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Beauty Tourism Is a Quietly Flourishing Global Industry

From rhinoplasty and liposuction to Botox and veneers, the burgeoning beauty tourism industry is developing as quickly as breasts in the operating room.
Photo:  Mike McKeown/Daily Express/Getty Images

Photo:  Mike McKeown/Daily Express/Getty Images

From rhinoplasty and liposuction to Botox and veneers, the burgeoning beauty tourism industry is developing as quickly as breasts in the operating room. Tourists are traveling to all corners of the globe in pursuit of cosmetic surgeries and beauty treatments.

And brands can capitalize on these beauty tourism trends, offering consumers far more convenient, safer and even cheaper alternatives to overseas procedures. Like all trends, these can inspire product innovation — from cellulite-reducing lotions and laser-lipo devices to teeth whiteners and hair-growth serums that achieve comparable results.

People travel overseas for a whole wealth of reasons — better quality of care, insurance-excluded treatments, shorter waiting periods, the lure of some place new and, perhaps most of all, cheaper costs.

"In Europe, wellness tourism is most often associated with going to a spa town, like Karlovy Vary in the Czech Republic; in Asia, it could include going to Thailand or South Korea for a nip and tuck," says Daniel Levine, CEO of the Avant-Guide Institute, a trends consultancy. "This type of travel is growing, and it is inspired by vanity, brag-ability, the desire to add meaning to one's travels and the promise of saving money."

Traveling overseas for anything from a fat to a hair transplant can save some serious dollars, which makes beauty tourism a primarily price-driven phenomenon.

"Depending upon the country and type of treatment, uninsured and underinsured patients, as well as those seeking elective care, can realize 15 to 85% savings over the cost of treatment in the United States," explains Josef Woodman, CEO of Patients Beyond Borders.

Research from Patients Beyond Borders suggests that the medical tourism market, which is inclusive of cosmetic and dental surgeries, is worth upwards of $87.5 billion, as patients spend an average of about $3,410 per visit. While the market boasts a pretty penny, the price individual patients pay is a relatively small one, as it includes medical care costs, transportation, inpatient stays and accommodations — which still amounts to only a fraction of what some surgeries could cost in the United States.

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In Brazil, for example, Americans can save upwards of 30%, according to the research. In India, they can save up to 90%. In Thailand, they can pocket a quarter of what they'd spend at home. Meanwhile, everywhere from Costa Rica and Mexico to Turkey and Taiwan, Americans can expect to drop just about half of what they'd otherwise pay.

A full facelift, for example, costs $11,500 on average in the United States. In Malaysia, it's just about $3,300 and, in Mexico, it's only around $4,750. Likewise, rhinoplasty costs around $4,800 in the United States but, in India, it's only about $1,400 and, in Thailand, it's just about $1,600.

Couple cheaper costs with the advent of visual social media platforms that not only promote coveted travel destinations, but that also blow up with beauty trends, and even more people are willing to go the extra mile — or, rather, a few thousand extra miles — for treatments. They swipe through copious posts of people flashing their veneers in Thailand and breast implants in Colombia, and they're tempted to travel, too.

"We're constantly bombarded with images of what we are 'supposed' to look like, from the perfect set of pearly whites to wrinkle-free faces and cellulite-free bodies," says Mina Agnos, president and co-founder of Travelive. "With travel becoming easily accessible to everyone, having a nip-tuck in another country doesn't seem like mission impossible anymore."

More than 70% of Americans who receive healthcare abroad hit the road for elective treatments, and Patients Beyond Borders research anticipates that some 1.9 million Americans will travel outside the country for procedures this year.

Where they're going, however, depends largely on what they're seeking.

Countries with the highest government and private sector investments in healthcare infrastructure, as well as the most discernible commitment to international accreditation and transparency, are top competitors in beauty tourism.

Many countries comply with the same rigorous standards set by the U.S.-based Joint Commission's international affiliate agency, the Joint Commission International (JCI). In fact, there are now more than 950 hospitals and clinical departments around the world with JCI accreditation, and that number is growing by about 20% per year, according to Patients Beyond Borders.

That's largely why, today, the United States, Brazil, Japan, Italy and Mexico account for 41.4% of the world's cosmetic procedures, followed by Russia, India, Turkey Germany and France, according to the International Society of Aesthetic Plastic Surgery (ISAPS).

Breast augmentations are the world's most popular cosmetic procedure, accounting for 15.8% of all surgical procedures, followed by liposuction (14%), eyelid surgery (12.9%), rhinoplasty (7.6%) and abdominoplasty (7.4%), according to ISAPS. The most popular non-surgical procedure continues to be injectables — primarily Botulinum Toxin (Botox).

Of course, some destinations are reputed for specific specialties over others.

"Many countries are known for a particular category of treatment," Woodman says. "If you're seeking cosmetic surgery, Mexico, Costa Rica and Thailand rank among the most popular destinations. Dentistry will have you exploring Mexico, Costa Rica or Hungary."

Greece, for example, has become a top destination for Botox. In fact, according to ISAPS, Greece ranks second in the world for Botox injection procedures per capita. This means that the country boasts experienced clinicians, typically in bigger cities like Athens and Thessaloniki.

"A great selection of high-tech private medical institutions and an almost endless array of procedures available [make Greece] a fantastic option for medical tourism," Agnos explains. "Furthermore, hospitals, beauty and dental clinics in Greece are fully complying with strict EU and international health standards, and they're staffed with internationally accredited professionals in their respected fields, so tourists can rest assured that they'll be getting the best possible care."

