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Special Issue
WWD Scoop issue 09/29/2008

Bernadette, a 48-year-old human resources manager from London, planned to return home from her summer vacation in Los Angeles looking more than simply rested. She wanted to look perfect.

This story first appeared in the September 29, 2008 issue of WWD.  Subscribe Today.

So, in addition to sightseeing and a spot of shopping, the Birmingham woman spent a day with a Beverly Hills cosmetic surgeon, getting her forehead and brow lifted and bags under her eyes removed.

Bernadette, who asked to use her first name only, is one of a jet stream of cosmetic surgery-seeking Europeans on U.S.-bound flights whose travel plans are driven by the weaker dollar.

It’s reverse medical tourism: Americans long have been known to fly to places like Bangkok and Mexico to save on procedures such as root canals. Now, given the currency conversion rate, patients and surgeons say flying Stateside for a facelift or tummy tuck, even including airfare and hotel stays, is significantly cheaper than getting the procedure done at home. And that’s even though the pound and euro have weakened against the dollar in recent weeks.

As the American economic crisis continues and Americans put off indulgences including liposuction and breast implants, surgeons say their practices are being shored up by tourists from Russia, the Middle East, South America, Europe and Asia. As a result, a number of top-tier practices have started acting as de facto travel agencies, helping their overseas patients book stays at hotels and recovery centers, hiring multilingual office staff and canvassing further business by advertising in in-flight magazines.

“Frankly, we’re a bargain for them today,” says Richard Fleming, Bernadette’s surgeon, who runs the Beverly Hills Institute of Aesthetic and Reconstructive Surgery and who is seeing 20 percent more patients from overseas than he did a year ago. “A lot of this is related to the value of the dollar, and that’s what everything comes down to.”

For Bernadette, who stayed with friends, the savings were substantial: The surgery cost her $9,500, the airfare another $700. She figured the entire month in Los Angeles would total about 6,000 British pounds, or approximately $10,500. She compared that with the estimates she had been given by cosmetic surgeons in London, where she was told the surgery alone would be closer to 10,000 pounds, or about $19,000.

“Now, it seems so cheap,” she says. “And I got a whole holiday out of it.”

Surgeons are taking note and tailoring their businesses to encourage the trend. Simon Ourian—founder of Epione, a cosmetic surgery practice in Beverly Hills whose international patient base has leapt from 5 to 20 percent in the past couple of years—recently purchased a home near his clinic that serves as a private hotel for his overseas patients.

“In their minds, they are really getting world-class procedures done at what can amount to a 50 percent discount,” he says.

Dallas surgeon Jeffrey Adelglass is rolling out the red carpet for international patients in a bid to make his home base as popular as Beverly Hills and Manhattan. He boasts strong connections at the local Ritz-Carlton, pairs patients with personal shoppers at Neiman Marcus and arranges reservations at the best restaurants in town.

“We have high-profile patients who can be assured of privacy here,” says Adelglass. “There aren’t going to be photographers outside the building.”

Los Angeles–based surgeon Anthony Griffin credits his high-profile appearances on the reality show Extreme Makeover, which still airs in reruns in 122 countries, as the reason he’s seen a steep spike in overseas business. He estimates that a third of his practice is now international. “We really make it seamless. We’ve teamed up with after-care facilities, we have a concierge service that can arrange airport pickups and our office will make flight arrangements. I speak French and Spanish, and one of my employees is fluent in Spanish.”

Perhaps most remarkable is that surgeons who operate both in the U.S. and Europe are seeing Europeans fly to America.

Renato Calabria, who has clinics in Beverly Hills and Palm Springs in California, Rome and Milan, says that, while he tries to keep his European prices on par with those offered in the U.S., Italian patients fly to Los Angeles, nonetheless. His Vertical Facelift costs $20,000 on American soil. But, given that it’s the same in euros, more of his patients opt to trek to Los Angeles.

“They then spend the money they save on Rodeo Drive,” he says.

Cristina Ambrosini Sittoni is one such patient. A 50-year old government official in a town near Verona, Italy, she says she opted out of a four-hour trip to Milan for the procedure and instead is flying to Los Angeles in November.

“It’s still 20 percent cheaper after you consider all the costs,” she says.

There are others who figure that if they’re making the trip, they might as well get the works. Each month, Los Angeles–based surgeon David Matlock performs roughly 12 of what he calls his Wonder Woman Makeover—a $60,000, eight-hour series of surgeries with an ensemble team of surgeons, who work simultaneously on liposculpting, breast lifts and “Brazilian” butt augmentation. Of those dozen monthly procedures, half are on women from England.

“While it’s a bargain for overseas women, it’s not just about the savings,” he says. “A lot of these services are just not available in other countries. As a result, my overseas business now makes up 35 percent of all my business, and that’s the highest it’s ever been.”

Still, some doctors are slightly cautionary about the practice, saying major surgery is best and safest when done close to home.

“The real problem is you travel several thousand miles away from home to have a procedure done, and who’s going to do the follow-up if there’s a problem?” cautions San Francisco surgeon Edmund Zingaro. “The whole medical tourism thing can be a catch-22 because maybe you’re saving money at one end, but if there are complications, it isn’t necessarily in your best interests. Those are the questions people have to ask themselves before they do this.”

While some surgeons say the trend relies largely on global economics, others insist that, once that door has been opened, there’s no turning back.

Fleming declares, “Once an approach is established, it doesn’t really reverse.”