Expert: The Risks and Rewards of Medical Tourism

Kristen Aliano Messina
Dr. Kristen Aliano Messina (Courtesy of Dr. Aliano Messina).

Each year, thousands of Americans travel abroad to seek medical care elsewhere. Their motivations vary, but oftentimes, this is motivated by finances. Certain pharmaceutical agents, as well as surgical procedures, can be less costly overseas. However, this portends risks about which the individual may not necessarily be aware.

Some patients seek aesthetic surgery in the Caribbean, Mexico, or Central America because it is cheaper than compared to undergoing the procedure by a qualified, trained plastic surgeon in the U.S. While there are many well-trained surgeons in these nations, it may be hard for the average consumer to appropriately evaluate if the surgeon he or she has chosen, as well as the surgical center or hospital, are reputable entities. There are many clinics established in these nations that provide fly-in and fly-out cosmetic surgery, with limited pre-operative evaluation.  They often market their procedures as inclusive vacation packages. In addition, some of these surgical clinics do not provide standard post-operative care like a practice in the United States would, and do not provide assistance when complications arise; this usually occurs once the patient has returned home shortly after the surgery. While many of these centers may appear to be state-of-the-art facilities in photographs on their websites, they are not held to the same sterilization and sanitary conditions as those in the U.S, potentially causing infection and blood-borne pathogen transmission rates to be higher. Antibiotic resistance may also be higher in these nations. Additionally, the physicians performing the procedures may not have had the same extensive training as those qualified in the United States.

Last year, a young Dallas realtor, 36-year old Laura Avila, travelled to Mexico to undergo rhinoplasty. She suffered anesthetic complications, and died shortly after she was transferred back to Texas; by that point, Texas doctors were only able to recommend hospice care.

In my plastic surgery residency training, we saw many patients in the emergency room and in our university hospital clinic with negative sequelae from cosmetic surgery undertaken elsewhere. One patient was septic after undergoing gluteal fat grafting; another had wound-healing complications after undergoing abdominoplasty and subsequently required multiple surgeries to address her scarring. In addition, she had contour deformities to both arms because too much skin had been removed from them when she underwent an arm lift.

Traveling after surgery can increase the risk of blood clots in the legs, known as deep vein thrombosis. These clots can then travel to the lungs; a clot in the lungs is known as a pulmonary embolism. Orthopedic procedures, as well as plastic surgery procedures, especially abdominoplasties, convey a higher risk of these issues at baselines; adding long distance plane or car rides can make this risk more likely to occur.

Many Americans, especially those in border states, seek to purchase their medications in Mexico. They can even be purchased over-the-counter, as opposed to being prescription. However, counterfeit medications are prevalent, or purchased products may be contaminated with other substances. They may lack the active ingredient that makes a medication effective, or it may have a decreased potency compared to the true pharmaceutical agent. The Food and Drug Administration (FDA) has previously issued warnings about this. To illustrate the popularity of purchasing medications overseas, a 1992 survey conducted by Texas Tech University Internal Medicine Clinic found that more than 80% of their patients sought prescription-type medication in Mexico.

While people have their own free will to make decisions about their bodies, healthcare, health care providers, and medications, educating the public on the risks of receiving care in countries that have fewer safety standards is of paramount importance. Patients should fully investigate any physician, hospital, pharmacy, or medication that they might encounter in all countries.

Dr. Kristen Aliano Messina is a plastic surgeon at Renaissance Med Spa in Plano. She finished training in 2019, and focuses on plastic and reconstructive surgery, including aesthetic surgery, breast reduction/reconstruction and more.