Beauty and the Best of Us
Medical tourism is the new buzzword. Cosmetic surgery, the kind insurance doesn’t cover, isn’t cheap in the United States. The same operations can be hugely discounted in Latin America. Lately, boomers have been known to travel to Asia for prescribed treatments like colonoscopies at a fraction of the cost. Some patients fantasize that they’ll recoup on a chaise lounge with an umbrella drink in hand. Others prefer the ruse of coming back looking “rested” vs. ’fessing up they’ve undergone the knife. Still others are attracted to the cost savings
By Nancy Clark
Imagine the palm trees swaying above, the breeze off of the ocean just cool enough that sunbathers drift off to sleep in between sips from an umbrella drink. Imagine the rush of the waves, the sand underfoot. Imagine.
Debra can only imagine that scenario. Her trip to Latin America was nothing like that. Hers was a combo of a little nip here, a little tuck there…a surgical getaway.
Medical tourism is a new concept in both hospitality and medicine. Born after Y2K, the concept has been popularized in the half decade since Debra elected to have her eyelid surgery (called a blepharoplasty) plus a neck lift in San Juan.
If anyone could find the right plastic surgeon in the States or anywhere else, it would likely have been Debra. She’s a Registered Nurse and a graduate of University of Texas. As it turns out, that’s the same University where her Costa Rican surgeon trained, a comforting thought to Debra who had vetted plenty of hospitals and surgeons online for months. Online, even six years ago, Debra and other prospective candidates for plastic surgery could check out photos of the foreign hospitals and surgeons’ offices where they would be treated. Bios of the surgeons were posted along with a formal curriculum vitae for each of the four surgeons in the practice Debra had determined was a fit for her.
At 50, Debra was feeling the effects of aging. Her eyelids were heavier than they used to be, her neck not as taut. The fact that she’d been in medicine for her entire career, including a stint in research medicine, gave her a sound appreciation of the near-miraculous outcomes possible with cosmetic surgery these days.
Another bonus was cost. She was living in Boston in 2004 and the cost of living wasn’t cheap. She’d had consults with plastic surgeons in Massachusetts and the average cost of the neck lift alone was $7,500. Eyelid surgery doubled the tab for the rejuvenating surgeries she’d decided could benefit her most.
Alternatively, the cost of her surgery in Latin America plus one night in the hospital and a 10-day stay in a lush 10-room resort that specialized in hospitality for recovering surgical patients was only $3500. And that included the plane fare.
The doctor’s office and Debra exchanged a few emails in between her scheduling her surgery and her arrival in the country, among them a list from the surgeon of the things Debra shouldn’t ingest prior to surgery: vitamin supplements, certain meds, no aspirin because it can cause bleeding.
Debra traveled alone to San Juan. A driver from the hotel picked her up at the airport and took her directly to meet with the surgeon. Her surgery was scheduled for the very next day. A driver transported her to the hospital.
“The hospital was first class,” says Debra. She met with the anesthesiologist and in short order was prepped for surgery. She woke up in recovery hours later and remembers, even though she was still hazy, hearing the surgeon tell her she’d had “some problems.” She was bleeding profusely and she had two Penrose drains inserted in her neck, instead of the Jackson Pratt-type drain she would have expected, even in her present drug-induced blur. The Penrose drain, explains Debra, is rubber tubing inserted in the surgical area that allows drainage naturally. A Jackson Pratt drain would have been a tiny tube inserted into her neck connected to a bulb that could be manipulated manually to drain the area, optimum by all means.
Debra had her first panic attack in the hospital recovery room. Her neck had swollen so badly that she felt she couldn’t breathe. She spent the night in the hospital and the next morning the driver arrived to return Debra to the hotel. Over the next 9 days, the surgeon made house calls two or three more times to Debra’s hotel room. “The resort was excellent really, serving soft meals and helping me take showers,” says Debra.
A huge hematoma had developed on the right side of her neck and the surgeon took Debra to his office to try to drain it with a needle. He was unsuccessful.
Two days later Debra was on a flight headed back to Boston and it wasn’t really until then that she realized how much of the process she hadn’t thought out. “I wasn’t supposed to carry anything of any weight at all,” says Debra. “So I had to have a woman help me get my suitcase off of the carousel.”
She’d been home two days recuperating when her husband remarked that he noticed blood on her neck. Debra knew that triage in this situation meant expressing the blood and infection from the hematoma so she did. But she wasn’t prepared for the volume of blood released into the bathroom sink. She weeps a little now, even six years later, recalling that horrific moment.
She’d accidently opened up a new path to her surgical wound and her husband took Debra directly to the nearest emergency room where a plastic surgeon treated her. “He saw me as an out-patient, and his diagnosis was that it wasn’t a good idea to close up the wound just yet,” Debra remembers. “It didn’t occur to me until that very moment that no surgeon in the U.S. would want to be responsible for my after-care when they hadn’t performed the surgery in the first place.”
As the swelling went down, Debra began to notice little black silk dots underneath the lines in her neck where the neck lift surgery had been performed. She pulled them out with tweezers as did her Boston surgeon when she went back to him for follow-up care. Turns out the sutures used in her surgery were non-absorbable, not the recommended kind used in the U.S.
It wasn’t a surprise then when Debra noticed that her neck really wasn’t tightened or lifted. She had scars behind her ears and now a scar where the hematoma had been. “Anyone can get a hematoma,” she admits. “It can result in nerve damage. I think back on it and I wonder why the surgeon in Costa Rica didn’t take me back to the emergency room to drain the hematoma. After my surgery, my hematocrit (blood count) was down to 22. A normal level would be 32 and 24 is around the point where you get a blood transfusion. The doctor didn’t offer a transfusion, and I wouldn’t have wanted one. He did however prescribe iron tablets when I complained that I was exhausted just walking across my room.”
“I guess you get what you pay for in anything,” she adds.
Six years later, Debra had relocated to Denver. The move was a fresh start in a lot of ways. Debra renewed began research to find a plastic surgeon to perform a revision neck lift surgery. She just “wanted it done right.” She took her time to find Dr. Jeffrey Raval, a double board certified head and neck surgeon practicing in Cherry Creek North. “I saw him in his office every day for the first three days following the surgery and I’ve seen him weekly in his office ever since the surgery. I haven’t had the same sort of experience at all that I had the first time. I never had problems breathing. The skin on my neck is tight like it should be. And just knowing I can get a hold of Dr. Raval if I need him is comforting.”
Debra recently got word that an acquaintance of hers is planning to undergo liposuction in Latin America. Debra’s recommendation: “think it through…think all the way through.”