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There were more than 300,000 cosmetic surgeries in Greece in 2018, according to ISAP, and that number is expected to grow by 15% this year. These surgeries include noninvasive face and neck lifts, vampire facials, laser skin treatments, breast augmentations (the most common aesthetic plastic surgery operation in Greece), power-assisted lipoplasty, gluteoplasty, hair transplants and more.

Dentistry, too, is trendy in Greece given that services can be up to 60% lower than in the United States. Thailand, dubbed "The Land of Smiles," is another hot spot for dental procedures, as cost savings there range from 40 to 60%, according to Patients Beyond Borders.

Following a dramatic overhaul of the Thai healthcare system, with revamped hospitals that vaunt state-of-the-art instrumentation, technology and services, Asia's first JCI accreditation went to a Bangkok-based hospital. Today, 61 Thai establishments are JCI accredited, which is more than any other nation in the region, according to Patients Beyond Borders.

Meanwhile, in Colombia, patients primarily from the United States come for plastic surgeries — sometimes more than one. According to a review of 658 international patients and 1,796 cosmetic surgery procedures, 72% of patients received "combination procedures," with an average of 2.7 procedures per patient.

The biggest procedures? Liposuction, buttocks augmentations and tummy tucks. These are also popular surgeries in Brazil, which boasts more than 4,500 licensed cosmetic surgeons, with the highest number of practicing cosmetic physicians per capita in the world, according to Patients Beyond Borders. There are more than 60 JCI-accredited hospitals throughout the country, including São Paulo's Hospital Israelita Albert Einstein, which is the world's first hospital to receive JCI accreditation.

Today, however, other countries in the region, such as Costa Rica, rival Brazil with better medical travel infrastructure (read: tourist services, widely spoken English and a consistent reputation of political stability).

In 2017, Costa Rica welcomed some 53,000 medical travelers, about 5% of whom visited to take advantage of primarily cosmetic surgery and dental care. After all, the World Health Organization ranks Costa Rica as one of the top three healthcare systems in Latin America, and it consistently ranks higher than its industrialized counterparts, including the United States.

Perhaps even more impressive is Turkey, which welcomed about 400,000 patients in 2016, many of whom visited for hair transplants and dentistry. That's largely thanks to the thriving network of more than 1,200 public and private hospitals — 45 of which are JCI-accredited (more than any other country in the region), and many of which are affiliated with credible institutions from Harvard Medical International to Johns Hopkins.

Ultimately, beauty tourists are spoiled for choice, with anywhere from South Korea for laser skin treatments to Israel for Dead Sea-inspired spa services. Still, however, they need to do their homework and observe best practices.

Of course, traveling overseas for beauty procedures and cosmetic surgeries is not without risk. But there are precautions beauty tourists can take to abate potential threats. For starters, a tummy tuck and tequila sunrises on some sun-sodden beach do not pair well — despite how dangerously rife all-inclusive sun-sea-sand-and-silicon vacation packages are becoming.

"We encourage [travelers] to focus more on [their] treatment and recovery than on tourism, even for the less-invasive procedures," Woodman says. "Websites and health travel brochures peppered with zealous recreational promotion tend to ignore the realities of health travel. Long flights, post-treatment recovery and just plain being alone in a faraway place can be overwhelming, even for the most optimistic health traveler."

While overseas cosmetic surgeries are often touted with holiday packages, the British Association of Plastic, Reconstructive and Aesthetic Surgeries (BAPRAS) calls these "misleading" and "unwise."

"Package deals and special offers can also encourage people to make rushed decisions about cosmetic procedures, which we know can lead to less consideration of risks and actually also raises the chances of being unhappy with the final result," a spokesperson from BAPRAS adds.

But Americans considering treatments overseas are less concerned with their package plans and, more so, with the quality of their care, according to the American Journal of Medicine. Fortunately, in an ever-globalized world, quality care isn't nearly as few and far between as it once was.

"Although no medical procedure is 100% risk-free anywhere in the world, the best hospitals and clinics abroad maintain health and procedural standards equal to, or higher than, those you might encounter in the U.S. or your own country," Woodman says. "The leading hospitals abroad are accredited by one of several renowned international accreditation institutions, including the [JCI]."

Of course, complications can occur no matter where you are. But managing them is where the real risk lies.

"Complications after cosmetic surgery can occur whether you undergo a procedure at home or abroad," says a spokesperson from BAPRAS. "However, if you choose to undergo a surgical cosmetic procedure at home, the consultant plastic surgeon will provide you with necessary aftercare and complication management. This reassurance cannot easily be provided when traveling abroad to have cosmetic surgery."

Should there be complications upon returning home from a procedure, patients will likely have to find new healthcare providers and pay out-of-pocket — costly postoperative care isn't necessarily covered by insurance. And research from Brigham and Women's hospital reports that complications such as infections, un-healing wounds and pain have occurred after some patients return home.

For many, however, the savings, care and experience are all worth the risk — at least until brands push out products that curb the need to travel for such results.

Already, brands around the world are picking up on beauty tourism trends, marketing to those who might otherwise travel for treatments. Take, for example, the flourishing K-Beauty marketplace in the United States.

"There is a lot of cross-pollination going on in the beauty industry, particularly with Asian brands making inroads to American and European markets," Levine notes. "At the moment, Asian women — especially Chinese and South Korean — are leaders in their use of cosmetics and treatments."

As more international brands realize the demand, perhaps consumers will be able to travel the world in the aisles of their own local beauty shops.

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