Anonymous - 9-13-2005 at 11:18 AM
http://www.azcentral.com/arizonarepublic/news/articles/0911m...
by Susan Carroll
Sept. 11, 2005
TIJUANA - Gail Rolow grew up chubby, with lanky long legs. The other kids, the mean ones, nicknamed her "Moose."
Even as a teenager, when Rolow thinned out to 5 feet 9 and 149 pounds, she still saw "Moose" in the mirror. After her first baby, she weighed 203
pounds. By the fifth, she was up to 260. And that was before the birth of her twins.
After losing nearly 100 pounds following Lap-Band surgery, which restricts the amount of food she can eat, Rolow still carried a constant reminder of
"Moose:" pounds of sagging skin.
That's how Rolow, a 42-year-old housewife from the small northern Arizona town of Taylor ended up in a plastic surgery clinic in Tijuana on a Tuesday
afternoon in August with her daughter, Leesa Lopez. Rolow was waiting to ask a Mexican surgeon about a lower body lift to remove the sagging skin, and
possibly breast implants.
"I can't believe I'm doing this," Rolow said, settling into a modern, plush armchair in the clinic's waiting room. "It's so not me."
The U.S. and Mexican governments do not keep statistics on the number of Americans who head south of the border for plastic surgery. But Mexican
surgeons said the trend seems to be growing, fueled by word of mouth and slick Internet sites advertising cut-rate prices.
The patients, from teenagers to business executives to retirees, slip south of the border for weeklong vacations that include some nip-and-tuck, often
at nearly half of the price compared with the United States.
Clinics have cropped up from Tijuana to Nogales, and in Mexican beach resort towns, including Cancun and Acapulco.
But there are risks that come with the bargains. Although Mexico requires that plastic surgeons have certification, like in the United States, border
clinics are often difficult to police, authorities said.
For American patients, checking credentials in a foreign country can prove more difficult, in part because of the language barrier, and some have
returned home to the United States in recent years with horror stories about botched plastic surgeries.
In the Tijuana clinic waiting room, Rolow found reassurance in three women, friends from Fresno and Firebaugh, Calif., all just days post-surgery,
talking about their bargains on breast implants and tummy tucks as if they'd snagged Gucci purses on clearance at Neiman's.
"She actually had (surgery) scheduled in the States," one woman said, gesturing to Sandy Flores, 52, who had breast implants, liposuction and a tummy
tuck. In California, Flores was quoted $16,000 for the work. In Tijuana, she paid $8,900.
"Aren't they great?" Flores said, referring to her new breasts. "After the tummy tuck, (the doctor) said I'd look 16!"
Her enthusiasm paled compared with that of Sharon Ramirez, 50, of Firebaugh, who wore a flowery muumuu to cover up white surgical bandages. She had a
tummy tuck with liposuction, a lower eye and chin lift. It was the chin she was the most excited about.
"I never had a neck before" she said in a confessional tone, likening her pre-surgery appearance to a "football player."
"Now I have a neck!," she said, smiling.
Denise Wasson, 45, of Fresno, tried to reassure Rolow. "You couldn't be in a better place."
The risks
Rolow knew the risks associated with surgery in Mexico. The horror stories had reached back to her hometown north of Show Low. A woman from nearby
Eagar went to Tijuana in August 2004 for Lap-Band surgery and said she came home with a perforated esophagus.
Blanche Hamblin, 41, said the surgery had sounded like a good deal at first. In Tijuana, it was $7,500 to $8,000, instead of $25,000 in the United
States.
But shortly after the surgery, she said, she realized something had gone very wrong. The hole in Hamblin's esophagus was leaking air and food into her
chest cavity, she said.
The pain became unbearable, and she said she had to return to the Valley for emergency corrective surgery to remove the Lap-Band. She spent two weeks
in the hospital racking up a $110,000 bill, covered by insurance, plus $12,000 out of her own pocket for rehabilitation, she said.
"I have all these bills I'm paying - for nothing," Hamblin said.
Rolow went to the same Tijuana clinic five months earlier for her Lap-Band procedure. She said she was pleased with the results, although she had
minor complaints about getting the "run-around" during follow-up care. The surgeon for Hamblin and Rolow, Dr. Jaime Ponce de Leon, did not return
phone calls seeking comment.
When it came to plastic surgery, Rolow decided she needed some guidance. At 184 pounds and 5 feet 10? inches, Rolow wasn't looking to lose more
weight. She was just hoping to have a tighter body, without the extra skin, and wanted a surgeon she could trust.
