Medical Tourism: How Insiders Afford New Hips, Hair Plugs, and Facelifts

"I look better than movie stars who’ve had lots of work done," says Michelle Darracott. And she’s right. The vivacious 56-year-old brunette, from Salida, Colorado, appears 20 years younger than her age.

A few years ago, though, she wasn’t feeling it. Always a nature lover, she’d started working in Colorado as a whitewater rafting guide while still in college, and years of outdoor activity had taken its sun-damaged toll.

"I wanted to look as young as I feel," she says.

Through a community-sourced website—RealSelf—she researched rejuvenation treatments and got unbiased input from others who’d done what she was considering… a trip overseas for cosmetic surgery.

"I’m an avid traveler," she says, "so I wasn’t concerned about the idea of going abroad for this. I chose Mexico because I’ve been there many times and know how easy it is to get there."

Through RealSelf, Michelle found Lori Payne, a medical concierge in Guadalajara.

Soon after that, Michelle was on a Zoom call with Lori and a surgeon in Guadalajara. "This surgeon had an excellent professional background and positive customer reviews. She spoke fluent English. And Lori was there for every step from there on."

In April of this year, Michelle and her husband went to Guadalajara—Mexico’s second largest city—where Michelle had a full facelift.

"We kicked around for a week prior to the surgery," Michelle says. "We went to markets and visited surrounding neighborhoods. Guadalajara is a fantastic city with lots to do. The suburb of Zapopan, where Hospital Puerta de Hierro Andares is located, is beautiful and very upscale.

"In those days before the surgery, I also had pre-op consultations, including a check-up with a cardiologist and blood work. They were very thorough. I spent two nights in the hospital, one prior to the surgery and one recovery night."

In addition to her full facelift, Michelle says, "I also had my eyes lifted, a neck lift, and fat transfers to my lips and cheeks. I can’t say enough about the professionalism and quality of care I received."

Michelle opted for an Airbnb stay for her recovery. "My husband was there to watch over me and bring me food that first week," she says, "but that’s part of the service Lori provides. She can arrange everything… a place to stay, a driver… She translated documents for me, and she became a friend."

In all, Michelle and her husband spent a month in Mexico. "You need about two weeks for the surgery and follow-up care. After that, I was comfortable going out, wearing makeup, a big hat, and sunglasses. We took a bus to the beach where I strictly stayed under an umbrella like a good girl."

Michelle spent $10,000 on her cosmetic work in Mexico. If she’d had the same procedures in her home state of Colorado, she conservatively would have spent three times that amount. Instagram-famous surgeons in New York City reportedly charge as much as $150,000.

"I definitely encourage people to not be hesitant about having surgery in Mexico," Michelle says. "The hospital there is so amazing and state-of-the-art… it makes our brand-new hospital here in Salida, CO look terrible in comparison. Plus, Mexico is close… and the food is delicious."

Last year, Greg Sedgemore, 60, of Seattle, had his hip replaced at Puerto de Hierro Medical Center, the same hospital where Michelle had her surgery. He’d been denied coverage by his U.S. insurance company even though he’d suffered debilitating pain over the years to the point of being "basically sedentary."

Greg and his wife, Beth, spent two months in Guadalajara prior to the surgery, and like Michelle, they loved the glorious architecture, fabulous museums, and historic cathedrals. They particularly enjoyed the markets, festivals, and the city zoo, Greg says, and visiting nearby towns like Tlaquepaque—famous for its ceramics, many art galleries, and strolling mariachis—and the scenic and serene Lake Chapala, home to Mexico’s largest expat community.

Greg says he met with the surgeon "at least three times prior to my surgery. He’s fully qualified and experienced in all kinds of hip, knee, shoulder repairs… I felt very comfortable."

For reference, a surgery like Greg’s costs about $14,000 on average in Mexico, compared to $40,000 in the U.S.

Now pain-free, Greg says, "My right hip will be next, and I’ll be going back to Mexico and the same doctor for that."

Why Travel For Medical Care?

Excellent healthcare is available in the U.S… but if you don’t have health insurance (and close to 28 million Americans don’t), that’s not quite the case.

Even good health insurance is unlikely to cover anything elective, such as cosmetic surgeries, dental care, weight loss surgeries, and more… or even cardiovascular and orthopedic surgeries deemed non-emergencies.

