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Dr. Barry Eppley

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Surgeon Dr. Barry Eppley

Posts Tagged ‘medical tourism’

Infection Complications from Overseas Plastic Surgery

Saturday, February 1st, 2014


Medical Tourism Dr Barry Eppley IndianapolisMedical tourism, specifically getting plastic surgery outside of the U.S., continues to gain in popularity. Lower costs are the obvious reason and many procedures may be as much as 50% less than in the States, often more. While there is no doubt that quality plastic surgery is available abroad and, in some cases it may be real cost saver, but it also comes with increased risks.

While the U.S. health care system is fraught with extensive regulations driven by a high drive for safety and medico-legal concerns, many countries have far fewer such safeguards. That is one major reason their per procedure costs are less. While one argument against medical tourism is the fear that the training and skill of the plastic surgeons may be less, an equal if not greater concern should be about sterility and how medical equipment and supplies are handled. The lack of following adequate sterilization protocols and the re-use of medical supplies are another way to keep down costs but place patients at increased infection risks.

Plastic Surgery in the Dominican Republic Dr Barry Eppley IndianapolisThere is now a rash of infections coming in from plastic surgery done abroad. The Division of Global Migration and Quarantine and the Division of Healthcare Quality Promotion (DHQP) at the Centers for Disease Control (CDC) are investigating multiple cases of infections caused by Mycobacterial species after plastic surgery in the Dominican Republic. Fifteen (15) such cases have been identified in five states which has led to several state and local health departments in the northeast United States to issue an advisory for doctors to be on the lookout for this problem and to report additional cases. A nationwide advisory has been issued by the American Society of Plastic Surgeons to its members to be alert to the potential of this infection. It is possible that additional infected patients have not yet been reported.

Such mycobacterium infections were seen in women in the 18 to 50 year-old age range who had undergone breast augmentation, tummy tucks and liposuction in the Dominican Republic from the spring through the fall in April 2013. Symptoms of the infection included abdominal pain, abscesses with wound drainage and fevers. Over half of the cases were done at the same surgery center by the same surgeon. The patients developed infectious symptoms after their return to the U.S.. Given that so many cases were from one location raises the very real likelihood about a break in sterilization or the quality of the sterile products used.

What is very unique about this type of infection, a rapidly growing non-tuberculous mycobacterium, is that it is a very difficult strain to treat. Patients must be on prolonged antibiotics and may require additional surgery. This is not your typical skin bacterial infection that is relatively easy to cure by common and inexpensive antibiotics.

While medical tourism may be a booming industry, it’s downsides are that the quality of safety measures may be less…not to mention that should you have problems after you return you are on your own to find a surgeon to take care of you. Everyone knows that ‘cheap deals’ may be risky but they just never think it will happen to them.

Dr. Barry Eppley

Indianapolis, Indiana


The Safety of Plastic Surgery Abroad

Monday, January 7th, 2008

Overseas Plastic Surgery – Is It Safe?


I recently was asked to see a patient in a hospital emergency room to take out sutures from a facelift that she had done in Mexico. While she suffered no terrible complications, the cosmetic outcome was certainly not what I would have considered acceptable here in Indianapolis. The incisions were poorly placed around her ears and her hairline had been pulled up high into her temple area.
Seeing her brings to light a somewhat disturbing trend that is evident nationally, particularly in the southern border states, but is also prevalent on the internet as well. The number of patients going overseas for plastic surgery and the solicitation to do so on the internet, promoting low prices and a ‘vacation-like’ experience. Historically, going overseas for surgery is not new but has been done in the past to seek out operations or treatments that were not available in the U.S. This new overseas trend is solely based on discounted price.
Having traveled the world extensively and both met and operated with many international plastic and maxillofacial surgeons, I know there are many fine plastic surgeons around the world doing great work. However, in the interest of saving money, I am amazed how many people would naively disregard some of the basic tenets of choosing a plastic surgeon and surgery center. Important criteria such as board-certification, professional reputation, and the quality and track record of the facility where surgery will be performed can not possibly be assessed without a prior visit or consultation. But these issues aside, overseas surgery brings up several extremely relevant issues that most patients have not even thought of:
1) What happens in the event of a surgical complication? Who is going to take care of it? Fortunately, in elective plastic surgery, this is usually a postoperative problem so you would be home by then. Who would you go to locally? And any plastic surgeon seeing you here is not going to take of for free a complication from someone else’s surgery.
2) In the event of a complication during or right after surgery overseas, will your health insurance provide coverage in a foreign country? Does your health insurance policy extend beyond the U.S. borders?
3) Will you really be saving a large amount of money by going overseas? When you factor in the cost of air travel and local accommodations before and after your surgery, you may not find it such a bargain. Know all costs before proceeding. The ‘sticker price’ may not reflect all costs involved.
While saving money on plastic surgery overseas can be enticing, cosmetic surgery performed by an unqualified surgeon or in a setting that is not safe can risk your health and result in unappealing outcomes. Doing your research is never more important than when you leave the more highly regulated state of medical affairs and plastic surgery in the U.S.

Dr. Barry Eppley

Indianapolis, Indiana

Plastic Surgery Overseas – Is It A Good Idea?

Wednesday, November 21st, 2007

Traveling Overseas for Discounted Plastic Surgery

With the increased interest in plastic surgery and the numbers of procedures being performed on the rise, more people than ever before look to overseas to have their desired procedures……..at a substantial savings. In the June 2007 issue of Financial Times, it is reported that well over 100,000 Americans a year leave the United States to have medical work done. This is expected to not only continue but to increase at an annual rate of nearly 20 percent. The main reason is cost. A breast augmentation in the U.S. may cost around $6,000, but in Argentina it would $2,999. A rhinoplasty (nose job) in the U.S. averages $7,000, but in Costa Rica it would be closer to $2,000. Many of these countries and their surgeons aggressively advertise….and it is now possible to easily do so through the internet.

The question is…is this a good idea. Is the financial savings worth the inconvenience and the risk? Many of those surgeons from other countries would argue that the quality of care and the results are just as good as in the U.S. That is an issue that is difficult to debate as it always depends on whom is doing the surgery and what is their experience. I have no doubt that some good quality plastic surgery can be had abroad……but always remember….when their risk is minimal (who are going to sue or complain to?)….it is hard to imagine that some corners are not being cut…..and at your potential expense. Equally important, what aboout postoperative care? How are they going to follow you up and who is going to take care of you if you have problems? The answer to that is simple…….they aren’t and it is falls on your shoulders to find care back here in the U.S. and pay for it. I recently saw a facelift patient from Mexico who came to the emergency room to have her sutures removed. She was highly offended that there would be a charge by me for suture removal.

The American Society of Plastic Surgery (ASPS) states, “Bargain surgery can be costly.” This can be particularly true if you develop complications, such as an infection, or are unhappy with your results, having to redo the surgery here. Furthermore, immediate travel after any surgery increases the risks of certain complications such as blood clots. The ASPS recommends waiting up to 10 days after cosmetic surgery before flying again to decrease these potential risks.

Dr Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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