#8 - Beauty Without Borders: Cosmetic Surgery and Medical Tourism

Explore the dynamic world of cosmetic surgery and medical tourism. Understand their profound impact on personal identity, societal norms, and global healthcare economies. We examine trends in cosmetic and plastic surgery, analyzing how the pandemic has influenced these trends. Learn about the ethical considerations and cultural shifts surrounding cosmetic procedures, and discover how medical tourism is reshaping healthcare perceptions and practices worldwide. Delve into the motivations driving individuals to seek beauty enhancements abroad and the balance between affordability, quality, and safety. Tune in to learn about the hotspots of medical tourism and their impact on the United States.

Researched and produced by Asiya Said.

Timestamps:

(00:00) Episode Introduction

(03:42) Trends in Cosmetic Surgery

(06:50) Effects of COVID-19 on Cosmetic Surgery

(09:04) Effects of COVID-19 on Medical Tourism

(10:59) Cost of Cosmetic Surgery in the US

(13:45) Ethical Issues of Cosmetic Surgery

(14:20) Role of Gender in Cosmetic Surgery

(16:12) Body Dysmorphic Disorder (BDD) and Cosmetic Surgery

(19:17) Reid Ewing’s Experience with BDD and Cosmetic Surgery

(22:03) BDD, Medical Tourism, and Suzy Katz

(24:13) Implications for Teenagers

(26:42) Controversial Surgeries (BBLs and Leg Lengthening)

(28:52) Medical Tourism Destinations: South Korea, Thailand, Turkey, and Brazil

(32:37) Trends in Medical Tourism

(34:58) Cost of Cosmetic Surgery Abroad

(37:47) Risks of Medical Tourism

(39:53) Kidnapping and Fungal Infections

(43:06) Regulations in Medical Tourism (“Ghost Doctors”)

(46:12) Impact of Medical Tourism on the US

(48:09) Conclusion

(49:35) Outro

Linktree: linktr.ee/gustavofrancopod

Chapters

• 0:00 Episode Introduction
• 3:42 Trends in Cosmetic Surgery
• 6:50 Effects of COVID-19 on Cosmetic Surgery
• 9:04 Effects of COVID-19 on Medical Tourism
• 10:59 Cost of Cosmetic Surgery in the US
• 13:45 Ethical Issues of Cosmetic Surgery
• 14:20 Role of Gender in Cosmetic Surgery
• 16:12 Body Dysmorphic Disorder (BDD) and Cosmetic Surgery
• 19:17 Reid Ewing’s Experience with BDD and Cosmetic Surgery
• 22:03 BDD, Medical Tourism, and Suzy Katz
• 24:13 Implications for Teenagers
• 26:42 Controversial Surgeries (BBLs and Leg Lengthening)
• 28:52 Medical Tourism Destinations: South Korea, Thailand, Turkey, and Brazil
• 32:37 Trends in Medical Tourism
• 34:58 Cost of Cosmetic Surgery Abroad
• 37:47 Risks of Medical Tourism
• 39:53 Kidnapping and Fungal Infections
• 43:06 Regulations in Medical Tourism (“Ghost Doctors”)
• 46:12 Impact of Medical Tourism on the US
• 48:09 Conclusion
• 49:35 Outro

Transcript

Introduction

Welcome to a new episode of the Gustavo Franco Podcast! Today, we’ll be exploring the fascinating world of cosmetic surgery and medical tourism.

We’ll start by peeling back the layers of a topic that's as captivating as it is complex - the dramatic transformation of cosmetic plastic surgery in the United States. This is a realm that's not just about vanity; it's about societal shifts, technological triumphs, and for many people it can also be about personal empowerment.

In 2018, Americans poured a staggering $16.5 billion into cosmetic plastic surgery and minimally invasive procedures. That's a four percent jump from the year before. This isn't just about splurging on looks; it's a clear signal of a broader trend. We're seeing a shift in societal values where enhancing one's appearance through medical intervention is increasingly seen as a standard option for self-improvement.

Let's take a look back to the year 1997, since then there has been a remarkable 446% surge in cosmetic procedures. This significant increase over two decades reflects a broader societal acceptance and normalization of cosmetic enhancements. What was once considered niche or taboo has transformed into a mainstream phenomenon, with individuals from diverse demographics seeking procedures addressing concerns ranging from subtle facial touch-ups to comprehensive body contouring.

So, what's fueling this surge in interest? It's a blend of cutting-edge medical technology and evolving societal attitudes. Advances in surgical techniques have dramatically improved the safety, efficacy, and recovery times of these procedures. This technological evolution has made cosmetic surgery more approachable and less intimidating to a wider audience.