Some experimental treatments, such as stem cell and regenerative cancer therapies, are only available overseas.

Same goes for prescription medications in the clinical trials phase at home but available in other countries.

For instance, Gerson therapy—an alternative cancer treatment of dietary and supplemental regimes—is not FDA-approved and is available only overseas in Mexico and Hungary.

It’s costly (around $40,000 for treatment and accommodation in Tijuana, Mexico, according to one patient we spoke with). Follow-up treatments may become necessary… but many report success.

(Be aware, though, that you risk being dropped by your U.S. doctor and insurance should you pursue this.)

A 6,000-Year-Old Industry

“If we have a free day, we may visit the Poás Volcano.”|©SIMON DANNHAUER/iSTOCK

Medical tourism is not a new trend. Since the ancient Romans trekked through the Alps to Switzerland and Turkey to soak in thermal waters, people have traveled the world in search of cures, antidotes, and restorative therapies.

Even before that—sometime around 4000 BC—the Sumerians, in what is now southern Iraq, built majestic temples around sacred hot spring pools. Ancient Greeks were the first to build a comprehensive medical tourism network in the temple of Asclepius, the god of healing.

By 300 BC, one Grecian complex—Epidaurus—featured thermal baths, a gymnasium, sacred serpents, and a dream temple for restful meditation that drew people from all over, seeking remedies for a host of ailments.

Today, medical tourism is a $50 billion industry expected to nearly quadruple in the next five years.

It’s not hard to figure out why. As healthcare and prescription prices soar and inflation eats into daily living costs, many of us put medical care on the backburner… especially elective procedures not covered by insurance.

Josef Woodman, who wrote the book on medical tourism (a fifth edition of his Patients Beyond Borders: Everybody’s Guide to Affordable, World-Class Medical Travel will be out soon), says that price, quality, convenience, and speed are the drivers behind medical tourism.

If you could save 60–70% or more on dental work (including travel costs) and be assured of state-of-the-art quality by an internationally certified dentist in Costa Rica, why wouldn’t you?

That was the dilemma my husband Dan faced. After being quoted $24,000 for much-needed implants by a dentist in Omaha, Nebraska, he turned to a dental team we met through International Living in Costa Rica. We expect costs there, including flights for both of us and an Airbnb for the week, will come in at one-third to one-half of that $24,000 sticker price… even with a follow-up visit six months on.

We’re longtime travelers and expats, and we know and trust these dentists, so for us, a trip to Costa Rica for treatment is a no-brainer. We’ll arrive the Saturday before, giving us a beach and ceviche day before treatment begins on Monday.

Likely, we’ll spend mornings at the Prisma Dental clinic, and afternoons will find us lounging poolside. If we have a free day, we’re planning a jaunt to nearby Poás Volcano National Park.

Invisalign braces are hugely popular in the U.S., but cost upward of $5,000. Prisma offers a version of these braces starting at about $1,000. And they can correct non-severe cases in as little as six months. The procedure requires regular orthodontic visits for replacement trays as your teeth begin to align, so if you’re planning a longer-term stay in Costa Rica, it’s worth considering.

Dan jokes that he’s now a "dedicated consumer of medical care overseas," having had rotator cuff repair in both shoulders, one in Ecuador and one in Mexico; cataract surgery in Panama; and several other optical surgeries in Ecuador. In each case, he’s received excellent care and paid a fraction of the cost of these same procedures in the U.S.

Speed and convenience, of course, can sometimes be even more important than price.

Canadians, Brits, and others who desperately need knee or hip surgery, for example, can have costs covered by their national health system… but the wait time might be two to five years or more.

In a matter of days, though, they can travel overseas for an immediate fix.

Where to Go for Popular Treatments

During the pandemic and travel-ban years, the medical tourism industry came to a crashing halt… except in countries like Mexico, which never closed its borders.

Elsewhere, clinics and labs were often forced to lay off staff, and in some cases, close altogether.

The silver lining: now, providers use even more stringent safety measures. Today, activity has returned to pre-pandemic levels. It’s projected that nearly 800,000 Americans will travel abroad this year for medical and dental treatments.

Here’s where they’re going…

Dental Work and Facial Treatments: Costa Rica and Mexico

Many Americans, like Dan and me, head to Costa Rica for dental work. But Mexico is the top dental tourism destination for Americans.

