Nov 15

Chapter 4 Page 6 | Other Cosmetic Procedures

Hair Implants

Hair implants involves the transplantation of thousands of tiny patches of hair-bearing scalp tissue to the balding areas of the head. Results vary from patient to patient and are by no means guaranteed. Though Costa Rica’s Dr. Cohen mentioned that he does not see as many hair transplant patients as he once did because transplantation has become less expensive in the United States, research indicates that there is still a substantial “overseas discount” of 25 percent to 50 percent. Hair transplant prices are generally based on the number of hair/skin grafts done. U.S. prices range upwards from about $3,000, depending on the extent of the work.

Ear Pinning (Otoplasty)

Prior to research, I’d had no idea that fixing protruding ears was a popular cosmetic procedure. Otoplasty is the general term for cosmetically enhancing the appearance of the ears. Roughly 25,000 U.S. residents underwent some sort of cosmetic surgery of the ear in 2004, according to ASPS statistics. Prices in the United States range from $2,500 to $4,000; prices abroad range from $800 to $1,500.

Weight Loss Surgery (Bariatric Surgery)

Bariatric surgery that is designed to cause significant weight loss is increasingly popular in the United States. The surgery alters the digestive process, either restricting the amount of food the stomach can hold or causing food not to be absorbed. There are several different procedures and techniques with more continuing to evolve. The intestinal bypass was the first and is still the most common in the United States.

There are eight recognized types of bariatric surgery including laproscopic bariatric surgery, bariatric bypass surgery, and vertical banded gastroplasty (VBG). Bariatric surgery is considered a drastic lifesaving solution for a major health problem. In this instance, it is covered by some medical insurance plans and prospective patients in the United States who have health insurance are generally well-advised to explore the option with their insurer. However, many patients do go abroad to afford the surgery. For those interested in bariatric surgery and wondering where to start, I recommend without qualification the Obesity Help website (, an online support group that boasts more than 200,000 members.

Dental Procedures and Appliances

My personal experience with going abroad for costmetic surgery is limited to dental work. It is ironic, perhaps, I did far less research prior to going to Costa Rica for full-mouth reconstruction than I now recommend that others do before making a decision. Readers interested in the extensive details of my own experience should visit my Web site Beauty from Afar (  Since having my work done in 2004, I have recommended at least dozens of patients to Drs. Cordero and Rubinstein at Prisma Dental in Costa Rica.  Invariably, however, I point out that there are other excellent dentists in Costa Rica and around the world, and I urge prospective dental patients to thoroughly explore their options at home and abroad before making a decision.

Dental insurance in the United States rarely covers the full cost of extensive cosmetic work. There is certainly little reason to go abroad for routine dental work. However, when the prospective out-of-pocket expense for wanted or needed dental work climbs into the thousands of dollars, going overseas can become the pragmatic option.

Generally, dental patients do not require extended convalescence abroad, or significant immediate after-care and support, as do medical surgery patients. Costs range widely based on various dental proceedures, but my general statement that patients can expect to save from 40 to 75 percent on medical services abroad holds true for dental work. Many cosmetic surgery patients abroad opt to get at least minor cosmetic dental work, such as teeth whitening, done on the same trip.



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Sep 28

Reading back over today’s segment:

Dear Dr. Rubinstein …

… made me remember just how nervous I was, originally — just how strange it felt — in 2004, to head off to Costa Rica to spend thousands of dollars to get my teeth fixed. Even though, as I briefly mentioned, I’m no stranger to travel or adventures. At 20, I’d run off to South Africa for a job, knowing only one person there, and I had an amazing time there. I’ve called it the best year of my life, out of many good ones …

But anyway, going to Costa Rica for dental work was also a life-changing experience for me, because,  besides getting my smile back, better than ever, I never would have gotten to write Beauty from Afar if I hadn’t gone. I still like the magazine piece I wrote about the trip better than how I handled it in the book but that’s because it was more concentrated, more detailed, more about … well, me.

In the book, Prisma Dental comes up a few times. I sort of deliberately broke up the experience. It comes here, in Chapter 1, just by way of telling readers how I came to be a medical traveler, a dental tourist. There is much more about Prisma and Drs. Rubinstein and Cordero later, in the chapter about Costa Rica.

I was in Costa Rica in June and met a gentleman from Cheshire, Conn., who had read my original article about getting my new smile back in 2004, and had finally, in 2009, decided to do what I had done. I asked him if he felt as though the article had been accurate, had prepared him for his own journal and dental work. He said that it absolutely had. So I felt good about that.

We’re up to page 32 of the book, by the way.

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Sep 23

Chapter 1 Page 1  | Medical Tourism: Here, There and Everywhere

More than 100,000 United States residents leave the country for
cosmetic procedures every year. Where do they go? Wherever they like …

It is April, 2004, and I am having breakfast with a few new friends at Las Cumbres Inn outside San Jose, Costa Rica. Sandy, perhaps 45, a Californian, is nearly recovered from her nips and tucks, and is contemplating having her teeth bleached. “Might as well do it while I’m here,” she mutters, knowing she’ll be heading home in a few days.

Vicki, also forty-something, and a self-described vagabond, wears dark glasses to cover the swelling from the work done on her still-healing eyes. She is a U.S. citizen who has lived frugally but comfortably in a Costa Rican village for most of the past 11 years. She is thinking she is going to need to get a job again, soon.

Nina looks like she had been in a car wreck. She has had a face-lift, a neck lift, a “medium chemical peel,” and perhaps some other “work” that does not fix in my memory. She shows me the estimate she had gotten from a cosmetic surgeon in New York City for the major procedures she wanted. It came to $22,420: $18,000 for the face and neck lift, $2,100 for an operating room fee, $1,320 for post-operative nursing care, and $1,000 for anesthesia. Her entire bill in Costa Rica will come to $5,700, she says. On this morning, she wonders if she will ever again look anything like she had looked before, let alone better or younger. We assure her that she will, and later, we are proven right.

Me? I tell Sandy about my dentists, Josef Cordero, D.D.S., and Telma Rubinstein, D.D.S., childhood sweethearts who went to college and dental school together, got married, and have spent more than 20 years building an international practice. Sandy decides to go with me in the van that day to see if they can squeeze her in for a teeth bleaching.

They can. We all feel pretty smart, in the way people do who have a shared secret.




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