But it's not all about the tech. There's been a significant shift in how we view beauty, aging, and personal choice. The societal lens through which we view elective cosmetic interventions is changing, moving towards greater acceptance and reduced judgment. It reflects a society increasingly comfortable with the idea of pursuing aesthetic enhancements as a form of personal expression and improvement.

Society is also becoming increasingly more comfortable with the idea of traveling for these cosmetic procedures. With the high cost of surgery in America and the increasing number of people seeking cosmetic surgery, medical tourism for many seems like the perfect opportunity. Here, we’ll discuss the ethics of medical tourism as well as dive into the internationals hotspots for this medical tourism. As we go deeper into this topic we’ll also look into some commonly asked questions about medical tourism such as do the risks outweigh the benefits? And is it really as good of a deal as it seems?

One thing is for sure. As we continue to explore this interesting evolution of cosmetic plastic surgery in America, it becomes clear that this field is about much more than altering appearances.

Trends in Cosmetic Surgery

First, let's begin with the latest trends in cosmetic surgery. The year 2022 brought us some eye-opening statistics that paints an intriguing picture of the trends in both cosmetic and reconstructive procedures in the United States.

We've seen a whopping 26.2 million procedures in 2022, a figure that underscores a significant rise in the popularity of cosmetic and reconstructive treatments. It's clear that more and more people are turning to these procedures for various reasons.

Let’s break down that number. We're talking about a 19% increase in cosmetic surgeries since 2019, totaling 1.5 million more procedures. But what were the most significant procedures during this time? I think it’s interesting to understand the landscape of these procedures at the beginning of this conversation so we recognize what people are looking for. Leading the charge is Liposuction, with 325,669 procedures. For those unfamiliar, Liposuction is a surgical procedure that removes fat from specific body areas to reshape them. This procedure alone saw a 23% jump since 2019

Breast Augmentations aren’t far behind, with nearly 300,000 procedures. This surgery involves using implants or fat transfer to increase the size of the breasts. Following Breast Augmentations are Abdominoplasty, or tummy tucks, which have seen a massive surge of 37%. Tummy tucks involve removing excess skin and fat from the abdomen to create a firmer profile.

We also saw a rise in Breast Lifts and Eyelid Surgeries. But here's a standout trend – Breast reduction procedures soared by 54%, with over 71,000 surgeries. This procedure reduces breast size to alleviate discomfort and/or achieve a proportionate body figure. It's a clear indicator of people prioritizing comfort and health alongside aesthetic enhancement.

But we can’t forget about Noninvasive procedures, which are really making waves in recent years. These treatments, like laser-based skin rejuvenation or injectables, offer less recovery time and discomfort. They're perfect for those looking for a quick beauty enhancement without the commitment of surgery

Here's where it gets interesting. While traditional surgical procedures have slightly decreased, noninvasive ones have skyrocketed by 180% since 2000. In 2022, Neuromodulator Injections commonly known as botox, which is used to temporarily paralyze muscles to reduce wrinkles, topped the list with an astounding 8.7 million procedures. Hyaluronic Acid Fillers, used to restore facial volume and smooth lines, also saw immense popularity.

Covid-19 Affect on Cosmetic Surgery

Speaking of trends in cosmetic surgery, it’s important to look at how the Covid-19 pandemic affected this industry. Rewinding to 2020, a year of unprecedented changes, the American Society of Plastic Surgeons reported a drastic downturn in plastic surgery, a first since the early 2000s. We saw a steep drop from 18.4 million procedures in 2019 to 15.6 million in 2020, marking a 15% decrease. But, interestingly, this trend saw a dramatic turnaround by 2021, with facial cosmetic surgeries increasing by 40%. Not only did cosmetic procedures return to pre-pandemic numbers, but it far exceeded it.

During a time of economic uncertainties, a surprising trend emerged. According to the Inaugural ASPS Insights and Trends Report of: Cosmetic Surgery in 2022, a significant number of cosmetic-focused practices have seen business booming, with some reporting even doubling their clientele compared to pre-pandemic times

So why are we seeing this massive increase in people changing their physical appearances after the pandemic? One reason could be the heightened self-awareness, thanks to hours of video meetings for school and work. This new reality, where our virtual image is front and center, has given rise to phenomena popularly referred to as 'Zoom face' and 'Zoom dysmorphia,' where people are increasingly conscious of their on-screen appearance.

A study sheds more light on this shift as it revealed that 56.7% of providers noted an increase in patients seeking cosmetic consultations compared to pre-pandemic times. Moreover, a whopping 86.4% of these providers stated their patients cited video-conferencing calls as a reason for seeking cosmetic surgery.

But remember, it's not just about surgeries. Non-surgical treatments have seen a considerable rise. Since the first talks about the pandemic in 2019, Botox treatments increased by 54% and filler treatments by 75%.