Within Mexico, Woodman says, medical tourists lean toward three areas: Mexico City, resort communities like Cancún and Cabo San Lucas, and along the border in cities like Tijuana.

Tijuana (also world-renowned for bariatric procedures) is the top destination for dental care for southern Californians, but Mexico’s best-known dental center is Los Algodones, across the border from Yuma, Arizona. It’s known as "Molar City," and you can also get dermatological treatments, stem cell therapy, and more there.

A friend of ours goes to Puerto Vallarta a couple of times a year for fishing and fun, particularly nightlife. "While I’m there," he says, "I always get my dental work done at Just Smiles clinic… very professional and the equipment is top notch. The money I save more than pays for my airfare and cervezas."

As Michelle Darracott discovered, Guadalajara is home to Mexico’s top medical university (the Universidad Autónoma de Guadalajara School of Medicine—even U.S. doctors study there) and is one of the world’s top destinations for cosmetic surgery, particularly rhinoplasty and liposuction.

Plus, it’s a lovely, historic city with impressive colonial architecture, excellent museums, cultural activities (catch an orchestra or ballet performance), shady parks, and a year-round spring-like climate. As the birthplace of both mariachi music and tequila, it’s a fun place to be.

If, though, all you want is a noninvasive cosmetic makeover—like Botox injections—you can find that just about anywhere in Mexico, including all those popular resort areas. As a general rule of thumb, you can expect procedures done here to ring in at one-half to one-third of their American equivalent.

Another option for these treatments is Costa Rica, a nature lover’s paradise with towering volcanoes, lush rainforests, and stunning sunny beaches on both Pacific and Caribbean coasts.

Enjoy your time exploring… in gorgeous Manuel Antonio National Park, known for white-sand beaches and coral reefs, or soaking in thermal waters beneath the stunning Volcan Arenal—a restorative experience in itself.

Then book an overnight stay in the capital city of San José on your way home for an outpatient treatment. The Tabush Dermatology Clinic, for example, offers fillers, skin resurfacing, laser facials, and more.

You’ll also find world-class cosmetic surgery options in San José. Didi Carr Reuben is the U.S.-based patient coordinator for one of Costa Rica’s top cosmetic surgeons and an enthusiastic advocate for the "compassion and great expertise he provides."

Here, she shares a candid look at her own procedure and recovery experience.

Current price for a full facelift (neck, jowls, cheeks, upper and lower eyelids) is $8,400 and includes the fees for the clinic, surgeon, and anesthesiologist, says Didi.

Turn a Medical Visit Into a Costa Rican Vacation

If you find yourself in Costa Rica for revitalization, don’t miss the Avenida Central, or Central Avenue, which tourists often overlook.

Central Avenue is a pedestrian-only promenade in the heart of San José, the capital. Its crown jewel: the Plaza de la Cultura, with floors dedicated to the Art Museum, the Numismatic Museum, and the Gold Museum. Find the National Theater, where you can catch an opera or a symphony, nearby.

Grab Chinese food at the south edge of Central Avenue, where there’s a small but steadily growing Chinatown… or grab an authentically Costa Rican bite at Sikwa Restaurante, which boasts indigenous cuisines made with provincial techniques.

If you’re looking to relax, head to La Sabana Park, referred to as "San José’s lungs." Its 178 acres offer fields, trees, and lakes, and in the summer, you’ll spot lots of families picnicking here.

Mommy Makeovers and Nose Jobs: Colombia and Brazil

"You see why Colombia is known for ‘boobs, butts, and boots,’" a longtime expat pointed out one evening over cocktails in El Poblado, Medellin’s nightlife district. Indeed, any in the passing parade of well-endowed women in stiletto heels could have given Sofia Vergara a run for her money.

Colombia is one of the top countries in the world in terms of plastic surgery per capita. The most popular procedure is liposuction. In Brazil, breast implants are the top offering, ranking just above Colombia.

Bariatric surgery in Ensenada, Mexico led Lesa Wolman to drop 100 pounds. After doing lots of research through the website Obesity Help, Lesa traveled to Vitoria, Brazil for two surgeries comprising a full-body lift.

"Everything from my knees to my eyebrows," she says.

These procedures are often necessary after bariatric surgery to tone and tighten sagging skin in areas—particularly arms, thighs, breasts, abdomen, and buttocks.

