Cheap plastic surgery abroad can turn costly, even deadly

Knight Ridder Newspapers

(KRT)

MIAMI - Many South Florida women travel to Latin America for discount plastic surgeries, searching for tighter tummies and smoother faces. Some return mangled or scarred.

Allyn Fader-Segura is one of them.

Six months after a botched tummy tuck in the Dominican Republic, the 40-year-old mother of three from Miami has endured several operations, long hospital stays and unimaginable pain.

"I was butchered," she said.

All she wanted was an end to chronic pain caused by multiple operations for hernias and ovarian cancer. And maybe, she admitted shyly, a waistline. For the first time in her life.

Similar dreams of transformation lead many South Florida women to clinics in the Dominican Republic, Colombia, Costa Rica, Brazil and other countries for cut-rate cosmetic surgeries. And while many doctors abroad provide high-quality care that rivals that of U.S. surgeons, those who advertise cut-rate services often do not.

Of course, unlicensed, poorly trained surgeons are also a problem in the United States, said Dr. Onelio Garcia, a Hialeah, Fla., surgeon and president of the Florida Society of Plastic Surgeons. Tales of botched procedures, even deaths, are fairly common in Florida. But patients can be at a great disadvantage if a problem develops and the person who recently conducted the surgery is thousands of miles away.

Fader-Segura recounts the surgery and complications that left her with a gaping wound and rotted her belly button.

Health insurance wouldn't cover the operation. She couldn't afford the $6,000 local cosmetic surgeons wanted for the job, so when she heard that doctors in the Dominican Republic would operate for $3,000 or less, she began making plans.

No one collects official counts of U.S. residents who travel abroad for low-cost cosmetic procedures, but surgeons locally and abroad estimate that they number in the low thousands.

Some emerge from the recovery room to enjoy spectacular results. But a growing number return with scarred bodies and infected wounds, rushing from the airport to the emergency room.

Low prices should put would-be patients on alert.

While many surgeons in Latin America provide high-quality care on par with their U.S. counterparts, their prices also match those of American physicians, Garcia said.

"Doctors who offer discount surgeries are not members of the accepted plastic surgery community in their countries," Garcia said.

These discount doctors from other countries frequently come to South Florida to perform consultations and book surgery appointments in hotel rooms, Garcia said.

Travelers seeking low-cost surgery can expect low-quality care, said Joao Sampaio Goes, a Sao Paolo cosmetic surgeon and head of the International Society of Aesthetic Plastic Surgery.

"If you just look for very low cost, you will go to bad places, to people who may not be actual plastic surgeons," he said. "Good doctors don't have to advertise directly to the public."

Local plastic surgeons and emergency room doctors say the problem is worsening as South Florida's arms-race beauty culture and makeover-themed TV shows herald cosmetic surgery as a shortcut to perfection.

"It's almost a healthcare crisis," said Dr. Seth Thaller, chief of the University of Miami's Division of Plastic and Reconstructive Surgery.

In the past year, he has treated eight patients returning from botched surgeries in the Dominican Republic, versus three from patients operated on in the United States. Garcia's office gets calls about similar problems once a month.

Though small, these numbers mark a worrisome trend.

"We see them right off the plane," said Thaller, who oversees the plastic surgery division at Jackson Memorial Hospital in Miami.

Cosmetic surgery patients should plan to visit their doctor for follow-up visits in the year after surgery, Thaller said. It's unlikely that a doctor can provide that kind of close observation from thousands of miles away, he added.

His staff treats the immediate problems of infections and wounds - often at public expense - then refers patients to private doctors for the costly removal of implants or repeat tummy tucks.

Most doctors, unwilling to work on another surgeon's mess, avoid patients returning from overseas surgery, said Foad Nahai, an Atlanta-based plastic surgeon and vice president of the International Society of Aesthetic Plastic Surgery.

"It's not something they do willingly," he said.

At best, patients must live with deep scars and massive medical bills - if they can afford corrective surgeries. Others endure chronic pain and misshapen bodies.

Triple-D breasts on a petite frame caused Denise Suarez severe back pain. Her insurance company wouldn't cover breast reduction, and the 25-year-old accounting student from Tamarac, Fla., couldn't afford it on her own. She booked a $4,000 surgery in Santo Domingo, Dominican Republic, in late 2003.

She loved the results at first. She felt beautiful and the strain on her back disappeared. Then the incision opened up, and an infection consumed part of one nipple. In the end, surgery and treatment cost her as much as a breast reduction in South Florida would have.

"You never stop to think. ... You just assume everything's OK," she said.

For their surgeries, Fader-Segura and a friend sought references from friends and on the Internet. They booked a six-week trip to the Dominican Republic last July to visit clinics, interview doctors and undergo surgery. Plane fare was cheap, and the two saved money by staying with Fader-Segura's family.

But the doctor they selected, Edgar Contreras, has been blamed in the deaths of several young women who went to him for surgery.

He was barred from practicing medicine in the Dominican Republic in 1999 after he was found guilty of involuntary manslaughter in the death of a patient. But he returned to practice, attracting the attention of law enforcement only when another woman died in his care last November, the Dominican press reported.

The Dominican Society of Plastic Surgeons has said in the press that it does not know how Contreras managed to practice again, but it does not accept him as a member. The Dominican press reported he and his brother left the country for Brazil late last year.

Silvia Torres would argue that Fader-Segura was lucky to escape with her life. Her sister, America Chavez, a home health assistant in West Kendall, died after a procedure to remove varicose veins and dark spots from her legs in Bogota in 2003.

Doctors allowed her to return to her hotel on the day of her surgery. She was far from the clinic when a blood clot traveled to her lungs, killing her in 30 seconds.

Torres was shocked to hear many similar stories of complications and even death after elective surgeries overseas.

"It happens more often than we think it happens," she said. "I never thought it was such a high risk.

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(c) 2005, The Miami Herald. Distributed by Knight Ridder/Tribune News Service.