Covid-19’s Impact on Medical Tourism

But another part of the pandemic that we must consider are travel restrictions. This brings up the question of what was the impact of the Covid-19 pandemic on medical tourism

When COVID-19 started, fewer people were flying overseas for cosmetic surgeries. But even with fewer people traveling for these procedures, healthcare systems around the world were still facing a lot of pressure.

Due to the overwhelming issues health care providers and hospitals were facing during the pandemic, there was an increase in cosmetic surgery complications. People would go abroad, have surgery, then come back home with issues. This all added more stress to hospitals already dealing with COVID-19.

Here, the European Association of Societies of Aesthetic Plastic Surgery had to make a big call. They put a pause on all cosmetic surgeries with the goal of hospitals putting all their focus on fighting the pandemic.

What's really interesting is that people kept going abroad for cosmetic surgery, even with all the warnings and travel bans. This just goes to show how personal choices about health and beauty can clash with broader public health needs during a pandemic.

On one side, you've got people wanting to change how they look. On the other hand, there's a need to keep everyone safe during a health crisis. And these may clash, as it many times did during the pandemic.

This whole thing has brought up some tough questions. Does individual autonomy matter during a public health crisis? Is cosmetic surgery necessary to a person’s physical and mental well-being? It's not just about the extra challenges for hospitals but also about the right thing to do when it comes to personal health choices during a pandemic. It's a tricky balance between what we want as individuals and what's best for everyone's health.

Why is Cosmetic Surgery in America Expensive?

Now, let's delve into the financial side of cosmetic surgery in the United States, where the costs can often be surprisingly high. A prime example is a tummy tuck, one of the most expensive surgeries. On average, a tummy tuck in the U.S. will set you back about $8,425, but prices can range from $4,500 to a staggering $18,447.

So, what's driving these costs? First up, the operating costs in clinics and surgical facilities. These places are decked out with state-of-the-art equipment, they adhere to strict safety protocols, and are committed to a high standard of care – all of which adds up. In America, maintaining high standards in medical procedures isn't optional – it's a necessity. Clinics and surgeons invest heavily in training, certifications, and adhering to medical guidelines. But this commitment to quality and safety comes with a price.

Then there's the matter of expertise. Cosmetic surgeons undergo extensive education and training. Their skill level, honed over years of experience, directly influences the cost of their services. It's a classic case of getting what you pay for – top-tier expertise equals a higher price tag.

Now, let's address a significant factor – insurance, or rather, the lack of it. Most cosmetic surgeries are elective, meaning they aren't covered by health insurance. This puts the entire financial responsibility on the patient, affecting the procedure's accessibility.

Accreditation plays a crucial role too. Many leading cosmetic surgery facilities in the U.S. are accredited by prominent organizations, ensuring adherence to strict safety standards. This accreditation is essential but leads to high operational costs.

**Medical technology is yet another major component to the high cost and it is continually advancing. For example, innovative tools like Piezoelectric inserts (PEI)**used in surgeries like Piezo Ultrasonic Rhinoplasty. This tool ****allows surgeons to selectively work on bones and hard cartilage without damaging soft tissues. While this increases the safety and accuracy of procedures, it also contributes to a higher price tag.

Despite these costs, there are financing options available. Many clinics offer plans to spread the cost over time, and medical credit cards provide dedicated lines of credit for healthcare expenses. Additionally, personal loans and specialized healthcare financing companies offer structured payment options.

Ethical Issues of Cosmetic Surgery

The high cost of surgeries is the only one of the issues people have with cosmetic surgery. Ethical considerations of cosmetic surgery have been a topic of recent debates as people are starting to ask the question of why people go under the knife to change their appearance. Let’s try to answer this by diving into the ethical considerations of cosmetic surgery, exploring questions about patient decisions, ensuring clear communication, and understanding its broader societal implications both abroad and within the United States.

• Gender

Starting with an issue that is often glossed over in discussions about cosmetic surgery - the over representation of women. According to the American Cosmetic Association, a staggering 90% of cosmetic procedures are performed on women. Let's unpack what this means for societal norms, female aesthetics, and the ethical considerations at play

This statistic points to a deep-rooted trend in our society, where the focus on female aesthetics is overwhelming. It's a reflection of the intense pressures that women face, often nudged by media portrayals, cultural influences, and ingrained societal expectations. This skewed ratio in cosmetic surgeries isn't just about numbers; it's a mirror to our societal fabric.

The heavy concentration of cosmetic interventions on women raises critical questions about autonomy and consent. How much of the decision to go under the knife or needle is influenced by these external pressures? Are we, as a society, subtly compelling women to conform to a certain aesthetic ideal?

The implications go beyond the physical. This trend has profound effects on mental health, self-esteem, and body image. Women, bombarded with an idealized version of beauty, might feel an implicit, if not explicit, push towards cosmetic procedures. It’s a scenario where personal choice might be entangled with societal expectations.

