In a recent article in the Long Island Business News, the American Society for Aesthetic Plastic Surgery reported that the number of surgical and nonsurgical cosmetic procedures performed in the United States increased by 20% in 2003 from 2002, to nearly 8.3 million. Surgical procedures increased 12%, while nonsurgical procedures increased 22%.

Liposuction ranked as the most popular procedure in 2003, with 384,626 patients opting for it. Breast-augmentation surgery (280,401) came in second place, followed by eyelid surgery (267,627), rhinoplasty (172,420), and breast-reduction surgery (147,173). In terms of cosmetic procedures, women had 7.2 million of them in 2003, while men had 1.1 million. These numbers, and the overall growth in the industry, are certainly impressive, but they would be even higher if fewer people opted to travel outside the United States for plastic and cosmetic surgery. The primary reason cited for seeking plastic surgery procedures in other countries is cost savings, which should be no surprise.

Take, for instance, a tummy tuck: In the United States, it costs at least $6,000; but in Costa Rica, it costs only $2,000. Breast-augmentation surgery here runs around $7,000. Go to the Dominican Republic, and you can get it for only $2,000. Want a facelift? You’ll typically pay $9,000 at home, but in Malaysia it will cost only $3,000. However, based on a recent news report titled “Plastic Surgery Tourism,” which aired on the television newsmagazine “Dateline NBC”–the transcript of which can be found on the Web site—saving thousands of dollars on a surgical procedure can end up being very expensive to one’s pocketbook and health, and, in some cases, even can be deadly.

As more people opt for plastic surgery, a growing number of patients are traveling overseas, with the term “lipotourism” becoming commonly used among the nip-and-tuck crowd. The Dominican Republic has been labeled “the Caribbean mecca of lipotourism,” with 80% of the plastic surgery patients there coming from abroad. The biggest concern among American plastic surgeons is the quality of care these patients are receiving, and the high rate of postsurgical infection and botched procedures. Some procedures can be reversed and repaired by American physicians—thus negating the original cost savings—but the high rate of infection, and, in some cases, irreversible problems that many patients encounter overseas, is of real concern.

Tales of woe abound from people who have traveled overseas for plastic surgery, particularly to the Dominican Republic. Just last year, the New York City Health Department issued a warning for people not to travel to the Dominican Republic for plastic surgery. Some may claim that US-based plastic surgeons are simply trying to protect their customer base by advising against traveling abroad. However, these physicians are not simply being territorial—they are exhibiting a legitimate concern for the health and well-being of patients who become overly enamored with saving money.

Plastic surgeons need to address the issue of price with their current and prospective patients, and explain to them why patients pay considerably more for surgical procedures in the United States than in such countries as the Dominican Republic and Malaysia. Instead of ignoring the fact that patients can get facelifts for one third of their US price in other countries, you should educate your patients on the dangers of buying plastic surgery procedures simply based on price. By explaining up front the concept of, “You get what you pay for,” to patients via advertising and direct-mail campaigns, in broadcast emails, on Web sites, and during in-office patient consultations, you will be able to convince at least some patients that seeking plastic surgery outside the United States is not such a good idea—regardless of the cost savings.

I’m pleased to announce that next month’s message in Plastic Surgery Products will be written by Mikael Block, the new editor of PSP. Mike has a bachelor’s of science degree from the University of Michigan and a PhD from Harvard University. He was the editor of Chemical Innovation magazine at the American Chemical Society, and he has also been a freelance editor and college instructor. Welcome aboard, Mike!