#233 – The Expat Files: Medical Tourism and Cosmetic Procedures in Latin America

Automatically transcribed from the original recording; names and wording may contain errors.

[00:00] South of the border down Mexico way That's where I fell in love when the stars above came up to play and now as I wonder My thoughts ever straight Hi everybody I'm Johnny Mueller and you're listening to the expat files Living in Latin America the show that tells you what it's really like to live work play and or retire in Latin America I tell it just like it is so let's get started Now as you might have figured I do get a lot of emails and the top three topics that expat wannabes Want to know about our number one business number two security and safety and number three guess

[00:45] No, I'll tell you health care issues And you know one thing that's big and getting even bigger by the day is medical tourism And of course I get a ton of emails about that, too Basically from gringos up north who don't necessarily want to move down to Latin America But they want to come down and get some first-world Quality surgery that won't break the bank like they know it will if they have it done in Boston or Cleveland And let's talk about elective surgery first. You know like cosmetic surgery, but I didn't have to tell you that now did I you know We used to call it plastic surgery up north, but now everybody says cosmetic surgery. It sounds less well plastic right But down here in Latin America. They don't say cosmetic surgery. They say sir. Yeah plastic

[01:30] Ah, it's that lag time thing again You know, but I'm sure soon enough they'll be talking about cosmetic surgery here, too But for now, it's sir. Yeah plastic Ah, it's very big up in the States as you know But with all those baby boomers including me slipping out of the far side of middle age and into the early stages of old Age and I do cringe a bit when I say that and I don't know about you But I kind of feel some days like I'm a 25 year old guy stuck in a middle-aged body You know what I mean? And you know I can't tell you how many expats I meet that see exactly the same thing They say God when I look in the mirror. I seem old but inside. I'm like 25 or 30 I thought when guys hit 60 or so they turn into cranky old farts like Andy Rooney, but not me

[02:17] What's up with that? But it does help a little bit to know old age ain't what it used to be and neither is middle age When I was a teenager, we thought 30 was old and 40 Ancient and just look how so many of the old-time classic movie stars never even made it to what we'd call old age today Like Humphrey Bogart, for example who died at 56 Errol Flynn 49 Gary Cooper 60 Clark Gable 59 and I guess I'm showing my age just by Mentioning those guys because young people today the Facebook generation. They have no idea who I'm even talking about What's old age to you 70 80 you have to decide not me so anyway today I'm gonna talk about elective surgery health care costs down here in Latin America and

[03:06] Why go there because people want to look good at third world prices. It's as simple as that So are we vain or what of course we are now if you happen to be mr. Or mrs. Natural and are turned off by the topic of cosmetic surgery because it's against Mother Nature or whatever Well, let me ask you this how many of you have had your old grisly yellow teeth bleached at the dentist office Well, did you know that it's the number one most requested cosmetic service in America today? And if you're that one in a million who thinks that dingy yellow crooked teeth are attractive, then you probably live in England Anyway, how many of you have bought toothpaste because the box says it whitens your teeth or be honest here Would you buy a tube of toothpaste that's set on the box?

[03:52] The ingredients in this toothpaste are 100% organic and natural, but it has the side effect of Darkening your teeth. Would you still buy it because it's all natural and organic? Well, you know what that little experiment has already been performed by some researchers at Michigan State University They placed tubes of toothpaste Labeled exactly like that on the shelves of health food stores right next to the regular organic brand And as you might imagine no one bought them when the price was higher than the regular organic toothpaste But get this when the price was lower Vastly lower half the cost guess what still no one bought the stuff In fact, they even tried to give it away and no one wanted it So the moral of that story is I guess we're all into looking good and looking young even the most dyed in the wool

[04:42] naturalists purists and tree huggers So anyway not to belabor the point by popular demand Let me tell you the real price of beauty down here in Latin America now Let me start off by reading this from an article that's been syndicated through many big Latin American newspapers It's in Spanish. So I'll translate of course the articles entitled What is the price of beauty and in the first paragraph it says liposuction breast augmentation? Rhinoplasty Botox and laser hair removal are the most common cosmetic Procedures performed in Latin America and it goes on to say only about five to ten percent of the Latin American Population can afford to have even some of the least expensive procedures done like hair removal in Spanish called

