Scheduling Overseas Cosmetic Surgery? Read This First.

Considering overseas cosmetic surgery? You’re not alone. In the past five years, I’ve worked with many clients who chose to travel abroad for cosmetic surgery. Unfortunately, several clients encountered complications that ranged from travel SNAFUs to life-threatening post-op complications. Before booking your surgery, please consider the following real-case scenarios.

Case Scenario Number One: The Language Barrier. A number of clients flew to the Dominican Republic for surgery, only to have difficulty communicating with the staff at recovery centers. One client thought her recovery garment was cutting off circulation in her arms, but couldn’t communicate with her caretakers because they didn’t speak English and she didn’t speak Spanish. In another case, a client misunderstood post-op instructions after having a BBL, and lost most of the harvested fat.

Case Scenario Number Two:  Your Lipo/BBL Surgery Leaves You With Burns.  Perhaps the most distressing case I’ve ever seen (and biggest motivator for writing this post) involved a woman who went to the Dominican Republic for 360-Lipo and a BBL.  When she came to me, she had burns at her fat-injection sites.  She was 11 days post-op, but the burns were still raw and oozing.  Her surgeon had given her some ointment for the burns, which, obviously, was not helping.  When I questioned her about the burns, she said, “I think this happens a lot, doesn’t it?”  In the over five years, I’ve treated cosmetic surgery clients, I’ve never seen burns like this.  In answer to her question about burns, I quote (in full) Dr. Robert T. Buchanan, a top contributor at

“Burns are caused when an energy source, either laser or ultrasound, is used with the liposuction. The fact that you have seen this after BBL shows you that untrained physicians attempting many of these cases. A trained plastic surgeon who understands both liposuction and fat grafting did not do these cases. Fat grafting, the essential procedure in BBL, is a very demanding procedure. The fat must be removed in a manner that does not damage the fat cell. It then needs to be washed and processed and then injected in such a way that the fat cells remain alive and grow. Harvesting the fat cannot be done with any method using an energy source as this will kill the cells. In fact, it must be done very carefully with less suction than is usual in order to protect the cells. Choose a board certified plastic surgeon who can show you excellent results with the procedure.”

Too many overseas “medical tourism” sites are staffed by unskilled surgeons.  Trusting your surgery outcome, and your life, to these doctors is so NOT worth the rist.

Case Scenario Number Two: The Surgeon Won’t Take Your Calls. I had a client come to me with abdominal swelling, tenderness and hardness after having trunk lipo and hernia repair. She also described a shooting pain on her left side, and her temperature was elevated. I asked her if she’d called her surgeon, and she said, “he won’t return my calls.” She’d called his office several times, but her calls went unanswered. Not knowing what was causing the pain and fever, I urged her to go to her doctor for follow-up and further evaluation. Another client related to me her frustration post-op when the surgeon’s office wouldn’t return her calls about her garment. She couldn’t remember how long she needed to wear it and when she needed to go down a size.

Case Scenario Number Three: The Overseas Trip Costs More Than Expected. A client came to see me after lipo and a tummy tuck. She’d had surgery in Honduras about a month prior, and she needed lymph drainage work, but could only afford one visit because she’d gone broke after her surgery. When I asked her what happened, she said she “nearly bled out” on the operating table and needed blood transfusions and an extended hospital stay after her initial surgery. The unexpected after-care and cost was something she hadn’t anticipated or budgeted for.

Then there was the client who had post-op complications and couldn’t afford the cost of a flight home. She ended up flying to Miami, where a family member met her to drive the rest of the way home. Afraid to wrack up more medical bills, she had her daughter remove her stitches. She ended up with an infection and required much more follow-on care.

In his article, “Risks to consider before getting plastic surgery abroad,” Dr. Jeffrey Kenkel, writes, “Over the past year, we have cared for multiple patients who had complications from plastic surgery abroad or received inadequate postsurgical care. Several have come in with awful infections such as E. coli or other destructive, often resistant, bacteria. And many have issues with surgical wounds that came apart during their flights or at home. Unfortunately, these patients have no ability for follow-up care following these large and often invasive procedures or because they weren’t given adequate follow-up instructions.” You can read his article that addresses the risk of overseas cosmetic surgery, as well as ways to mitigate the risk by clicking here.

Case Scenario Number Four: Flight Risks Post-Op. A few months ago, a client came to me and was worried that her BBL was done poorly because she felt lopsided and there was a visual difference in size from right to left. During her intake process, I found out that she’d had surgery in a Middle Eastern country, and that the multiple flights she had to take to get home amounted to over twelve hours in the air. Sitting. She thought she’d done a good job of balancing her weight on her thighs, and she stood as much as she could, but she wondered if the imbalance had to do with having to sit so much during her flights home. Also, both surgery and air travel increase the risk of deep vein thrombosis and pulmonary embolism. Dr. Franklyn Elliott of Atlanta Plastic Surgery addresses travel concerns in his blog post, “Addressing Complications after Overseas Surgery.” He writes, “Travel carries inherent risks for surgical patients. Long flights or drives alone can make you more prone to potentially serious blood clots, like deep vein thrombosis or pulmonary embolism, and this risk is amplified after surgery like a tummy tuck. This is especially true when you still have some soreness from your procedure, making it more difficult and less likely for you to stand and walk around periodically throughout your flight.” You can read his full article here.

I’ve worked with several clients who vastly under-estimated the discomfort of flying post-op.  One woman who’d had lipo and a tummy tuck talked about how the foam pad she wore underneath her garment made it difficult to breathe on her flight from the D.R. to Miami.  She was traveling alone, and had no one to assist her, so removing the pad wasn’t an option.  Another client said she didn’t realize her flight home would involve a layover in Atlanta, where she barely had the energy to get to her connecting gate.  And yet another client was so nauseated from pain medication that she vomited during her flight home.  It pays to thoroughly investigate what the trip home will entail, and to also have a traveling companion with you.

Case Scenario Number Five:  Painful Post Operative “Lymphatic Care.”  Over and over again, I’ve had clients describe getting what was called “lymphatic work” done post-operatively, only it’s nothing like true lymphatic drainage as we know it here in the U.S. and Germany.  First, the work is painful.  One client described how she would have to be zoned out on Percoset to even tolerate the procedure.  Second, clients describe fluid shooting out of incision sites and a “wringing out” process.  This is not lymphatic work.  Lymphatic drainage requires very light, gentle pressure and a slow, methodic stroke.   It’s also extremely effective, which is why, under normal circumstance, I usually need to see clients for 2-3 visits to meet their post-op goals of fluid and swelling reduction.  It’s disturbing to hear these accounts of post-operative torture being called lymphatic drainage.

All of the scenarios described above happened to clients who came to me for lymphatic work following overseas cosmetic surgery.  I did my own research, and can’t now understand how the benefits (if any) outweigh the risks. For this reason, I’m extra cautious when I work with clients who’ve had overseas cosmetic surgery.  I’m concerned because of what I’ve seen, and I’m also concerned about what I can’t see, such as the mycrobacteria from the D.R. that may have hitched a ride home with an unsuspecting client.  For more about that darling creature, and its dangers, read what the CDC has to say here.

I am passionate about lymphatic therapy work — its benefits, its efficacy, and its simplicity — and I love sharing this work with clients. It’s just that having seen the downside to overseas cosmetic surgery, I thought it was time to share this information.