"You only have one body," she said.
She contacted Kristy Blackman, who lives in the Valley and runs a Web site that refers patients seeking Lap-Band surgery to clinics in Mexico.
Blackman, who is paid $500 for each client she sends south, referred Rolow to Dr. Alejandro J. Quiroz, a Mexican plastic surgeon who is board
certified in the United States and Mexico.
Blackman said that too many Americans go to Mexico without making sure their surgeon is certified by the Mexican government or don't make sure medical
devices and implants are approved by the U.S. Food and Drug Administration, which requires stringent testing before allowing their use.
"Surgery in Mexico can be good, and it can be safe," Blackman said. "The reason there are so many horror stories is because the American public tries
to get too good of a deal. They get on the Internet and hop on the first, cheapest bandwagon they can, and then when they end up with problems, it's a
bad deal."
Dr. Jos? Luis Haddad, with Mexico's national plastic surgery association, said there are plenty of qualified, certified surgeons south of the border.
"They have to look for a board-certified plastic surgeon. That is the most important (factor)," said Haddad, a Mexico City-based surgeon. "The problem
- and this also happens in the United States - is that there a lot of doctors that are not certified to perform plastic surgery."
Dr. Todd Case, a Tucson-based plastic surgeon, has treated patients who had surgery in Mexico who came home with "major complications," he said,
including infections and ugly results, such as asymmetrical breast implants or uneven liposuction.
"My overall advice would be: Buyer, beware," Case said. "Just because it's cheaper doesn't mean it's as safe or better."
Going under
A nurse led Rolow into Quiroz's corner office with bay windows overlooking the city. Quiroz, a charismatic surgeon with salt-and-pepper hair, got
right to the point.
Because of the rapid weight loss associated with the Lap-Band surgery, Rolow's upper and lower body would need extensive reconstruction. He
recommended a lower body lift, which involves removing excess, sagging skin and light liposuction to transfer fat from the stomach area to the
buttocks.
Quiroz also recommended an upper body lift instead of a breast augmentation to reshape the breasts without weighing them down.
Quiroz showed her before-and-after pictures of other clients who had the same procedures. He scheduled a physical for Rolow before the surgery to make
sure she had no major health problems.
Quiroz, who estimated about 90 percent of his clients are Americans, reassured Rolow that the Tijuana clinic has a good safety record.
"We've never, ever had a major catastrophe, death or sepsis," said Quiroz, who is also licensed to practice in Santa Ana, Calif.
He explained that Mexican surgeons are able to charge lower prices for a simple reason: lower overhead costs.
The costs of running a surgery clinic in Mexico, from labor to rent, allow him to charge about half of the price of a procedure in Arizona, he said.
Plastic surgery in Beverly Hills or New York can run about four to five times as much as in Mexico, he said.
Rolow liked Quiroz's bedside manner, found him kind and reassuring. She signed the paperwork and said she would return the next morning for surgery.
Quiroz warned her before she left that the surgery would last about four to five hours "because you're a big girl." He smiled and patted her on the
shoulder.
Rolow thought to herself: "Moose."
Surgery and recovery
At 8:35 a.m., Rolow was ready to head into surgery.
Her daughter, Lopez, a pretty 21-year-old pretty blonde, walked her to the door of the operating room.
Lopez asked, "Are you nervous?"
"No, I'm not really nervous," Rolow said. They hugged.
"OK, we can do this," Rolow said.
Liposuction is not a delicate procedure. Quiroz, assisted by another surgeon and a nurse, removed fat cells from Rolow's belly to inject into her
buttocks. He made an incision from one side of her body to the other, then carefully cauterized blood vessels to minimize bleeding.
After almost six hours of surgery, the doctors had rearranged the skin on her torso and reconstructed her belly button.
By 5:40 p.m., Lopez was able to visit her mom. She kissed her on the forehead. Rolow's husband, Howard, a papermaker, called the clinic from Taylor
worried and wanting to know that his wife was OK.
After the first few days of nausea and pain, Rolow said, she was surprised by how quickly she recovered.
She was released from the clinic the day after the procedure. Three days after surgery, Rolow was on a plane from San Diego back to Phoenix.
Within three weeks, she had her stitches out, removed by a doctor in Taylor. She was running around after the children still living at home, ages 12,
10, 9, 8 and the 4-year-old twins.
Rolow said she is not planning to get any more surgery. She loves the results of what she has had done, she said.
And she doesn't see "Moose" in the mirror anymore.