[05:30] Depolacion since some of these cosmetic procedures can cost up to nine times the monthly salary of the average Latin American Okay. Now look at that from our perspective a first-world perspective Suppose you made four thousand dollars a month, which is about the median monthly income for the average family up in the States now Suppose you're somewhat homely teenage daughter Asked for a nose job for her 16th birthday because her friends are all getting Katy Perry noses, too Now if that nose job ran nine times your monthly salary like it does for the average working person in Latin America Which for you would be thirty six thousand dollars, obviously it would be out of the question So anyway, that would be the mindset of the average family guy down here in Latin America, too for him

[06:17] There's just no way to afford it even on a payment plan And by the way, every doctor's office down here in Latin America does offer payment plans Often through a local bank or finance company just like up in the States. And of course, they take credit cards Okay. Now, here's the average cost of cosmetic surgery in Latin America off the tourist trail You can double these prices if you're in Panama Costa Rica Argentina Chile in most of Colombia and Brazil and by the way even at double the average cost when you're on the tourist trail Like Costa Rica nevertheless. It still seems like a very good deal Compared to what you'd pay up in Cleveland or the rest of the first world and of course Let's not forget that if you get cosmetic surgery done in places like Brentwood or Beverly Hills

[07:04] Manhattan or the Gold Coast or Lakeshore Drive in Chicago or any of the very wealthy areas up in the first world now If you decide to get cosmetic surgery there You could be paying double what you'd pay in less pretentious places like Cleveland Boise, Idaho Madison Wisconsin or Minneapolis Either way, it's so expensive to do that kind of work up in the first world because insurance doesn't cover it Of course The fact is you could have your surgery done down here in Latin America And save so much money in the process that you not only get the free trip out of it, too But you'll often save enough money off the difference in first world prices that you can use the savings for a real vacation Anyway, here's how it breaks down for Latin America off the tourist trail Let's talk first about upper and lower eyelid surgery, which is called an eyelid tuck up in the states

[07:55] You'll pay about a thousand to fifteen hundred dollars when you're off the tourist trail down here And that's the whole cost of the treatment the hospital the anesthesiologist Medications and follow-up visits and all the prices i'm quoting right now include the complete treatment So anyway a thousand to fifteen hundred dollars for an upper and lower eye tuck whereas up in the united states The average cost for the same thing is four thousand to fifty five hundred dollars about four times as much And by the way down here in spanish, they call an eyelid tuck sueria de parfado Okay, next we have breast implants and boob lifts Well down here in Latin America off the tourist trail again. It costs between two thousand and twenty five hundred dollars complete And yes, that's for both of them Whereas in the states the average is six to eight thousand dollars

[08:43] So down here breast implants are about a third what should pay up in the first world Not a quarter like most other procedures and the reason for that is the doctor has to buy the implants from a first world So you're not talking about third world pricing there Which is a fixed cost of about a thousand dollars or more but his labor and the Anesthesiologists in the hospital and all that still only cost about a quarter of what you'd pay up in the first world Added to the cost of the first world implants, which is still a huge savings And by the way down here in spanish, they call that procedure almento de senos Okay, what about a complete facelift, which is called? Well that comes in also at around two thousand to twenty five hundred dollars as compared to a first world average price of eight

[09:32] Thousand to ten thousand dollars again in latin america. It's about a quarter of what you pay up there Okay, what about extensive liposuction the works we're talking about sucking out the whole enchilada here Not just removing that little turkey gobbler under your chin. Anyway down here again It's two thousand to twenty five hundred bucks. Whereas up in the state's a big procedure like that's eight to ten thousand bucks again Four times as much and what about that? Oh so famous botox? Well down here depending how many areas you have done It's about 100 to 250 bucks Whereas the average cost up in the states could be anywhere from 250 to 600 dollars depending how many units are necessary And of course i'll mention this again Here in latin america doctors use the very same products as doctors up in the first world. They order from the same companies

[10:22] Now here's one thing an expat lady told me about her botox sessions down here in latin america She said when she was getting botox up in the states in texas She could tell they were diluting the botox because sometimes it just didn't kick in like other times And that was up in the states and her suggestion for getting the full dose down here is to always watch when the doctor Withdraws the liquid from the bottle into the syringe She says make sure they open up a fresh vial in front of you So you can see that it's new and untampered with and if he doesn't want to do that Because they've got a lot of units left in a bottle that's been previously opened Which is okay by the way because it's still sterile Anyway, just tell him to put you on a call list for the next time they open a new bottle So you can run down there and be the first in line now the doctor might think you're nuts for requesting that

