Procedures

Medical Tourism and Plastic Surgery

Wednesday, February 11th, 2015

One of the great things about Fort Worth is the ease of access to the world afforded by DFW airport. American Airlines has its headquarters here in town and DFW is its largest hub. With U.S. based airlines like United, Delta, and Spirit, it's easy to either fly here from anywhere in the country, or to fly from here to anywhere else. DFW now even has nonstop flights to and from Australia on Qantas, the UAE on Etihad and Emirates, Seoul on Korean Air, and a number of carriers to many places in Europe.

So, why am I talking about this on my plastic surgery blog? Because of medical tourism. It has become all the rage. Forbes magazine estimated that 1.25 million Americans would travel abroad for some type of medical care in 2014. That number seems a bit high to me, but it's Forbes and they seem to know a lot about numbers. The point of the Forbes article is that Americans are traveling to other countries for care. Costs for many treatments and many surgical procedures are higher in the US than many other places in the world. If quality of care is high, outcomes are good, and cost is low, why not go?

Seoul, South Korea, is one of the "hot spots" listed in almost any article about medical tourism. Apparently Chinese citizens are traveling there in throngs to undergo cosmetic surgery. The Ritz Carlton in Seoul even partnered with hospitals there, offering an "anti-aging beauty package" for a mere $88,000 (US dollars). Sounds like a bargain! Other popular places people are going for surgical procedures include Costa Rica, India, and Mexico. To see what all the fuss is about I thought I'd check into what it would cost for a woman to undergo breast augmentation in each of these four hot medical tourism destinations: Seoul (Korea), San Jose (Costa Rica), Mumbai (India), and Monterrey (Mexico). As a comparison, breast augmentation in Fort Worth typically costs somewhere between $4,000 and $5,000, depending on the specific breast implants used. This cost includes the breast implants, surgeon's fee, facility fee, anesthesia, and preoperative and postoperative visits. Different surgeons charge different amounts, but I believe the total cost of $4,000 to $5,000 is about right for Fort Worth. If you travel to Seoul, be prepared to pay about $6,000 for your augmentation. Monterrey Mexico? About $4,000. Mumbai: about $3,800. Costa Rica will also cost about $3,800. Interestingly when looking at websites that promote international medical tourism, I found that those websites typically list the "average" cost of breast augmentation in the US to be $9,000. Gulp. $9,000!! So of course it seems like $3,800 in Costa Rica is a huge bargain when you compare it to $9,000. There probably are places in this country that charge $9,000; I just don't know where. Maybe Manhattan? But really, when you compare the cost of breast augmentation in Fort Worth, Texas to those four "hot spot" medical tourism destinations, it almost makes me wonder why anyone from North Texas would travel to one of those places to undergo this type of cosmetic surgery.

Having been a plastic surgeon in Fort Worth for 20 years, I have had the privilege of performing cosmetic surgery for women not only from all areas of Texas but also from places like California, Canada, New York, and Florida. DFW airport makes the travel easy, but it's our outcomes that make it even possible. I do surgery in hospitals and ambulatory surgery centers that undergo strict accreditation processes. If you want to see a hospital administrator sweat, tell her that The Joint Commission (formerly known as the Joint Commission on Accreditation of Healthcare Organizations, or JCAHO) is coming to do an inspection of the facility. The Joint Commission has created and continuously improves strict sets of standards and clinical practice guidelines that hospitals and other facilities must meet or exceed if they want to continue providing care for patients. Failing a Joint Commission Survey means a facility may have to close. Facilities are inspected every three years. It is through inspections like these that surgical facilities in the United States maintain some of the very highest standards in the world. The Joint Commission doesn't just look at the physical layout of a surgical facility. It also inspects things like the credentialing process the facility uses to make sure that the doctors who work there are qualified to do the things they are doing. For instance, if I want to do breast augmentation surgery at a facility, the facility needs to make sure that I have completed appropriate training and have met certain national and community standards. Board certification by the American Board of Plastic Surgery is one measure that facilities use to help them make sure a surgeon is qualified to perform cosmetic surgery. The facilities also request information about where a surgeon did his or her training, about malpractice suits, and about having a medical license to practice in that state (in my case, Texas). The American Board of Plastic Surgery has its own rigorous process regarding certification of plastic surgeons. This all sounds great, but if you are still reading you're probably getting a little bored by now. The point of all of this is that if you undergo breast augmentation in Fort Worth, Texas by a plastic surgeon who is certified by the American Board of Plastic Surgery, you have a pretty good idea about the qualifications of the facility and the qualifications of the surgeon who is doing your surgery (preferably me!). Can you really say that about undergoing breast augmentation in Costa Rica or Mexico or some other country? Maybe, maybe not. Certainly different countries have requirements regarding who can do what as far as surgical procedures are concerned. One of the biggest problems is that we, as consumers, don't really necessarily understand what those qualifications are. Are standards regarding sterilization processes of instruments the same in India as in Dallas? Maybe. What about standards regarding immunization status of the personnel who will be taking care of you? The same in all places, or different, and does that really matter? In the U.S., you know that there are amazingly high standards of care. There may be similar high standards in all of these hot spot medical tourism destinations as well, but it's just not as clear.