This leads us to a crucial ethical crossroad. Are we respecting individual autonomy when societal norms heavily influence such personal decisions? It’s a delicate balance, where the line between personal desire and societal pressure blurs. As we go deeper into the topic of ethical issues in cosmetic surgery it’s important to think about this gender gap.

• Mental health

This brings us to the topic of mental health. Mental health presents a whole new set of issues to the debate of individual autonomy when it comes to getting cosmetic surgeries.

• Body Dysmorphic Disorder

Let’s get into the intersection of mental health and cosmetic surgery by looking at Body Dysmorphic Disorder, or BDD. This is a condition that significantly influences patients in the cosmetic surgery world, so let’s explore the depth of this issue.

Let's start by understanding what BDD really is. Picture this: You're fixated on a flaw in your appearance, but it's not just any flaw. It's a perceived or even an imagined imperfection that becomes an obsessive focus, severely impacting your life. This isn't about a simple dislike; it's a deep-rooted issue that distorts self-perception.

Now, bringing BDD into the cosmetic surgery scene. A survey of 173 professionals who perform cosmetic procedures sheds light on an interesting discovery. About two-thirds of them said over the past years, they have met about 1 to 5 patients who they had body dysmorphic disorder. This poses a real ethical question for surgeons – to operate or not operate?

The dilemma deepens as a staggering 84% of these surgeons have turned away patients they believed had BDD, wary of worsening the condition. But there's a flip side: 84% also reported unknowingly operating on BDD patients, leading to mostly negative outcomes. It's a tightrope walk between ethical responsibility and patient autonomy

But there's more: only 30% of surgeons view BDD as a deal-breaker for surgery. This opens up a complex discussion about ethical decision-making in the world of cosmetic surgery. How do you balance psychological impacts with a patient's desire for physical change?

The stakes are high when operating on patients with untreated BDD can lead to dire consequences. We're talking lawsuits, and alarmingly, physical altercations. Shockingly, 2% of plastic surgeons have faced threats, and 10% have encountered violence and legal actions from BDD patients.

This brings us to the crucial role of preoperative assessments. Many surgeons lean on intuition rather than standardized tools for diagnosing BDD. The need for comprehensive psychiatric assessments using validated tools is paramount. It's about seeing beyond the physical, delving deep into a patient's psyche.

But let's zoom out for a moment. The prevalence of BDD in cosmetic surgery patients isn't just a medical issue – it's a societal one. It reflects the broader impact of societal beauty standards on mental health. It's a conversation we need to have, exploring the intersection of societal norms, mental health, and cosmetic surgery.

Experience with BDD & Cosmetic Surgery

It’s important to see these people's experiences as more than just numbers, so let’s discuss actor Reid Ewing's account of his struggles with Body Dysmorphic Disorder and the impact of cosmetic surgery.

You may know Reid Ewing from the hit TV show 'Modern Family.' Beyond his on-screen presence, Ewing's personal journey with cosmetic surgery and BDD is both saddening and eye-opening. His story provides crucial insights into the often-overlooked psychological aspects of cosmetic procedures.

Reid Ewing's experience with cosmetic surgery began with what he perceived as physical imperfections. Driven by his battle with BDD, he underwent multiple unnecessary procedures that did not bring him the satisfaction or relief he sought. This is a common reaction that patients with BDD have to surgery.

So what does Ewing’s experience tell us about the ethical issues of cosmetic surgery? It shows the critical issue of a lack of mental health assessments. Ewing revealed a shocking fact: none of the four doctors he consulted had mental health screenings in place. Their focus was on the physical aspect, with only a glance at his mental well-being, limited to a basic inquiry about depression. And keep in mind that these were probably some of the best doctors in the field.

Ewing's experience highlights a significant oversight in the cosmetic surgery industry. The emphasis often lies on the external transformation, while the internal, psychological state of the patient may be neglected. This gap in patient care can lead to adverse outcomes, especially for individuals struggling with mental health conditions like BDD.

In sharing his story, Reid Ewing isn't just seeking understanding; he's advocating for change. He calls for the integration of robust mental health assessments into the preoperative process of cosmetic surgery. This isn't merely a suggestion; it's a plea for a more holistic approach that considers both physical and psychological well-being.

Ewing's story is a call to action for the cosmetic surgery industry. It's a reminder that patient care should extend beyond the operating table and delve into the realms of mental health and body image. Incorporating comprehensive mental health screenings can safeguard patients, ensuring that their decisions are made with a clear understanding of the psychological implications.

Reid Ewing's journey urges us to look beyond the surface and recognize the profound impact cosmetic surgery can have on mental well-being.