[11:11] But being that you're a finicky gringo or gringo, they'll generally oblige Oh and while you're at it, make sure you have a look at the little bottle and the expiration date Now from what i've heard that's never been a problem, but you should check anyway Now I know up in the states They have botox parties like they used to have Tupperware parties And i'm sure the cost is a lot less than it would be in the doctor's office However, i've yet to see botox parties hit down here in latin america yet though I guess with that lag time effect they'll get here soon enough But I can tell you this there are an awful lot of high-end beauty salons and women's beauty spas that offer botox treatments You see ads in the big newspapers for that stuff all the time And of course at much lower prices than I just quoted the prices I quoted were from a real doctor's office

[11:57] Now at the spas and salons, there's just no way of knowing how qualified they are They all look nice in their name tags and pressed white coats and all that but i'd stick to the doctors if I were you Why not now here's a new one on me calf implants. Have you heard about those before? Apparently some women and some men bodybuilders like to have a more proportioned lower leg now I admit I have pretty ghastly looking legs myself But I wouldn't think of having something like that done though. It seems there is a market for it Obviously they're doing that procedure quite a bit down here or they wouldn't be talking about it in this news article It says here calf implants, which in spanish are called implantes de pantorillas You got that pantorillas. Anyway, they cost from 1500 to 2000 bucks

[12:44] Whereas the same thing in the states cost from five to seven thousand bucks And since we're talking about implants I have to say that wealthy latin women are getting butt implants like crazy And I can tell you the reason too You see latin men and women have their own ideas about what the perfect body shape should be In fact, all you have to do is look at the mannequins in the stores down here and the billboard models coming out of columbia And venezuela and you'll know what I mean. The mannequins especially are very very big in the rear end department Have a look at latin clothing mannequins and billboard models and you'll see what latin men and women think is the ideal woman's figure And that's why that 5 of wealthy latin women ones that can't afford it and ones that aren't already naturally endowed

[13:29] Often undergo a butt implant procedure now down here They call that almondo degludios and that costs anywhere from 2000 to 2500 bucks end up in the states Six to eight grand now from what I hear they talk a lot about butt implants up in the states But very few people actually get them and here's the actual numbers on that which is kind of amazing It turns out according to the american society of plastic surgeons in 2008. There are only 850 people in the whole united states that opted for butt implants and of these 87 were women who either wanted to emulate jennifer lopez or Beyonce or another one of their big butted celebrity favorites and the other 13 of those

[14:16] 853 just wanted to reverse the effects of gravity, but that was back in 2008 and do excuse me if i'm saying but a lot here but anyway In 2011 in the whole united states. There are only 1150 reported butt implants according to the american academy of cosmetic surgeons, but down in latin america It's a completely different story down here round firm gravity defying butts are all the rage If you can afford it, but still up in the states It's kind of way down the line on the cosmetic surgery wish list for most american women for them It's usually botox breasts eyes Liposuction and that's about it But it seems down here in latin america

[15:01] Butt implants are way up on the cosmetic surgery wish list And you can easily tell that by just having a casual walk through a high-end shopping mall Just have a look at the ladies with the real jewelry and the bodyguards look but don't stare, you know Okay. So what about nose jobs? Well, just like in some places in the states a nose job can be a rite of passage for a young teenage girl Kind of like clear than candy colored braces were with orthodontists some years ago Anyway down here in latin america You do see some of that young girl nose job thing going down But like I said since only about five percent of the population can shell out for a procedure like that You might only run into young girls showing off their nose bandages and black eyes When you're in high-end malls and wealthy sections of the bigger cities and down here a nose job runs anywhere from a thousand to

[15:52] 1500 bucks whereas in the states it's generally five to six thousand Now again with that five percent of women that can actually afford it And even with quite a few hair sweet ladies from the middle classes who save their pennies It seems that just recently permanent laser hair removal is all the rage In fact in the last year or two those laser hair removal places have been popping up all over in wealthier sections of latin America where the clients are but why all of a sudden are they so popular? Well, it's like this Like I mentioned in a number of past shows latin women have this deep seated desire to be and look like what they're not They want to be and look like first world women first world gringas except of course for the butt thing I was talking about earlier