Now, suppose you take the next step and actually go to another country to undergo breast augmentation. Maybe you're thinking, hey, it costs a little less (excluding the travel, of course), you've researched what you can, and what the heck, there's a little vacation thrown into the mix. After all, travel to Costa Rica can be pretty exciting. Monkeys, exotic butterflies, rain forests...just an amazing place. But when you are being wheeled into the operating room, do you know what implants are going to be used? Different countries have different implants available. Just ask women in France how they liked their PIP implants. That company used industrial grade silicone rather than medical grade silicone for their implants, the implants had twice the rupture rate of other implants, and the head of the company was sentenced to four years of prison for fraud. While those implants are no longer even available, they were available and being used at one time. Knowing specifics about the breast implants that will be used is really important. Also, will there be a warranty with the implants being used? Probably, but you better make sure. And making sure might be kind of difficult. While your surgeon probably speaks and understands English well, most of the staff responsible for getting you safely through surgery and the recovery area probably don't.

Medical tourism is a growing industry. Travelling abroad is exciting, and people usually have good results. There are some uncertainties, though, that are worth considering as discussed above. Here in Fort Worth we see patients from all areas of Texas as well as from all over the country. The distances some of these people travel make this, too, a form of medical tourism. However, undergoing surgery in the U.S. does provide some certainties regarding standards. Language is not usually an issue. Cost definitely varies around the country. In my experience costs for cosmetic surgery are lower in Fort Worth than almost any other city of similar or larger size in the U.S., and similar (at least for breast augmentation) to costs in the international hot spots for medical tourism. So, skip the passport and the immunizations! Jump on American Airlines or Delta or United or Spirit or load up the car and come on down/over to Fort Worth. It's a great city with a vibrant art scene and cool downtown, nice places to stay, and all kinds of interesting places to eat. My office is in the downtown medical district and we would love to have the opportunity to help you fine tune your image!

Microneedling

Tuesday, July 8th, 2014

We are excited to introduce microneedling (also known as collagen induction therapy, or CIT) to the practice!  This evolving technique uses an electronic device to create controlled channels or microwounds into the skin.  These micro-passages stimulate the normal wound healing cascade by releasing growth factors, leading to the production of new collagen, elastin, and microscopic blood vessels (capillaries).  The micro-channels may also be used to aid delivery of cosmeceuticals, growth factors, and bioactive peptides into the dermis.  Microneedling has many uses, including improving scars (acne scars, surgical scars), reducing stretch marks, improving fine lines, and helping create more even skin pigmentation.  Unlike laser treatments and deep chemical peels, microneedling causes minimal injury to the skin.  This makes microneedling a versatile technique, being able to treat areas that lasers cannot like the neck, chest, and hands.  Collagen induction therapy is an area of growing interest in cosmetic plastic surgery. Come visit and learn more about microneedling!

Thursday, June 26th, 2014

I just came back from a fantastic meeting in Las Vegas.  This was a multidisciplinary meeting with plastic surgeons, dermatologists, ophthalmologists, and ENT facial surgeons from around the world.  I was looking for an opportunity to see how physicians in other specialties address issues that I see as well.  For instance, how do ophthalmologists who do cosmetic eyelid surgery treat patients with baggy eyelids?  How do ENT facial surgeons do facelifts?  I have been to many, many meetings in the past where plastic surgeons talk about how they do things; this was an opportunity to meet with many types of doctors.  I spent time talking with a doctor from Dublin, Ireland who gives talks around the world about research showing that Botox may actually be medically helpful in patients with depression.  Another interesting doctor I spent time with was an ophthalmologist from Beirut, Lebanon.  We talked about fat grafting around the eyes, as well as life in Lebanon in general.  The meeting exceeded my expectations.  So much information!  The only 'downside' is that now my office staff will have so many new things to integrate into the practice!