In all, Lesa spent six weeks in Brazil, the first week accompanied by her husband.

"We studied some basic Portuguese before we went," she says, "so we could take a taxi, order food, go shopping… but my surgeon spoke fluent English and his nurse and staff spoke some, too."

Recovery was in a wonderful boutique hotel in the beachside city of Vila Velha, Lesa says, where staff took very good care of her.

Total cost: $28,000 not including travel expenses. "The cost in the U.S. would be well over $100,000," Lesa says. "Plus, having had surgeries in the States, I know for a fact I got far better, more personalized care in Brazil."

Alex Pichardo of Miami, Florida, suffered from severe congestion for years, thanks to a deviated septum. He consulted with five top doctors in Miami, and the minimal cost of corrective nose surgery was $15,000 with insurance. If Alex added in rhinoplasty to reshape his nose, the cost went up to $21,000.

So in February of this year, he consulted with Dr. Maria Clara Guerrero of Clinic Cirusabana, a small private hospital in Bogotá. She injected his nose with hyaluronic acid filler to give him a "nonsurgical rhinoplasty" (which lasts 6-8 months). Alex loved the temporary results and scheduled a rhinoseptoplasty—a combination of deviated septum and cosmetic surgery—for August.

Dr. Guerrero suggested he arrive two weeks before the surgery to allow his body to adjust to the high altitude in Bogotá. And since he’d need some recovery time, Alex booked a two-bedroom Airbnb for a month for $1,500 in an upscale area called Chico Norte, which he reports as safe, quiet, and highly walkable, with tons of restaurants. Alex says he’d easily pay $4,000 or more for the same modern space in Miami.

Alex was released from the hospital the same day as the surgery with antibiotics and anti-inflammatories—no painkillers. The doctor says he’ll be able to resume all his normal activities within a month.

Although the Clinic Cirusabana doesn’t take insurance, that’s okay. Alex’s total cost out of pocket: $3,000.

"I was nervous about having the procedure abroad," he says, "but Dr. Guerrero was awesome, the clinic incredibly clean, and the nurses attentive. Plus, Colombia is so inexpensive. It also has a quick approval process for a 2-year digital nomad visa. So I’m considering staying on…"

Colombia’s Largest City… And a Haven For Medical Tourists

To get the most out of Bogotá’s sprawling cityscape during your medical vist, stay at boutique hotel Casa Legado in the Quinta Camacho neighborhood. Quiet but central, and nestled between the affluent Rosales, El Nogal, and Chapinero neighborhoods, Quinta Camacho is a favorite of locals and tourists alike.

Eat in nearby Zone G (short for "Gourmet Zone"), where you’ll find a range of low- to high-end restaurants. Or check out Prudencia, a farm-to-table restaurant in the historic La Candelaria area (just don’t stay too late in this area, as foreigners stand out here).

Take a stroll around the Parque el Virrey, just north of Zone G, or opt for Simon Bolivar Park. There, you can find outdoor concerts, plus paths to walk or bike and a lake to paddle-boat in.

Bogotá is a sustainable, pedestrian city… which means that occasionally it hosts car-free days when only taxis and buses are allowed on the road. Plan accordingly.

Medically Necessary Procedures: Thailand

Europeans and Australians tend to head to Asia, where Thailand is the most popular destination for their medical needs.

In Bangkok, the Bumrungrad International, Samitivej, and Bangkok Hospital are all internationally accredited and well-recommended, offering everything from optical, dental, and cosmetic procedures to bariatric, cardiac, and orthopedic surgeries, fertility treatments, and more.

Suffering from a painful wrist, David Justice was living in Vietnam when he traveled to Samitivej Hospital for an appointment with an osteopathic hand specialist. He needed surgery, which was done within two days of the initial appointment. In just a few weeks after a few post-op physical therapy appointments, he was fully recovered.

The cost, including local anesthetic, was just $750. Had it been done in the U.S., he says, the same procedure would have been around $3,500.

"We have only good things to say about medical care in Thailand," says David’s wife, Wendy. "Hospitals are clean, modern, and fully equipped, the doctors are total professionals, and most staff at the better hospitals speak English well. Most doctors and even many nurses have received at least part of their education overseas."