[16:39] In fact latin american women will often point out that first world caucasian gringas have been short changed in the butt department And you know even to get more on pc about this I have to mention not any old big butt will do if you ask an average latin guy Any latin guy for that matter rich or poor he'll say it's just not about any old big butt It's about a certain style of butt a round firm kind of high rising butt that seems to defy gravity Now you first world ladies out there. Don't shoot me. Those aren't my words That's what you get when you ask a latin guy what he prefers in the way of a woman's figure And this show the expat files is about living in latin america So I am obliged to mention all the sociological idiosyncrasies that go with the territory Which means that every so often i'll give you just the kind of stuff you'll never read about in international living

[17:27] Or any of those global retirement newsletters So if you want to hear it like it is you have to listen to the expat files as Unpc as it might sound sometimes Anyway, I was talking about how latin women are nuts about laser hair removal Well, in fact, like I may have mentioned in the past show you often see latin women with blonde or highlighted hair Sometimes even redheads and latins with green or blue eyes, but the truth is that's all fake It's their attempt to look like a first world gringa And the only real blue eyed blonde latin women or latin women with red hair and green eyes Are latins whose parents or grandparents came from europe and they never interbred with the local latin population? Because when they do intermarry with the locals their kids will lose those northern european traits

[18:14] They'll get diluted and those traits are highly prized down here in latin america simply because they're so damn rare The fact is people who are tall light skinned have light hair and or blue green or gray eyes Are considered to be on top of the genetic heap down here and they always always get preferential treatment So if a pure european or caucasian american hooks up with a local latin and they have kids The first european style genetic traits to get washed out are the light hair and the blue green gray eye color Which just happen to be the most desirable traits of all if you're a latin person And that's why so many women lighten their hair and they wear contact lenses to make it look like they've got blue or green eyes Just have a look for example at chiquita or jennifer lopez or christina algileira who's half equidorian or jessica alba

[19:07] Who's half mexican for some of the famous latina models like chiquita? So many of them have blonde hair along with brown eyes and if you know anything about genetics That's a very very rare occurrence Anyway, the dark brown eyes with the blonde hair is always a telltale sign that a latin woman's had a tint job But in reality on any given day in any decent sized city in latin america You'll see dozens of light haired even blonde women But you'll almost never see a blonde or light haired latin guy We should give you a very good idea what the natural hair color scheme is down here Very dark brown to black hair with dark brown to almost black colored eyes And latins no matter how attractive they are with those color combinations They'd all rather have been born with light skin blonde hair and blue gray or green eyes

[19:57] And if you don't believe that come on down and take an unofficial poll and you'll see what I mean But then again, I guess most of us would like to be something that we're not And that's why latin women that can afford it will go to great lengths to wipe every dark follicle From their legs and arms and faces and other even more sensitive areas And nowadays laser removal of facial and body hair is kind of affordable even for the middle classes So it's a huge growth industry down here Especially since all these little laser clinics offer nice long payment plans plans flexible enough Even for a woman making three to four hundred bucks a month For example, if a woman has a bit of a mustache or an upper lip shadow She can get that taken off and it's called

[20:43] Depolacion de bigote She can get that done for around 75 bucks And by the way, that's for five or six treatments each one a month or so after the last and for that in the states About four to five hundred bucks And for underarm which is axilla laser removal It's about a hundred dollars for six treatments in latin america and about six to eight hundred dollars in the states And what about that oh so common bikini hair removal that a lot of girls up in the states are getting? About a hundred bucks and in the states again about six to eight hundred for the six sessions And what's popular these days is what they call the brazilian bikini You ladies know what that is, right? And I don't know about up in the states, but down here it's extremely popular and how do I know that? Well, don't jump to conclusions just yet

[21:30] I was told that by one of the ladies that works at one of the laser clinics So what does a brazilian bikini job cost about 200 bucks and that can cost over fifteen hundred in the states So as you can see some of these laser hair removal treatments can be almost one tenth of what you'd pay up in the first world And that's because labor is so damn cheap down here The fact is once one of these clinics buys a laser hair removal machine or two After it's been paid for and amortized The only expenses the spa owner has are labor utilities and rent and rent for sure would be a third of what you'd pay In the states and labor about a fifth or a sixth of the cost and that's how they can offer those treatments So inexpensively now the only problem for expats and expat wannabes that might want to come down to latin america for hair removal

