgeries, the general recommendation is to spend at least 7 days in the destination country before going back home. For body contouring procedures (liposuction, abdominoplasty and others), the no-fly period is at least 14 days. Some surgeons recommend even longer stays, depending on the procedure.
This changes all your travel plans. You are not traveling for a short weekend vacation. Plan your budget, taking into consideration your accommodation costs, food, local transportation costs for the recovery period, and your prescribed medications for recovery.
Build your budget based on the real costs
Your quoted surgical fee is not the whole sum you have to pay.
Many people are underestimating their total cost, comparing the surgical fee alone to the whole cost of the surgery performed in their country, which already includes facility fees, anaesthesia fees and post-op visits. They are comparing apples to oranges.
International medical trip costs include airfare, accommodation for the recovery period, local living expenses, medications, garments and products prescribed for recovery and, perhaps, lymphatic massage.
There are also unexpected expenses: if you develop a complication requiring an extended stay before you can fly home, you may have to move to a hotel because you cannot stay at the clinic anymore and need to pay the room rate. Moreover, you may be missing work for several weeks before you are able to return home.
Some clinics provide revisions for free within a certain time period as part of the surgical package. Make sure you get this commitment in writing. A contingency fund (usually 20-30% of the total estimated cost) needs to be reserved before the surgery.
Know the legal environment of the destination before traveling
Medical malpractice law is national law. The protections in your home country don’t apply abroad.
If something bad happens during the surgery, your rights are defined by the laws of the destination country. Some countries make it really easy to sue a surgeon, some countries don’t. Some countries keep large amounts of money aside for patient compensation, some keep very little. There is nothing consistent in the foreign laws and regulations concerning medical complaints – each country is different.
Before choosing the destination country, research how the medical complaints are handled there. Find out if the surgeon you want to go with has professional liability insurance and what this insurance covers. Ask the clinic whether it has a process for handling medical complaints and what that process is. This is not a threatening question – a good clinic will answer you openly and honestly.
This is not an argument against international surgery. This is an argument for researching the environment before making a choice.
A checklist mentality can save you from disasters
Patients with good experiences of international plastic surgery share one characteristic – they take pre-planning seriously. They check credentials independently. They talk to the surgeon before booking anything. They plan their recovery period before planning return travel.
Patients who have problems usually skip at least one of the steps above to gain convenience or save money. These small oversights can lead to major complications later. Do the work before traveling.
Thank you so much for reading! – xo N
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this is a contributed post.
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