Elsewhere in Asia, Malaysia offers great care (largely in Penang), as does India (particularly Chennai). Vietnam is a good place for dentistry. Singapore is not inexpensive, but known for specialized cardiac care and stem cell/oncology. A big Korean population in California goes to South Korea for care, including for advanced cancer treatments.

Bangkok: Recover in The World’s Most Visited City

If it makes sense for your procedure, stay at hotel Praya Palazzo on the Chao Phraya River… and accessible only by private barge. With just 14 rooms in the hotel, you’ll relax and recover in peace.

Check out the birthplace of Thai massage at temple Wat Pho. Show up early to beat the heat and crowds… and do keep in mind that Thai massage can leave you sore!

For a bite to eat, a street cart meal costs about $3. (The Thai meal of grilled chicken— gai yang—with salad and sticky rice is a must.) Or opt for Thipsamai, a restaurant known for originating pad thai. Pro tip: go for lunch, as the dinner lines can wrap around the block.

For a quick getaway, head up the Chao Phraya River to Koh Kret, an island known for its ceramics and traditional sweets. To navigate it, rent a bike—you won’t be competing with cars on Koh Krit’s motorfree roads.

Turkey: An Emerging Medical Tourism Destination… Especially for Hair Grafts

Like Mexico, Turkey also kept its borders open during the pandemic. As a result, it has quickly risen in popularity as a medical tourism destination, especially among Brits, the Irish, and other Europeans.

While airfares to Turkey from the U.S. will surely be more than flights to Mexico or Costa Rica, the low cost of treatments, hotels, meals, etc. in Turkey can still make it the more cost-effective choice.

"Turkey is the epicenter of hair transplants," says Woodman. "And Dunyagoz Hospital in Istanbul is known as the world’s best vision center. Cosmetic surgeries, too, are popular."

Hair grafts in Turkey typically cost $1,500 to $4,000, while in the U.S. the average cost is $10,000. And Dunyagoz Hospital recently offered a Lasik surgery package, including exam, surgery, and post-op follow-up on both eyes, plus two nights’ accommodation and all meals… for $1,730.

Some of the most popular cosmetic surgeries performed in Turkey include breast augmentation, liposuction, and rhinoplasty, with average costs reported as $3,720, $2,655, and $3,100, respectively.

Those costs include pre-operative appointments, anesthesia, all operating fees, and post-operative care. By contrast, the average cost for rhinoplasty surgery and associated fees in the U.S. starts at about $10,000.

Miami Ph.D. student Gulum Yenesehirli, 23, is a dual American/Turkish citizen who was born in Turkey but moved to the U.S. as a young child. Genetically predisposed to undereye bags, she decided to explore a cosmetic procedure (blepharoplasty) to have them removed during a trip to visit family in Istanbul. As an elective treatment, she knew costs would not be covered by her U.S. insurance.

Once in Istanbul, the surgeon she met with talked her out of the procedure. "She said I was too young and that it would be better to wait until my 30s. Instead, she recommended cheek filler and Botox under my eyes. So that’s what I did."

Gulum’s bill came to $500, an amount she was happy to pay. In Miami, cheek fillers alone cost anywhere from $2,500 up.

Will she return to the same doctor when the time comes for surgery? "Very likely," Gulum says. "I trust this doctor, especially since she didn’t push me to do something I wasn’t ready for."

A caveat: Because medical tourism is booming in Turkey, many less-than-upstanding service providers have cropped up. Earlier this year, the U.K. Foreign Office issued a warning to its citizens seeking medical care there, to which the Turkish government responded that its regulatory efforts meet the "highest standards of quality and safety."

If you’re considering medical care anywhere in the world, it’s important to do an abundance of due diligence. Look for accredited providers with years of well-established experience and verifiable credentials (see research tips below).

Pharmaceutical Tourists: Try Mexico

Recover under an umbrella on Conchas Chinas Beach in Puero Vallarta, Mexico.|©WIRESTOCK/iSTOCK

"A close friend has a serious cardiac issue for which he takes Entresto. He lives on Social Security income and he’s in the Medicare ‘donut hole,’ the point at which your coverage plan has reached its payment limit," says Woodman.

"This prescription costs him $600 a month. So I’ve convinced him to go to Mexico with me where he can buy the same medication for 80% less."