Experience with BDD and Medical Tourism

This brings us to an eye-opening experience on how medical tourism and body dysmorphic disorder connect. Let's set the scene: Suzy Katz, caught in the relentless grasp of body dysmorphia, found herself in a never-ending quest for the perfect body. But in the U.S, the cost of cosmetic surgery made her realize she’d have to give up on her living expenses such as food and rent for the next two years in order to achieve her goals, then entered what she believed to be the solution to her problem—medical tourism. Medical tourism provided her the opportunity to get multiple surgeries for a fraction of the cost.

In her revealing piece, 'As a Former Medical Tourist, I Have Complicated Feelings about Plastic Surgery,' Suzy lays her journey of seeking relief through cosmetic surgery.

Her story isn't just about chasing beauty across borders – it's about battling mental health struggles, specifically body dysmorphia, and how this led her down the path of multiple surgeries she regretted.

She left her home for the promise of transformation in Colombia – a country where cosmetic surgery didn't mean breaking the bank. Suzy's journey was fueled by hope but shadowed by complexity and risks to her physical health.

Suzy's story unfolds with each surgery abroad driven by cost, yet blind to the lurking risks. It was a balancing act between financial reality and the psychological depths of body dysmorphia. She thought she was always one surgery closer to the impossible body.

Suzy's experience isn't just about saving thousands of dollars. It's a profound look at how the allure of affordable beauty can eclipse the essential care for mental health, especially when dealing with something as complex as body dysmorphia.

Her story serves as a wake-up call advocating for the need for a holistic approach to cosmetic changes and mental health screening.

• Teenagers

Another ethical issue facing cosmetic surgery is teenagers getting work done. In 2017 alone, around 229,000 cosmetic procedures were performed on young people between the ages of 13 and 19. This number isn't just a statistic; it's a reflection of adolescent self-perception, societal influences, and the temptation of cosmetic enhancements.

Let’s unpack this number by looking at a study that tracked teens from 11 to 18 years old. The researchers found something intriguing. Body image satisfaction often peaks at 18, suggesting many teens grow more content with their appearance over time, irrespective of undergoing surgery. This raises a critical question: how necessary are cosmetic interventions during these formative years?

Another key factor in this discussion is the average onset age of Body Dysmorphic Disorder – 16 years old. Remember, BDD involves an unhealthy obsession with perceived physical flaws and can profoundly impact an adolescent's self-esteem and mental health."

In today's era, where social media exerts a powerful influence, we see an increasing number of teenagers opting for plastic surgery. Their reasons vary, from health needs to addressing features they are getting bullied for. This is why the American Society of Plastic Surgeons stresses the importance of understanding a teen's motivation and conducting thorough preoperative evaluations. But can we really pick and choose cases that are worthy of cosmetic surgery? Well, the answer is no. But we can do our best to ensure they make informed and appropriate decisions.

In the United States, the rules are clear – you must be 18 to consent to cosmetic surgery on your own. For those under 18, parental consent is a mandatory step. This regulation is crucial for ensuring that young individuals make such significant decisions with adequate guidance and support.

However, the scenario changes in the context of medical tourism. Several countries popular for cosmetic procedures lack standardized age restrictions, opening up ethical dilemmas about offering such surgeries to teenagers. This lack of regulation highlights a gap in safeguarding the well-being of teens seeking cosmetic surgery.

• Controversial Surgeries

Now let’s talk about controversial cosmetic surgeries. These surgeries have gained immense popularity, but not without their share of ethical and safety concerns.

First up, Brazilian Butt Lifts or BBLs. This procedure has skyrocketed in popularity, driven by the desire for curvier, more contoured figures. Despite its appeal, BBLs have raised significant safety concerns, particularly regarding the risk of fat embolism.

Fat embolism is a serious complication, where fat enters the bloodstream and travels to the lungs, potentially causing life-threatening issues. This risk has brought BBLs under intense scrutiny, with medical professionals urging caution and highlighting the importance of choosing qualified surgeons.

The controversy deepens with instances of BBLs being performed by unqualified practitioners, often in less-regulated environments. This has sparked discussions about the need for stringent safety measures and choosing reputable clinics to ensure patient safety.

The trend of traveling for affordable BBLs in countries like Turkey and Mexico, and other countries in South America poses additional risks. While the cost savings are appealing, they must be weighed against potential complications, emphasizing the need for thorough research and informed decision-making.

Another controversial surgery is leg lengthening surgery. Originally intended for medical conditions affecting height, it's now sought after for cosmetic height alterations. There is an increasing number of men and women seeking to increase their heights. This surgery has led to ethical and safety debates.

The procedure involves breaking the shin bones and gradually extending them. It's a complex, invasive surgery with risks like infection, nerve damage, and delayed healing. The pursuit of cosmetic height changes raises questions about societal beauty standards and the pressures driving these decisions.

