Elevate Magazine

Should You Consider Going Abroad For Surgery?
By Anne Dimon

Since more and more Canadians are choosing to go overseas for medical treatments,
cosmetic and otherwise we wanted you to be well-informed.

We asked freelance writer and wellness travel expert Anne Dimon to follow
a cosmetic surgery procedure in Mexico and report back to us.

The Mexican mid-day sun streams through the glass facade of Medica Avanzada Celaya (MAC), a modern and private hospital in the city of Celaya, as Susan Hemy checks in for a scheduled facelift.

The procedure – something she’s considered for the last five years “is a gift to myself for my 65th birthday,” says the Calgary resident and former Spanish teacher. “I was becoming unhappy with the way I looked. A few of my friends had had facelifts, and I felt [having a similar procedure] would make me look so much better.”

The Decision
Hemy decided to “go for it” when an acquaintance told her about Face Lift Mexico — a Miami-based business and pioneer of medical tourism since 1994 (faceliftmexico.com). “She told me the procedure was “amazing” and “way cheaper” then what one would expect to pay here at home,” says Hemy. It was an easy decision for her because, “the whole procedure had been mapped out already, including a gifted surgeon who had been recommended by someone whose work I had witnessed. There was also a comfortable place to recuperate, which would not have been provided in Canada.”

No stranger to travel in Mexico (she’s been travelling to the country since the 1970s), Hemy contacted Pat Marino, CEO and Founder of Face Lift Mexico, earlier this year, and went through the required pre-operative screening process. This involved providing the surgeon with EKG and blood work documentation. (Hemy had the tests done through her family doctor, and they were covered by Ontario’s health plan.) Photos (in Hemy’s case, taken by a friend) were also required to allow the surgeon to assess the area to be operated on.

The Doctor
Dr. Guillermo Keolliker, a plastic, aesthetic and reconstructive surgeon certified by the Mexican Association of Plastic Surgeons and currently on staff with MAC, plus two other hospitals in Celaya, has worked with Face Lift Mexico for the last several years. During his 19 years in practice, he’s operated on an estimated 2,500 patients, and the most common procedures he has performed are facelifts, liposuction, breast implants and tummy tucks (abdominoplasty.)

The Procedure
Based on her submitted medical tests, health history and photos, Hemy was pre-approved as a patient and the surgery was scheduled for April 2012. One of the most common issues that these pre-operative medical tests might indicate is anemia. If levels of hemoglobin are too low (10 or less), the healing process may be compromised. Dr. Koellicker says anemia can be corrected with supplements of iron and folic acid taken up to a month prior to surgery. The healing process may also be a concern for diabetics and heavy smokers. He stresses the importance of avoiding Aspirin and other blood thinners (including alcohol) for at least 14 days prior to surgery to avoid the risk of complications such as excessive bleeding. In all cases, the doctor may decide not to operate.

It’s about 2:30 p.m. when Hemy is escorted up to the hospital room for her pre-op evaluation (which includes blood pressure and an EKG) , and for an initial face-to-face with Dr. Koelliker. He discusses her medical history and lifestyle (exercise, smoking, medication, alcohol, allergies, etc.), and takes the time to explain the upcoming procedure, which will be performed by him and his team of five, including one assisting plastic surgeon and an anesthesiologist, who will administer an IV sedation to work in tandem with a “local” instead of a “general’ anesthetic, which is what’s commonly used in Canada.

The difference: “The combination of a “local” plus IV sedation is, in most cases, safer than a general because the patient is breathing on his or her own and not hooked up to machinery,” says Dr. Koelliker. The decision is based on the doctor’s preference, and 95 percent of the time Dr. Koelliker’s chooses the IV and local option. A general is administered if the patient does not respond to the IV sedation.

Hemy’s surgery will include the upper and lower eyelids, the removal of fatty deposits and loose skin under the chin, plus filling in of the “number eleven lines” in the forehead with her own removed fat.

The goal is to restore the contour of the jaw line and reduce sagging and puffing around the eyes. Dr. Koelliker is a bit concerned about Hemy’s low levels of iron in the blood (a reason to cancel surgery) so they schedule another test. He recalls one patient who flew in from Hong Kong for a facelift. When pre-operative tests showed her iron levels were too low for the scheduled next day’s surgery, she had two options: to postpone the surgery for a month or accept a blood transfusion. “She choose the blood transfusion,” he says.

