Crossing seas for surgery a risky bet

WASHINGTON — Cut-rate plastic surgery at a foreign hospital may seem like a good deal — a great way to save some big bucks. But there are downsides to what has been called “medical tourism.”

Local doctors say they are hearing from women and men who went abroad for surgery and returned home with complications. They can’t see the doctor who performed their operation, and American physicians who weren’t part of the procedure are sometimes reluctant to treat them.

It’s a big problem, according to Dr. Joseph Michaels, a plastic surgeon in the Bethesda area.

“Unfortunately, people going abroad for plastic surgery are not uncommon and these stories of people having unfortunate complications are not uncommon as well,” he says.

Michaels says anyone contemplating plastic surgery, whether here or abroad, needs to do some careful homework. He says it’s not enough to know that the surgeon is well-trained. Of equal importance is the quality of the facility where the procedure will take place and its medical support staff.

Beverly Brignoni, the 28-year-old New Yorker who died during surgery in Santo Domingo, ended up at a facility that she thought was good but was closed by health authorities after her death for numerous sanitary violations.

Michaels acknowledges that sometimes it is difficult to get detailed information about conditions at facilities that advertise on the Internet. But he says it is crucial to feel comfortable with the level of sanitation and care.

“If you don’t have a good feeling, that is an internal signal to go somewhere else,” he says.

He says the Brignoni case brings up another problem with foreign surgeries. She had a tummy tuck and liposuction the morning after she arrived in the Dominican Republic on a late flight. Her cause of death was a massive pulmonary embolism — a condition that can occur when a blood clot travels from the legs or other parts of the body to the lungs.

The two-part surgery in and of itself raised the risk of clotting. So did the long flight — especially if she did not get up and walk around to keep the blood moving in her legs.

Michaels says he would never consider conducting surgery on someone who had just spent hours on a plane. He called the events that led to Brignoni’s death “really a set-up for disaster.”

Read more information about pulmonary embolisms, on the Mayo Clinic website.

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