Medical Tourism

Popular destinations

But to understand the world of cosmetic surgery and medical tourism, let’s look at some global hotspots known for their exceptional services and the unique factors driving their popularity.

Our first stop is South Korea, often hailed as the 'plastic surgery capital of the world.' It's not just a nickname; South Korea boasts the highest number of cosmetic surgeons per capita globally. One of the most popular surgeries in South Korea is the blepharoplasty commonly known as double eyelid surgery. Monolids are a common feature in Asian countries. The surgery creates a crease in monolids creating double eyelids. The country's commitment to excellence is evident in its meticulous certification process for medical tourism providers. Incheon International Airport even features a medical tourism information center, a testament to South Korea's strategic approach to attracting medical tourists. Districts like Gangnam are filled with people seeking top-tier cosmetic treatments, firmly positioning South Korea as a leader in the industry.

Thailand is renowned for its expertise in gender reassignment surgery. Each year, Thailand welcomes hundreds of transgender people across continents, eager to undergo life-changing procedures. Thai clinics, known for their specialization in gender reassignment surgeries, offer a welcoming and inclusive environment. Coupled with board-certified surgeons and advanced facilities, Thailand provides high-quality care at a fraction of Western prices. It’s important to also know the country's Joint Commission International-certified hospitals and American Board-certified doctors ensure adherence to international medical standards. Thailand's allure isn't just medical; it's also a travel paradise, making it an irresistible destination for medical tourists.

Now, let's talk about Turkey, a name synonymous with quality and affordability in plastic surgery. The country's skilled surgeons and rigorous healthcare safety measures have attracted global attention. One recent trend capturing social media's eye is 'Turkey teeth' - a term referring to the sought-after dental procedures available there. It describes overly perfect white teeth to some it’s considered botched teeth due to its unnatural look. Despite mixed reviews, the trend reflects Turkey's rising influence in the global cosmetic surgery scene, bolstered by its easy accessibility and cost-effective treatments.

Lastly, this brings us to Brazil, a country that accounts for an astounding 10% of the world's plastic surgeries. Breast augmentations is one of the most popular cosmetic procedures in Brazil with over 200,000 surgeries in 2018, it accounts for about 14% of all breast augmentations performed around the world. Ranking second in the world only to the U.S. in terms of the sheer number of procedures performed annually, Brazil has cemented its status as a major medical tourism destination in the cosmetic surgery world.

India, Czech Republic, and Poland are also countries that are becoming increasingly popular with medical tourism. Each of these countries present a unique experience from cost-effectiveness to quality care and technological advancements - that position them as leading destinations in the ever-evolving landscape of cosmetic surgery tourism.

Trends

Let’s look at trends in medical tourism. The practice has undergone a fascinating journey from 2000 to 2017. It's a story of growth, transformation, and the ever-increasing allure of crossing borders for healthcare.

Let's set the scene with some striking numbers. Back in the year 2000, 2.4 billion dollars were spent on medical tourism. Fast forward to 2017, and that figure jumped to an impressive 11 billion dollars. That's a whopping 358% growth over 17 years, showcasing a significant shift in the landscape of international healthcare.

Now, think about this - in 2000, medical tourism expenditures made up 0.6% of total international visitor spending. By 2017, that number had doubled to 1.2%. There was also a steady annual growth rate of around 9% in total medical tourism expenditure. What does this tell us? Medical tourism isn't just growing; it's becoming a major player in the general global tourism expenditure scene and is a reason for travel for many.

So, what's fueling this remarkable surge? It's a mix of factors – advancements in medical technology, the search for specialized treatments, the allure of cost-effective healthcare options, as well as the increasing numbers of people seeking these procedures as they become less and less stigmatized. These elements are drawing more and more people to seek medical services beyond their home countries.

But there's more to it than just numbers. It's about confidence and recognition in international healthcare solutions. It's about people's willingness to travel for quality care, driven by trust in medical advancements and a desire for affordability.

As medical tourism continues to be normalized in the international travel and healthcare sectors, its growth becomes a testament to a world that's increasingly open to exploring diverse healthcare options. There is no one size fits all healthcare solution or hotspot for these procedures and people are more and more willing to explore.

Why is Cosmetic Surgery Abroad Cheaper

A big reason for the rising popularity of traveling abroad from the United States for cosmetic surgeries is the significantly lower cost.

First off, it's no secret that the United States is notorious for its high healthcare costs as we previously discussed, often making medical procedures and treatments unobtainable, especially those that aren’t covered by insurance. This is where medical tourism offers an attractive alternative. Many countries provide the same, and sometimes arguably better, quality of care at significantly lower prices. It's a game-changer for those seeking affordable healthcare options.

But what's the secret behind these lower costs? It boils down to variations in labor and operational expenses. In many of these destination countries, the cost of living is lower, allowing medical facilities to offer competitive pricing without losing quality.

