Beauty from Afar

Today’s so-called “page” is just three paragraphs. That is the way it worked out with the subheads from the original book.

Chapter 2 Page 8 | If You Can’t Beat Them …

I excerpted this aside from a lengthier interview with Oscar Suarez, M.D. in his office at CIMA Hospital, and I quote him more extensively later in the book. I don’t know if he is still head of the Department of Plastic Surgery at CIMA but it is evident that his practice is thriving. That is one of the problems with including official titles in books — people move on from where they were.

When I first walked into the waiting area of Dr. Suarez’s office, his assistant asked me what procedures I was interested in … and it was the first time anyone ever suggested I might need (or at least want) cosmetic surgery. I’m sure it was SOP for the office and no psychological harm was intended. For the record — at 53, I’m unmodified, other than my teeth.

Dr. John Corey, an aesthetic plastic surgeon in Scottsdale, Arizona, was kind enough to write the foreword for Beauty from Afar. I found him on the web long before I asked him if he would do that. There are not many cosmetic surgeons in the United States who are openly admiring of the work and advances made in other countries.

Specifically, John has trained at one of the most renowned cosmetic surgery facilities in Brazil He talks about how that has influenced his work in today’s segment:

Chapter 2 Page 7 | The Best of Both Worlds

I’m grateful to have had the benefit of John’s point of view and experience.

One of the great things about being a writer is that it gives one lots of opportunities to talk to interesting people one would otherwise never have met. For me, over the past 25 or so years, this has meant chatting with people ranging from accused murderers to U.S. Senators, the infamous and the celebrated.

For Beauty from Afar, I got to talk to doctors and surgeons. Lots of them. And they are a fascinating bunch. In today’s segment:

Chapter 2 Page 6 | Point, Counterpoint

… I compared and contrasted statements from two doctors, one from Texas and the other from Brazil, both renowned plastic and cosmetic surgeons.

I remember thinking that Dr. Rod Rohrich of Texas probably wanted to hang up on me while we were chatting on the phone and that I wouldn’t really have blamed him if he did. I was clearly writing something that was going to be at least somewhat at odds with his public pronouncements about going overseas for plastic surgery. I remain grateful that he took time to talk.

The Brazilian surgeon, Dr. Luiz Toledo, is now apparently working in Dubai! Links for both surgeons are provided in the segment.

The web site and staff of the International Society of Aesthetic and Plastic Surgeons (ISAPS) were both very helpful in my research. Sometime after Beauty from Afar came out, ISAPS published its own briefing paper on medical tourism which was rather less negative than the one put forth by the American Society of Plastic Surgeons.

The American Society of  Plastic Surgeons (ASPS) released in April 2005 what amounted to an acknowledgment that medical tourism exists, in the form of a briefing paper that got some media attention. This was when I was in the middle of researching Beauty from Afar and was pure gold, as far as I was concerned. In the end, I quoted and commented on the entire document — which makes today’s “page” pretty long. But I thought it best to keep all the material together.

Chapter 2 Page 5 | American Doctors Speak Out

By that time, I’d spoken with enough doctors and surgeons with varying opinions on the subject of medical tourism that I was pretty sure I had a more complete and nuanced view of the subject than the ASPS could possibly put out, given that they had to present a united view … and given their constituency. I felt qualified to comment despite my lack of medical credentials.

To the credit of the ASPS, they have updated their information and resources on medical tourism over the past few years. A new link for them is in the “author’s note” for the page … and also here.

I still don’t know the source of the infections that caused the Center for Disease Control and the U.S. State Department to warn against cosmetic surgery in the Dominican Republic in 2004. I don’t know the names of the patients; I think it would be very hard to find those out. Their privacy would be protected by both the CDC and their doctors.

But there has been no such outbreak since that time, or I almost certainly would have heard about it. In:

Chapter 2 Page 4 | Sticks and Stones

… I kind of closed the circle on that story, as much as I could. Good doctors and surgeons everywhere agree on fundamental practices that impact patient safety. Surgery, almost by definition, is not 100 percent safe. Even good surgeons can have poor or even disastrous results on occasion, despite every effort to reduce the likelihood to zero.

Patients take risks. They sign a lot of papers before undergoing surgery in which they acknowledge risk. They do their own part to minimize risk by informing themselves about what to expect; by preparing their minds and bodies for surgery; and by choosing a good doctor and surgeon. That is a lot of what Beauty from Afar was (and is) about: patient choices, and how to make good ones. I included the lengthy segments about the Dominican Republic because the story illustrates so many aspects of medical travel. In the end, I draw a different conclusion than did New York City officials, or the U.S. news media. I would not tell anyone not to go to a particular country for surgery. Tens, even hundreds of thousands of patients have gone to the Dominican Republic … or to Mexico, Costa Rica, Brazil, Columbia, Thailand, Malaysia, etc.  for cosmetic surgery in the last five years and have been happy with the results and the price.

And a few have gone and have been unhappy, or worse.

Today, we continue the short saga of the U.S. and its media vs. cosmetic surgery in the Dominican Republic in 2004.

Chapter 2 Page 3 | A warning lives on, mostly unheeded

When I was writing Beauty from Afar, I remember being somewhat concerned about the fact that I was saying that the U.S. State Department was still warning in 2006 against having cosmetic surgery in the Dominican Republic based on a 2004 CDC report … surely, I thought, that warning will be taken down at some point in time.I was careful to note the time element.

I needn’t have been concerned on that count, anyway. The warning is still up in 2009.

In this passage, I quote Dr. Roberto Guerrero. I remember the conversation well and regret that I never have gotten to meet him in person. His web site isn’t in the book. I see he can now be found at PlastiCenter: New Concepts in Plastic Surgery.