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Ginger Kramp of Andalusia, Alabama, traveled thousands of miles by herself to a strange country where she didn’t speak a word of the language and didn’t particularly trust the food. Then she had a major operation. “I can’t believe I did it,” she said from a hotel in Vitória, Brazil, where she was recovering from plastic surgery. “I’m so happy!”
Kramp’s health insurance paid for her original weight-loss surgery in the United States, but she wasn’t covered for the procedure to trim away the excess skin left sagging afterwards. Estimates from stateside surgeons came in the $56,000-$86,000 range, leaving the travel agent and pastor’s wife in a quandary. “I could never do this in the states,” she said.
Kramp spent 18 months investigating her options. Then she filled her suitcase with canned food, cashed in some frequent flyer miles and headed down South America way. Her entire trip, including the surgery and personalized attention by the bilingual staff of a specialized travel company called MedPlasticBrazil, rang in for less than $10,000. And Kramp seemed more than happy with the outcome: “I only wish my husband were here to see the results.”
Kramp’s story is hardly unique. Women from the US, Europe and other rich countries with high medical costs are flocking to have their tummy tucks and liposuctions done for less in places like Brazil, South Africa, Thailand, Mexico, Costa Rica and Argentina.
Plastic surgeon Marcos Grillo reports a 10-20% increase in foreign patients last year over 2004. “Not just me,” he said from his clinic in the southern city of Curitiba. “Everyone has seen growth.” The popular cable television program Entertainment Tonight has followed women on the so-called “beauty and the beach” trail to Brazil. However neither the Brazilian government nor the Brazilian Society of Plastic Surgery (SBCP) knows how many foreigners cross the country’s borders for aesthetic purposes.
The best evidence of a trend is probably the emergence of a nascent cottage industry of travel companies specialized in what is sometimes called “lipotourism” (a term registered as a trademark by an Albuquerque, New Mexico, USA, doctor). At least three start-ups offer choices of physicians and maintain their own multilingual support teams in Brazil: MedNetBrazil, launched by an American in Brazil; Cosmetic Vacations, incorporated in Florida with offices in Rio de Janeiro; and the Brazilian owned and operated MedServicesBrazil. The Ft. Worth-based Vanity Medical Holidays opened its doors last year and offers a selection of seven Brazilian surgeons. The member-only forums of an informational website called Plastic Surgery Journeys (PSJ), which Kramp used in her research, grew from 250 original participants to 3,000 less than 12 months after its launch. And, as a simple search on the Internet will reveal, that’s only a sample of what’s out there.
Price is the biggest incentive for prospective patients. Depending partly on the often fluctuating exchange rate, total expenditures in Brazil usually run from one-third to one-half of what the same procedure would cost in the United States, say insiders. An unscientific poll based on five dozen responses from members of PSJ found that about 40% saved $10,000-30,000 by going outside the US; another 40% saved $2,000-10,000. “It is like going abroad to buy a Mercedes and bringing it back without paying taxes,” said Marcel Bates, co-founder with his wife Lily of the PSJ website.
Brazil stands out from much of the cut-rate Third World crowd because it can keep a straight face as it offers First World quality. A Brazilian economist once dubbed the country “Belindia” – a place where the best of Belgium coexists with the worst poverty of a place like India. For those who live on the “Belgian side,” plastic surgery is common. Over 600,000 operations were performed in 2004, including over 365,000, almost 60%, for purely aesthetic reasons, according to a Gallup poll conducted in conjunction with the SBCP. Brazil has been a recognized international leader in the area for decades. Indeed it might be the only country with a procedure named after it: the Brazilian butt lift. Though cheaper than the northern hemisphere, Brazil isn’t the rock-bottom option. “Anybody who is worried only about cost can go to Argentina or Thailand,” said Peter Ryan, president of Cosmetic Vacations.