But it’s blood pressure that causes the greatest concern. If it’s too high they will not operate due to the risk of excessive bleeding both during or following surgery. Low blood pressure is not an issue.

The Details
Ultimately, Hemy is a good candidate because her health is good and the problem areas are easily removed fatty deposits and saggy skin, says Dr. Koelliker. There is some concern that removing skin around Hemy’s eyes might make them protrude, so he makes a note to be conservative in this area. Following the hospital’s pre-operative tests, the doctor delivers the results himself: everything is fine and surgery is a go for the next morning. Hemy receives antibiotics prior to surgery and pain medication following. The operation itself takes three and a half hours.

Of the hospital experience, Hemy reports, “it was the best hospital experience. Pain was very well managed and staff was very, very good — Dr. Koelliker is quite talented and attentive, and very good with explanations.”

What also impressed Hemy about the hospital was that staff allowed a friend to stay with her in the room. Hemy recommends travelling with a companion if possible, “if only for moral support.”

While English is spoken only minimally throughout the hospital, Dr. Koelliker speaks English and the bilingual coordinator from Casa Marino is easily accessible by phone in case language problems do arise.

Following Hemy’s three-night stay at MAC hospital, it’s about an hour’s drive (the driver is included in the package sold by Face Lift Mexico) to the historic town of San Miguel de Allende, and Spa & Club Casa Marino where clients recuperate following surgery. Here, staff serve meals, pick up prescriptions (for pain medication and antibiotics) and generally make a guest feel comfortable. Complications, if they occur, are usually evident within the first two to three days following surgery and, in such cases, Dr. Koelliker is called.

Located in a residential neighbourhood, a ten-minute walk from the centre of the iconic Spanish Colonial town, Casa Marino is a comfortable, traditionally-decorated Mexican casa with three guest rooms with private ensuite baths, plus a dining room, living room, yoga studio, spa, several outdoor spaces and lovely rooftop views of the town. “To relax while smelling the local flowers, breathing the fresh air, feeling the breeze all night long, is such a luxury and is so healing,” says Hemy of her six-night stay.

Seven days following surgery, Dr. Koelliker arrives at Casa Marino to check his patient, remove stitches and dispense further advice on home care and a prescription to assist with the healing of scars. He explains that it typically takes two weeks for bruising to disappear following a face lift and one to three months for swelling to completely subside. The results, he says, should last 10 years or longer depending on lifestyle and genetics. Once they return home, patients are welcome to follow-up with Dr. Koelliker by phone or e-mail.

When I telephoned Hemy in her Calgary home just shy of three weeks following surgery she told me that her husband and daughter were both impressed with the results so far. “They say I look good and more youthful.” She says the healing process has not been painful, “just a bit of numbness.”

“This is a very positive and well-managed process,” says Hemy. “Particularly for those who don’t speak Spanish or those who may feel a bit out of their element when travelling to a foreign country.”

A note from the writer: “As a Canadian living in San Miguel de Allende, Mexico for six months of the year, I can personally vouch for the medical system here,” says Anne Dimon. “The local doctors and medical facilities are first class. Following this cosmetic procedure with Dr. Koelliker, I have found him to be a talented and dedicated professional.”

Medical tourism, however, can be risky. “It is crucial that consumers do their homework,” says Dimon. “Research, get recommendations and choose a qualified doctor. Companies such as Face Lift Mexico can definitely help facilitate the procedure but it is important to delve into things on your own, too.” Always find out how long a company has been in business, and whether they can provide references.

Face Lift Mexico is one of several companies helping Canadians and Americans facilitate medical tourism in Mexico. Cost for a facelift package including surgeon fees, a three-night hospital stay, six nights at Spa & Club Casa Marino, ground transportation between airports, the hospital and Casa Marino, plus most meals, is $8,300, for single accommodation.

For a tummy tuck, the package price — with 14 days of accommodation — is $9,000. Packages do not include flights to Mexico or the daily service charge/gratuity of $10 U.S. per day, per guest. In the event that a patient is not approved for surgery due to an unforeseen or last minute medical problems there is a charge of $400 – $600 for physician consultation, hospital room and pre-operative consultation.