Posts Tagged ‘North Texas’

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!

24 Hour Saline Breast Enlargement

Wednesday, September 10th, 2014

It seems to be all the rage in New York these days. Saline injected directly into the breast tissue. Wow!

So, why on earth would a woman have something like that done? There are a few reasons. Some women who are considering breast augmentation want to have a good idea of what they'll look like with breast implants. Rather than trying on implants in their bras, they can have a doctor inject saline into their breasts. Seeing what 350 cc's of saline in the breast looks like may provide some indication of the look a 350 cc implant may create. Some women have no desire to actually get breast implants, they just want to have larger breasts for about 24 hours. The injections can certainly provide an amazing look for parties, weddings, and red carpet type events. The effect, however, only lasts about 18 to 24 hours. In New York City these procedures go for $2500 to $3500. That's quite a bit to pay for a 24 hour pick-me-up.

I understand the thoughts behind saline injection into the breasts. On some level it makes sense. On the other hand, in our office we use the Vectra XT three dimensional imaging system to help women understand about how they may look with specific breast implants. Rather than do multiple needle sticks (some of which invariably will pass through milk ducts, potentially introducing contaminants into the breast tissue), the Vectra system lets the computer do the work to help show potential results. A study published just last month found that this system has about a 90% accuracy rate. Saline that is injected directly into the breast will not give a reliable representation of what a breast implant will do. Saline that is injected into the breast is placed in the breast tissue itself; an implant is placed behind all of the breast tissue and in most cases partly behind the pectoral muscle. Saline injected into the breast tissue will expand the skin and breast tissue in all directions. An implant placed behind the tissue pushes the tissue forward. The look really is different.

There may be some risks to the saline injections. As mentioned above, they may push contaminants into the otherwise sterile breast tissue. This could lead to infection, even if the procedure is done as sterilely as possible. Also, if you've ever been given a shot, you know that some bruising may occur. Injecting saline deeply into breast tissue requires fairly large needles to pass through a lot of tissue, including some blood vessels. That's likely to create some bruising and soreness. Finally, if the procedure were to be done multiple times to the same woman, it's possible that her skin would stretch and become droopy. That's not likely to happen with one or two injections, but it's conceivable that it would happen after multiple procedures.

I have not yet had a woman come into my office asking for saline breast injections. If she wanted to do it for some special event and understood the effect would only last about 18-24 hours, I would probably consider it. On the other hand, if her thought is that she'd like to see how she would look with that volume implant, I would have her try three-dimensional imaging with the Vectra system. I think it's likely that the Vectra system will provide a more accurate representation of the potential outcome, and do it with no real risk.

Come by and see the Vectra XT three dimensional imaging system. We use it with almost every patient we see in the office. It's cool, it's powerful, and it makes the consultation process so much more meaningful.

Wednesday, April 9th, 2014

Each year in April Fort Worth, Texas magazine publishes its list of Top Doctors.  The magazine sends a survey to 4,500 local physicians and asks them to submit the names of the physicians in each field that they think are the best in Tarrant County.  I am once again honored to be selected to the list for 2014 (my 14th time!).  Texas Monthly magazine similarly publishes a list of Texas Super Doctors in its November issue, and I have been named to that list 10 consecutive years as well.  More than just me, however, these awards are a reflection of my entire office staff and their dedication to outstanding outcomes and experiences for our patients.  There are certainly other excellent plastic surgeons in Fort Worth.  Call around, then call us.  Visit with them, then visit with us.  Come experience how and why this practice has been selected to so many Top Docs and Super Doctors lists!

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!

Breast augmentation: Now's the time!

Tuesday, February 11th, 2014

This unusually cold North Texas winter will soon be a memory. Spring is just around the corner! Temperatures warm, heavy coats are put away, and warm weather clothing makes its way to the display racks. It's a perfect time for breast augmentation! Contrary to what a lot of people think, most women who come to see me for breast augmentation surgery don't want really big breasts; they just want to wear great tops. Most of these women have never felt comfortable in cute tops or bathing suits and they want to feel confident wearing sleeveless and strapless clothing.

One of the best things about breast augmentation is that there are so many shapes and sizes of breast implants available. We can help you choose an implant that enhances your figure without making you look disproportionate. In our office the Vectra 3-dimensional imaging system is used as part of the consultation to help you find the look you want. The Vectra system takes photographs of your torso with 6 cameras, and the computer blends these photographs into one three-dimensional image. We can choose any implants available in the US today, click a mouse, and like magic the software creates a simulated image of your breasts with those exact implants in place. Rather than seeing before-and-after pictures of other women who have undergone breast augmentation, this system lets you see what you may look like after an augmentation. The software even includes bikini tops and sleeveless tops that may be superimposed on the image to show you how you might look in those.

Spring is a fantastic time for breast augmentation. Be ready for the summer! Come visit with us and see what you might look like after an augmentation. The Vectra technology is way cool. Check it out!

Plump up the volume!

Tuesday, July 12th, 2011

I have been doing some landscaping around my house.  This spring I put a great plant in my backyard, a Japanese aralia.  This plant has a tropical look to it.  In the summer heat, however, it quickly lets me know when it needs to be watered.  It wilts and looks a bit sickly.  With just a little water, however, it perks right back up.

How is this relevant?  It reminds me about people, about what really happens when we need water.  Our cells crave water.  The right amount of water allows all the cellular processes to take place normally.  Losing just a little bit of water causes cells to shrink and all the things in them to become more compacted.  The machinery just doesn't work the same.

We have had so many 100 degree days and so little rain here in North Texas this summer.   Just starting your car will cause you to work up a sweat.  It's easy to fall behind on your hydration.  By the time you become thirsty you have probably already lost 2% of your total body fluid.  Your best protection is to try to remember to drink water frequently through the day, rather than waiting until you become thirsty.  This will protect you and all of your cells, particularly through this heat.

Now, imagine yourself as that Japanese aralia.  Picture your skin as those drooping leaves.   Maybe the best thing you can do to maintain your normal, healthy appearance this summer is to keep hydrated. Moisturizers will help, but there really is no substitute for healthy, well-lubricated cells.  Don't wilt in this parched North Texas summer!

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