A third American recently died while undergoing an abdominoplasty, or tummy tuck, at a medical clinic in the Dominican Republic. And yet, rates of surgical tourism to countries outside the US are higher than ever before.

With ever-increasing pressure from social media to obtain a perfect body image, men and women are looking for affordable ways to improve their facial appearance and body shape. Many clinics outside the U.S. boast their affordability as well as an experience comparable to a resort vacation. However, these wishes and hopes are far from the reality of surgical experiences overseas.

I have treated many patients who have presented through my local emergency room (most directly from the airport!) who are relieved to be home alive, and scared at the complicated course that lays ahead.

Here are some Red Flags that may make you want to think twice before undergoing the knife in a foreign country, or improve your success if you insist on doing so.

#1. Meet your doctor.

Most patients seeking surgical tourism said that they initially did not speak with a physician or licensed health care professional prior to their arrival in a foreign country. Some only communicated with clinic staff through email or Instagram, and only met the physician minutes before their surgery began. There is no physician – patient relationship established. Trust is replaced by fear.

Solution: Do not have plastic surgery overseas.

If you still insist on having surgery overseas: Do your homework to make sure the physician is actually a physician, is certified in plastic surgery, and is available to speak with you and evaluate you before you book a flight.

#2. Do your homework & ask tough questions: What are the risks of this surgery? How can I minimize risk?

Most patients did not undergo a comprehensive history or physical exam performed by the physician to determine if they were a good candidate for surgery. Telemedicine (Skype, FaceTime, etc.) makes this possible, so demand it.

Patients had a limited (if any) routine preoperative workup (blood work, EKG, Chest X-ray).

Additionally, none of the patients I spoke with remember being educated on the risks and benefits of the procedure they were about to going to undergo. Expectations were left unclear. Most patients did not remember signing an informed consent, and could not even tell me what surgery was performed on them.  They did not have any copy of their operative report.

Solution: Do not have plastic surgery overseas.

If you still insist on having surgery overseas: read the proposed surgical consent form and understand your risks and benefits of the proposed procedure. Obtain your preoperative workup to ensure you are a good surgical candidate before booking your flight.

#3. Understand how postoperative complications are managed.

Many patients are traveling solo (to avoid added expenses) for overseas surgery. It is important to know if anyone at the clinic or postoperative “home / hotel / living situation” speaks your language. It is important that you are able to communicate issues or complaints (such as chest pain, shortness of breath) to a qualified nurse or physician who can address these emergent issues.

Those who make it home and then develop issues are often told to find someone in the US to help them. This is incredibly common, and can cost thousands of dollars for simple drain removal to an emergency workup for a blood clot or wound healing delay.

Solution: Do not have plastic surgery overseas.

If you still insist on having surgery overseas: If you can afford it, bring a close friend or family member. Have a contingency plan and a physician who agrees to help manage any postoperative issues you may have.

When it’s all said and done, most patients agreed the hype of overseas surgery did not match the reality of the experience. Many stated they wish they never had the procedure done, or wish they had gotten an opinion by a local board-certified plastic surgeon and avoided the unforeseen expenses.   

Your local plastic surgeon may charge a modest consultation fee, but s(he) can give you expert advice about your body concerns, desires, and expected results. Surgery may be more expensive initially, but there are often financial resources to make it affordable and safe. And lastly, should you have a complication, your doctor is available to manage it.

At the end of the day, plastic surgery is elective surgery.  Better to be safe than sorry.