[22:18] Well, the procedure is to spread each treatment out a month to a month and a half apart Which means you're looking at more than a half a year to have the whole series of treatments completed And that puts the kibosh on that kind of medical tourism Since the idea is to fly down and get some work done Recover for a couple of days or a week and then fly back to cleveland with more than a little change left in your pocket And you know, the thing is you don't have to come to latin america for medical tourism You can always go to the far east china indonesia the philippines or india And they too have very cheap procedures and top of the line doctors many of them first world trained However, your round trip airfare there is going to cost you anywhere from 2000 to 3500 bucks In many cases more than the cost of the medical treatment itself

[23:06] Not to mention if you're flying from the states you're talking about a 10 to 15 hour air flight And it's not necessarily going to be a direct flight And if it is it's going to cost you more and that also means a 10 to 15 hour time change too And i'll tell you you don't know what jet lag is until you've flown to the far east By contrast if you fly down to latin america Let's say panama city or san pedro sulla honduras or guatemala city Then you're looking at round trip airfare of six to eight hundred bucks and possibly no time change at all or at most two hours And the flight time itself say from the midwest like chicago If it's a direct flight you're looking at four hours if you have a connection maybe six or seven Anyway, you can see some of the big advantages already and besides that

[23:54] All the doctors you'll be dealing with in latin america speak english And that's not necessarily going to be true if you fly to someplace like thailand or china or indonesia or the philippines Now a lot of people send me emails asking about the dentistry here They ask me if it's worth it to come down on a medical tourism jaunt to get some extensive dentistry done since it is Very expensive up in the states. Well in a couple of past shows. I mentioned how I feel about that If you choose a little more expensive high-end dentists, they're very good However, most of their laboratories and laboratory technicians suck compared to the high quality ones that you see up in the first world The ones with automatic computerized casting machines and such that's why i'm against having extensive dental work done here and flying back right away

[24:43] Everyone i've ever known who's done that when returning for a visit to the hometown dentist in boston or cleveland They nearly always find something deficient in the work that was done in the third world And I know a lot of first world people personally people from the us and canada People who brag how cheap they got the work done only to return to the states in canada with some complaints and problems with the work So what do you do then? You really can't fly back to costa rica and have some adjustments done there now, can you? Well you could but then there goes your bragging rights on the price differential, right? Anyway, like I said in a past show It's perfectly fine to get dental work done down here as long as it's not big time crown and bridge work Or multiple tooth porcelain veneers or dental implants or tmj workups or something major like that

[25:32] And sure you'll get it cheap. There'll be a huge price differential However, i've seen some pretty bad dental work done here and i've seen some bad stuff done in the states, too But the thing is the average person doesn't really know a good dentist from a bad one Most of us lay people are of the opinion that if it looks halfway decent and it doesn't hurt Then the guy must have been a good dentist Well in dentistry that's not exactly how it works A lot of people are walking around with time bombs in their mouths that actually look pretty good to the layperson I mean how many times have you been to the dentist and he said well, sorry to tell you this But that pain you're feeling is a cavity that's worked its way under an old filling or a cavity that's worked its way Under an old crown and now it's got to be replaced for a thousand bucks and often a person will act shocked and say

[26:20] How did that happen? I brush and floss all the time and your dentist up in cleveland will say something like yeah But you know that crown it had a little ledge on it beneath the gum line where you couldn't see it a food trap And no matter how much you brush your floss It's still gonna be a food trap because the crown was not exactly adapted perfectly to your gum line Which might not be the dentist's fault but the fault of the laboratory that made that crown Can you see the problem here tiny minute defects like that are beyond your powers of perception after all things like that don't hurt Not initially and i'll tell you the laboratories up in the states are very good But down here in latin america I've seen some of these laboratories and i've never seen one that matches the cleanliness or the quality of a very good us lab

[27:08] So bottom line if you need fillings a root canal or a crown here and there that'll usually work out fine But you're really taking your chances If you're a dental basket case and you're coming down to get the big stuff done However, if you can find a dentist who uses a lab that's got modern computerized fully automated casting and porcelain firing equipment Then I say go for it and let me in on it, too You've been listening to the expat files living in latin america coming to you each week from somewhere south of the border And don't forget you can email me on anything at all about latin america the expat files at gmail.com See you next time