For Americans, Mexico is overwhelmingly the most popular destination for this type of medical tourism, and Woodman himself travels to Cancún to buy prescription medications.

"I only go to the very best, well-regulated pharmacies," he says, "the larger retail chain equivalents of Walgreens and CVS."

You’ll find a list of Mexico’s top five pharmacies here and the FDA guidelines for personal importation of pharmaceuticals here.

"Customs officials turn a blind eye to bringing back a reasonable amount of pharmaceuticals for your personal use," Woodman adds. "A six-month supply that you put in your luggage is typically not an issue."

As for safety and efficacy, Mexico, Thailand, Turkey, and India all export pharmaceuticals to U.S. companies like Pfizer. So essentially, you’re going around the middleman and directly to the source… for substantial savings.

Tips, Guidelines, and Resources

Facebook and other social media groups exist for just about every medical condition or procedure… "Arthritis and Joint Pain," for example, has more than 15,000 members. (Just be sure anyone offering advice has actually had the treatment.) You can also drill down by locale… search "dental tourism Costa Rica," etc.

Keep in mind that every country has its own medical standards, variances, licensing, and certification protocols. No matter where you seek care, there are associated risks… and not just with treatments and surgical procedures.

One reason foreign healthcare costs are less is because malpractice laws aren’t as onerous as in the States. Disagreements typically go to a medical review board and not through courts, as they do in the U.S. Most care providers will offer to correct, at no additional cost, any problems that might occur… but don’t expect financial remuneration.

While standard travel insurance will not help if you have a complication when traveling for an elective medical treatment, there are some policies—such as those from TME and Global Protective Solutions—that may provide some compensation for complications and accidents. Be sure to read the fine print.

10 Considerations Before You Book

1) Review resources like Josef Woodman’s Patients Beyond Borders and check out referral agencies like Patients Beyond Borders or Medical Departures (and sister company Dental Departures), which has vetted over 1,000 international clinics and hospitals. Look for English-speaking physicians, staff, and third-party agents.

2) Stick with accredited facilities. For dental care, look for membership in the American Dental Association or the International Association of Cosmetic Dentists. For other types of care, seek hospitals that are accredited by JCI (Joint Commission International). There are more than 1,000 JCI-affiliated hospitals worldwide with strict industry standards for good hygiene practices and both preoperative and postoperative care. Find international board-certified plastic surgeons here.

3) Do additional due diligence via online search engines. Read reviews. Ask for referrals to prior patients. Remember, of course, that no clinic, hospital, or doctor will get perfect reviews. A 4.5 rating or above is a good starting point.

4) It’s wise to use a medical concierge like Lori Payne in Guadalajara (lori.mymedicalconcierge@gmail.com) to liaise between you and the care provider. Concierges can book flights and appointments, check on passport and visa details, arrange lodging, and transportation, provide translation services, and more.

5) If you’ll be going under general anesthesia, strongly consider having work done in a top-quality hospital rather than a clinic. If complications arise, you’ll have emergency personnel and an ICU at hand.

6) Whatever you do, don’t base your choice on price alone. Cheaper is not always best. This is the time to pay for expertise and experience.

7) Consider how you’ll handle follow-up care once you’re home. Alert your primary care physician about your plans and consider connecting them with your international doctor to discuss your case. Be sure your international doctor offers follow-up communication and can recommend medications or make referrals if there’s an issue.

8) Plan your trip as far ahead as you can. Just as at home, the best overseas doctors have busy schedules, so give them plenty of time to work you in. Plus, the farther out you buy your airfare, the lower it will be. Choose a flexible fare that allows changes if necessary. For lowest costs overall, plan your visit during the low tourism season.

9) Once you’re on site, be patient and tolerant of cultural differences. It’s respectful in many cultures, for example, to engage in personal chit-chat and small talk before getting down to business.

10) Flying after major surgery can be dangerous, so allow recovery time. Shorter flights are better. The U.S. Centers for Disease Control (CDC) provides medical tourism advice here.

Will Your Health Insurance Cover You?

Check with your insurance company to see if they cover medical tourism expenses. Most don’t. Some overseas medical providers can help you research your coverage, and if you have it, can assist with the proper paperwork.

Increasingly, overseas care providers offer payment or financing plans and most accept credit cards… although this may increase your costs. Our dental clinic in Costa Rica, for example, offers a 10% discount for cash.