Chatsworth High School
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“Harrison Bergeron”
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Despite risks, more get nips, tucks in Mexico
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,
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Chatsworth High School
Medical Careers Academy
“Harrison Bergeron”
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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 presurgery 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. 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 10½ 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
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Chatsworth High School
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“Harrison Bergeron”
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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. José 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
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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.
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Chatsworth High School
Medical Careers Academy
“Harrison Bergeron”
Highlighting Assignment
Directions: After reading the article, complete the chart below. You may
use quotes from the article to create an accurate time line of Gail Rolow’s
plastic surgery story. Quotes used must be significant to the details of
the summary.
Gail Rolow grew up chubby, with lanky long legs. The other kids, the mean
ones, nicknamed her "Moose."
And she doesn't see "Moose" in the mirror anymore.
Rubric: 9 points. One point for each item listed.
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