Tummy tuck: get ready for summertime in Fort Worth!

Friday, March 28th, 2014

 

(Tummy tuck patient from 2013)

In North Texas, when your children are young it's almost impossible to avoid the pool in the summer.  And for many women, therein lies the conundrum.  They love their kids and the whole pool scene, yet they're uncomfortable with how they look in their bathing suits.  Looking around, seeing so many tan, fit bodies, wondering what happened to them.  Why all the stretch marks, the pooch that falls over the top of the bikini bottom, the loose skin just above the thigh crease?  Where has the belly button gone?  WHAT HAPPENED?

Here's a little secret:  all those fit bodies?  Well, a lot of them look so good because they've had a little help.  Tummy tucks, for instance, can make a huge difference.  I often refer to this operation as, "the return of the belly button".  Look in the photo gallery section of the website in the Abdominoplasty section.  Women frequently choose us because they have seen a lot of pictures and think we create some of the best belly buttons.  All of those nagging issues described above can be addressed with a tummy tuck ("abdominoplasty").  It is common for a woman who undergoes a tummy tuck to end up with a "Wow!" type of result.  It's a difference-maker.

Come see us.  Spring is a great time for an abdominoplasty!

Facelift surgery: away with those jowls!

Thursday, November 7th, 2013

I love doing facelifts. There's some real art and finesse involved. Every millimeter counts. Usually a person considering facelift surgery notices loose facial skin, jowls, and a loss of the youthful neck contour. During the procedure tissues under the skin are lifted and tightened, then excess skin is trimmed away. The incisions are placed in inconspicuous areas, with the result being a refreshed, rejuvenated appearance. As with most cosmetic procedures several different techniques have been created, each technique trying to address particular anatomical areas differently. If you watch much television you've probably even seen infomercials about one of these techniques. However, no matter which technique is used, the concepts are similar: the tissues under the skin are tightened first, then the excess overlying skin is removed. This allows the fatty tissues in the jowls to be re-positioned and trimmed, neck muscles tightened, and tissues in the cheek elevated. It sounds kind of scary, but really most people have minimal pain and are very happy with their results.

If you're thinking about this type of surgery, come visit. We use Vectra 3-dimensional imaging to help identify what areas are of most concern to you. The image on the right is an example: while we can easily see the jowls and loose skin, areas of sun damage, pigment changes, and subtle contour irregularities may also be more readily assessed. You'll love the staff in the office, and we can help visually restore that beautiful inner you!

Girls' Night Out

Saturday, February 4th, 2012

We are going to have another of our Girls' Night Out events this Wednesday, February 8th, from 6 to 8 pm at our 8th Avenue office.  Each of our events, taking place three or four times a year, has a unique theme.  The theme for this event is "Beauty with Friends".  Our aesthetician, Lori Roby, will talk one-on-one with guests about some of the great products and services she offers.  Our clinical nurse injector, Krista Barrington, will demonstrate Botox injections on one of our current clients.  And of course, I will speak a little about surgical options over any number of topics, tailoring the discussion to the women present that evening.

These events also raise money for local organizations that provide special care and services that blend with the needs of many of our patients.  Previously we have donated portions of the proceeds from these evenings to the Joan Katz Breast Center (link:   http://www.wfaa.com/good-morning-texas/Celebrating-the-Opening-of-Joan-Katz-Breast-Center-92340909.html), and the local Komen Foundation ( link:  http://ww5.komen.org/).  For the February 2012 event, the recipient is Cuisine for Healing (link: http://www.cuisineforhealing.org/).  We are excited to partner with these groups.  Sue Austin from Cuisine for Healing will be present Wednesday evening and you can learn all about it from her.

Another terrific local organization that also offers special services to our breast cancer patients is Indigo Yoga (link: http://www.indigoyoga.net/).  Brooke Hamblet Hinkle, Founder and Director, will also be present Wednesday.  Come visit with her to learn about yoga may be of benefit to you or someone you know!

These are not just boring little wine-and-cheese events.  The office staff kind of goes 'over the top' in putting these evenings together.   Come join us and see for yourself.  Bring a friend!  Call the office and make a reservation because, darn the luck, the fire marshal only allows so many people in the building at one time!

 

 

 

 

 

 

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