Brazil’s leadership in plastic surgery can be traced in large part to a single man, Ivo Pitanguy. Described by admirers as the father of modern cosmetic surgery, the 79 year-old Pitanguy boasts a long line of rich-and-famous clients, starting with such icons of 20th century beauty as Sophia Loren and Gina Lollobrigida. Since 1960 his Pitanguy Institute has run a select three-year graduate specialization course for practicing physicians that has awarded diplomas to over 500 students from 40 countries. Pitanguy is a popular public figure in Brazil. The samba school Caprichosos de Pilares honored him in Rio de Janeiro’s 1999 Carnaval parade, dancing to the theme “The Universe of Beauty: Master Pitanguy.”
Plastic surgery tourism for regular gringas in Brazil may have started with Pitanguy. São Paulo-based physician Bernando Froes graduated from the Pitanguy Institute in 1991. He remembers small numbers of foreign commoners who had made their way to Rio for nips and tucks. “There weren’t many patients, but there were people who served as intermediaries,” recalls Froes. “And they made money that way.”
Pitanguy may be a household name in Brazil, but most foreigners only come across him when they begin to do their homework. “Not everybody knows that Brazil is one of the countries that develop techniques,” said Davyne Dial of Ashville, North Carolina, who went to Brazil to remove redundant skin following a gastric bypass operation and subsequent loss of 85 pounds. “Pitanguy has been on the national news, but none of us know that until we start getting serious.”
Christi de Moraes got serious in July 2002 when she moved south with her Brazilian then-husband. Suffering from morbid obesity, she soon underwent weight-loss surgery and later body reconstruction. That experience led to the idea of a concierge service for foreigners that evolved into MedNetBrazil. By May 2003, the first of her now over 120 patients had landed. Most of MedNetBrazil’s business comes from word-of-mouth and support groups, though Moraes now plans to return to live in the United States and beef up marketing efforts.
Cosmetic Vacations President Ryan has never had plastic surgery. The 44 year-old businessman “was looking for a change” from his financial markets job when he and his partners founded the firm. They copycatted Surgeon & Safari of South Africa, a firm run by that country’s businesswomen of the year in 2002, Loraine Melvill.
Full service companies like Cosmetic Vacations and MedNetBrazil meet patients at the airport with bilingual guides and arrange all of the logistics, including lodging and transfers to and from the hospital. Bilingual nurses and other specialists attend to patients as they complete their recovery periods in hotel rooms or short-term rental apartments after release from the hospital. “Most people want their hands held,” noted Ryan. Length-of-stay depends on the procedure, but the average is about two weeks, he added.
The American Society of Plastic Surgeons has released a white paper that urges caution for patients thinking about heading abroad. The warnings essentially boil down to buyer beware. “In the United States and some other countries there is quality assurance and more regulatory control,” said Scott Spear, professor and chief of Plastic Surgery at the Medstar Georgetown University Hospital in Washington D.C., in an interview. “When you leave home you take on an added risk, and when you go to a Third World country even more so.”
The surge in plastic surgery travel notwithstanding, such words do not fall on deaf ears. Indeed they find especially fertile ground among friends and family. “When you first tell people that you’re thinking of having plastic surgery, they think you’re crazy,” said PSJ’s Lily Bates. “Then when you tell them you’re going abroad they think you’ll be taken to a back alley and butchered.” Dial’s partner, a retired medical professional, at first joked with her: “Make sure the price includes a cardboard box to send you back.” But after he saw the before-and-after photographs of the Brazilian surgeon’s patients and heard their testimonials, he encouraged her to go.
Even among prospective patients doing their background checks, misconceptions often persist. “Some people think they’ll be going to the Amazon,” laughed Moraes. “One asked whether we use disposable needles.”
Full-service operators try to eliminate some of the worry by helping prospective patients perform due diligence on physicians and hospitals, an often difficult task given language barriers and an unfamiliar bureaucracy. “We take the time to check on the surgeons, to see, for example, if they have any complaints registered against them,” said Ryan.
Despite names like Cosmetic Vacations and Vanity Medical Holidays, the most reputable firms are all business. “We play down the vacation aspect,” said Ryan. Most patients take a similar attitude, although they can’t be blamed for dreaming about a return trip to the tropics. “I’m not here for tourism,” said Kramp. “But I would love to come back and spend some time on this beautiful beach.” |
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