And then there's the pull of all-inclusive surgery travel packages. These aren’t just packages; they're comprehensive medical journeys. From surgery to recovery accommodation, flights, and local transport – everything's included. These bundles offer significant cost savings, making the entire process more accessible. Let’s break it down.

Accommodation plays a crucial role in these packages. Recovery-friendly hotels or dedicated recovery centers ensure a comfortable and supportive environment, crucial for post-surgery recuperation.

Flights are another major cost component in medical tourism. Many people believe that medical tourism is not actually a good deal due to the cost of flights, but here's where strategic partnerships come in. Take Turkish Airlines, for instance. They offered special package rates for those traveling to Turkey for medical treatment, with discounts across various travel classes. This kind of collaboration makes air travel more affordable for medical tourists.

Technology also has a part to play. The rise of medical tourism is partly thanks to advancements in communication and travel tech. The ease of accessing global healthcare options, along with convenient booking platforms, empowers patients to make informed decisions.

While cost is a major draw, the quality of care is equally important. Many of these countries have invested in state-of-the-art medical infrastructure, adhering to international standards and certifications. So, patients don't just save money; they receive high-quality care from well-trained professionals.

As the world of healthcare continues to evolve, medical tourism stands as a top choice for those seeking both financial savings and quality care.

Risks of Medical Tourism

However, a popular response to the topic of medical tourism is the potential dangers of traveling abroad for cheaper procedures. And while cosmetic surgery anywhere including in the United States comes with a list of risks, traveling for procedures can pose new risks that you wouldn’t face if you got your surgery domestically as well as an increased likelihood of common surgery risks.

First, let's discuss infections – a major health concern in medical tourism is the increased risk of highly drug-resistant infections.

Language barriers present another critical issue. Effective communication with healthcare staff is vital. Misunderstandings due to language differences can lead to serious implications for patient care, impacting everything from understanding the procedure to post-op instructions.

Now, let's talk about quality of care. In some countries, the standards for medical licensure and accreditation might not align with those in the United States. This discrepancy raises questions about the consistency and reliability of healthcare services in the realm of medical tourism.

Another major concern in medical tourism is post-surgery air travel. Flying after a surgical procedure can increase the risk of blood clots, including deep vein thrombosis. Deep vein thrombosis, or DVT, is a condition where a blood clot forms in one or more deep veins, usually in the legs. These clots can travel to the lungs, blocking blood flow and causing severe complications. That's why doctors often recommend delaying air travel for 10-14 days after major surgeries.

Continuity of care is another significant concern. Complications after returning home could lead to extensive follow-up care costs, which might not be covered by insurance. This underscores the importance of thorough pre-travel planning and understanding postoperative care requirements.

It’s also very important to not overlook the safety of the destination country. The tragic story of Latavia McGee, who faced a devastating ordeal during her trip for a tummy tuck in Matamoros, Mexico, is a stark reminder of this risk. While being lost looking for directions, she and her friends were attacked by a cartel, leading to the murder of two friends and four days of captivity where she and another friend, who was put in a  wheelchair by the encounter, were held next to their dead bodies. This horrifying experience that made headlines in the news highlights the importance of considering the safety of the country you're traveling to for medical care.

Governments are taking note of these risks. The UK, for instance, issued warnings about cosmetic procedures in Turkey after 25 of its citizens lost their lives in four years. They also highlighted the risk of fatal botulism poisoning, especially following weight loss treatments, with an outbreak of 71 cases in a year.

• Story about Risks in Medical Tourism

To further unpack the issues facing medical tourism, let’s discuss the tragic case of Lauren Brooke Robinson, a Texan woman who lost her life after a cosmetic procedure in Mexico. Her story serves as a harsh reminder of the potential dangers of seeking cosmetic enhancements abroad.

29-year-old Robinson's journey began with the hope of aesthetic enhancement in Matamoros once again, near the US-Mexico border. But what should have been a routine cosmetic procedure turned into a harrowing experience, resulting in a rare but fatal fungal meningitis infection. Robinson's struggle with the severe condition led her to seek help at multiple hospitals. Tragically, she suffered three mini-strokes in her final weeks.

Stories such as Robinson’s often led people to ask if this was an isolated event? Do I need to worry about traveling to this area for my cosmetic procedure? And the unfortunate truth is that this was not an isolated incident. The Texas Department of State Health Services confirmed that at least 17 individuals who underwent procedures in Matamoros have shown symptoms of suspected fungal meningitis. Authorities also had to monitor 149 individuals who had surgery in Matamoros in 2023. Robinson's ordeal is part of a distressing pattern, joining at least two other Americans who faced similar fates after surgeries in Matamoros. This outbreak serves as a serious wake-up call about the risks of international cosmetic surgery.

State and federal health agencies are now advising individuals to reconsider, or even cancel, planned cosmetic procedures in Matamoros. This outbreak brings attention to the need for regulation in the cosmetic surgery industry, both at home and abroad, to protect those seeking aesthetic improvements.

Regulations in Medical Tourism

So what is being done to ensure the quality and safety of medical services for international patients? Countries around the world are addressing this issue, so let’s take a deeper look into the regulations being implemented.

The plastic surgery industry in South Korea faced a lot of backlash due to the rising problem of “ghost doctors.” Ghost doctors are unlicensed and under qualified people performing surgery on a patient without their knowledge. Their actual doctor would show up for consultations and prepare patients for the day of the surgery, however, during the actual day of surgery, when the patient is under anesthesia, a completely different person comes in to do the job.

People blame this practice on a lack of regulations and factory-like conditions due to the significant increase in people seeking cosmetic surgery.

The death of university student Kwon Dae-Hee in 2016 put a spotlight on this illegal practice. Kwon sought out plastic surgery because of insecurities and wanting to improve his work opportunities. He went to a well-known cosmetic surgery clinic in Seoul and met the surgeon that would perform his surgery.

It was later found by his mother through the camera footage that most of his surgery was done by a general doctor, someone who is not a surgeon that specializes in this type of surgery.

The surgery caused him to lose an estimated 3.5 liters of blood as assistants were seen mopping up blood over a dozen times. He died seven weeks after his surgery. His family not only wanted justice for their son, but they also wanted to see change.

In 2021, the South Korean government became one of the first countries to require cameras in operating rooms. Demonstrating the country’s commitment to providing safe cosmetic procedures

Another country where the focus on quality control in healthcare is evident is Mexico. Mexican plastic surgeons undergo a rigorous certification process to meet national standards. Particularly in Baja California, there’s a pioneering Health and Wellness policy in place that emphasizes patient rights and ensures that all healthcare providers are certified, thus instilling confidence in their medical services.

Keeping all of this in mind, the role of the Joint Commission International (JCI) in this context cannot be overstated. As a leading health care accreditation organization, JCI’s presence in over 100 countries is instrumental in enhancing patient safety and healthcare quality globally. Countries boasting a significant number of JCI-accredited institutions, like Thailand, Turkey, and India are not just healthcare destinations; they're leaders in ensuring medical quality.

Medical tourism’s Impact on America

All this information brings us the question: what is the impact of medical tourism on cosmetic surgery in the United States? So Let's look into this question by unraveling how the U.S. is both a destination and a source for medical travelers.

The year 2017 marked a significant chapter in U.S. medical tourism. Known globally for its state-of-the-art healthcare facilities and renowned medical professionals, the U.S. attracted international patients to the tune of nearly $4 billion. This remarkable figure cements the U.S.'s status as a pivotal player in global healthcare.

Americans themselves were exploring medical services beyond their own shores, with expenditures amounting to approximately $2.3 billion. Americans traveling to destinations across North and Latin America sheds light on their willingness to seek healthcare experiences that extend beyond the U.S., driven by factors such as cost.

Now, let's explore the factors that make the U.S. a magnet for international medical care, despite its higher cost bracket. We're talking about world-class medical facilities, highly skilled professionals, and advanced medical technology. The impact of these attributes goes beyond just the provision of healthcare services; it's about the overall experience and quality that the U.S. healthcare system offers to international patients. This makes the US a magnet for medical tourists, especially those with money to spend.

So to answer the question of how medical tourism impacts the United States, the U.S benefited economically by this exchange. In 2017, the revenue from inbound medical tourism exceeded outbound expenditure by $1.6 billion. This financial surplus shows the positive impact of international patients choosing the U.S. for their healthcare needs.

Conclusion

And this brings us to the end of this journey through the complex world of cosmetic surgery and medical tourism. We've observed how the United States plays a dual role, attracting global patients for its advanced healthcare while Americans seek more affordable options abroad. We've navigated through the trends and technologies that drive people to countries like Turkey, South Korea, Mexico, Thailand, and others for quality yet cost-effective surgeries. Our discussion also delved into the ethical and psychological aspects, especially around Body Dysmorphic Disorder and its impact on teenagers, underscoring the need for mental health evaluations in cosmetic surgery decisions. Today's talk has offered a comprehensive view of the complex, ever-evolving landscape of cosmetic surgery and medical tourism. It's a blend of personal choices, technological progress, and ethical considerations within the broader context of global health and wellness. And last but not least, I would like to thank our researcher Asiya Saeed for researching and helping prepare this episode. Thank you for joining me on this insightful exploration. Remember, the journey to better health and a deeper understanding of medical science is ongoing, and each one of us plays a part in it. Stay curious, stay informed, and most importantly, stay healthy.