cosmetic tourism - The Atrium

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COSMETIC TOURISM
Kelly A. Harrison
School of Hospitality & Tourism Management
University of Guelph
ABSTRACT
Societies shallow perceptions of beauty have been increasingly facilitated through media
exposure. Beautification, and the constant strive for physical perfection has made way
for a new form of tourism, cosmetic tourism. As a subsector of medical tourism, cosmetic
tourism is travelling abroad for the sole purpose of obtaining cosmetic surgery, most
commonly at a discounted price. Safety issues and a general lack of industry knowledge
are top concerns for potential candidates, but can be improved though the appeal of
discounted cosmetic procedures combined with a relaxing and restorative holiday has
made cosmetic tourism an increasingly sought after form of tourism.
Keywords: cosmetic tourism, medical tourism, cosmetic surgery, healthcare
Introduction
It is the unfortunate truth, but society has become increasingly persuaded by
media brainwashing. Billboards, magazines, television commercials and many other
forms of advertising have set standards for beauty that have relentlessly facilitated an
unhealthy, superficial body image. But what happens when cosmetic products, new diets,
and trendy clothing are just not cutting it? The mainstreamed societal standard of beauty
has made way for a new type of tourism, cosmetic tourism. Cosmetic tourism, a
subsector of medical tourism, involves travelling for the purpose of undergoing medical
procedures for enhancing one’s physical appearance. Altering one’s physical appearance
to mimic society’s perception of beauty is a very controversial issue; meanwhile
undergoing a cosmetic procedure to better one’s quality is a separate issue.
North American cosmetic procedures are amongst the highest in cost. Candidates
that would otherwise not consider undergoing surgery are now considering cosmetic
surgery in other countries due to the substantial decrease in cost. Europe, Asia, The
Middle East, South America, Africa and the Caribbean are among the most popular
dental & cosmetic tourism destinations according to the Medical Tourism Association
(Medical Tourism Association, 2012). Prices can range from 20 percent to 70 percent less
than North American prices (McLymont, 2010). A standard facelift in the U.S is
approximately $15,000 compared to just $5,000 in Mexico, whereas breast implants ring
in at about $10,000 on average compared to just $2,700 in Thailand (Medical Tourism
Association, 2012).
Although the primary reason for undergoing cosmetic surgery is to alter the
physical appearance, this type of travel is most usually constructed as a restorative and
relaxing experience (Bell, Holliday, Jones, Probyn & Taylor, 2011).
Whether it is vacationing to Mexico for dental veneers or Thailand for a nose job,
cosmetic tourism is definitely on the rise. Exact patient numbers and procedure statistics
are hard to validate because cosmetic tourism is considered ‘Medical Tourism’ for the
most part. However, in 2013 the medical tourism industry, including cosmetic; is
projected to reach over $100 billion making it one of the fastest growing sectors of the
health-care industry (McLymont, 2010). Realizing the market potential of cosmetic
tourism, health insurance companies have began to partner with accredited hospitals to
provide coverage and usually at a lower rate than traditional health insurance (McLymont,
2010).
The credibility of the hospitals facilitating cosmetic procedures for international
travelers is among the most important when considering surgery. For example,
UK citizen, Claudia Aderotimi died in a Philadelphia hotel after receiving a ‘toxic’
buttock augmentation (Bell, Holliday, Jones, Probyn & Taylor, 2011); serving as proof
that medical malpractice is not exclusive to solely ‘budget’ destinations. There are many
horror stories about the danger associated with travelling abroad for cosmetic procedures,
which could easily be a result of patients failing to conducts thorough industry research
prior to travel. The Medical Tourism Association is an American non-profit organization
comprised of top international hospitals, medical travel facilitators, healthcare providers,
and insurance companies aimed at promoting the highest level of quality healthcare to
patients in a global environment (Medical Tourism Association, 2012). Cost, quality,
service, and access are all determining factors of choosing a cosmetic tourism destination
(Bell, Holliday, Jones, Probyn & Taylor, 2011). As the industry expands, so does the
degree of invasiveness of cosmetic procedures; therefore, it would be in the best interest
of the patient to perform thorough research and make sure the hospital and practitioners
are credible.
Historic Perspective
Cosmetic tourism may seem like a relatively new trend; however, travelling for
the purpose of ‘health’ is not. The ancient construction of spa resorts in Rome and
seaside sanatoriums most commonly associated with Victorians could be considered to
have laid the foundation for modern European tourism (Bell, Holliday, Jones, Probyn &
Taylor, 2011). From the majestic healing powers of hot springs in the West to the
therapeutic, holistic alternatives popular in the East, medical tourism can be observed in
many forms all over the world. Medical tourism has been defined as “a form of niche
tourism, links leisure travel, the act of seeking fun, pleasure, relaxation and bodily escape
from the stresses and strains of daily life, with purposeful escape to medical interventions,
such as cardiac surgery, stem cell injections, organ and bone marrow transplants, body
enhancements and dental care”(Buzinde & Yarnal, 2012). Initially only wealthier people
could afford treatment overseas, however, the economies of scale theory has proven itself
in the medical tourism industry as the consumption of cosmetic procedures increases.
According to Jonathan Edelheit, Medical Tourism Association president, claims that
“Medical Tourism is the only thing in health care that has hard dollar savings”, and that
“if people actually start to use it, health care costs will start to go down”(Moody, 2007,
p.114). For example, a heart bypass, not covered in the U.S will cost on average
$144,000 as opposed to $27,000 in Mexico, a total cost savings of $117,000 on average
(Medical Tourism Association, 2012).
Initially medical tourism procedures were for the most part minor and only
undertaken because they were excluded from traditional health insurance programs
(Moody, 2007). Another attractive feature of medical tourism is the avoidance of long
waiting periods, which is a common complaint in North America (Mclymont, 2010).
Primarily in the U.S, waiting periods can be extremely lengthy and costly due to the lack
of universal healthcare, and can adversely result in life-threatening circumstances for
many critical patients. A reported excess of 45 million Americans are uninsured
according to Moody (2007). Patients now have the availability to travel and receive
medical attention abroad without remortgaging their house or claiming bankruptcy.
Another attractive feature besides low surgical costs is the ease and affordability of
airfare to many cosmetic tourism destinations. For example medical tourism facilities
such as the Bumrungrad Hospital in Thailand have created packages targeted at medical
tourists and have partnered with airline companies to offer reduced flight rates (Buzinde
& Yarnal, 2012).
The evolution of the rapidly growing medical tourism industry has sprouted the
cosmetic subsector. In many developed countries more lenient vacation time, increasing
salaries and a less focused ‘need’ based society have all made way for the new genre of
medical tourism deemed cosmetic tourism. “In a media environment increasingly
saturated with images and narratives of makeover and transformation, a cosmetic surgery
makeover is becoming a prevalent fantasy and a growing reality, and in affluent societies,
work on the body has now become a ‘project of the self’"(Bell et al, 2011, p.150). As
perceptions of beauty have become a mainstreamed focus of society, cosmetic surgery is
on the rise. A relaxing and restorative holiday experience combined with shorter wait
periods and attractive pricing drives the demand for cosmetic tourism (Hall, 2011). For
example, Rhinoplasty; more commonly known as a nose job, will ring in at roughly
$8,000 in North America compared to just $4,500 in Costa Rica, a gross savings of 45%
(Medical Tourism Association, 2012). A North American facelift procedure will cost on
average $15,000, but travelling to India for the same procedure would cost around $4,000
on average, a 74% savings (Medical Tourism Association, 2012).
Many popular destinations have realized the market potential for cosmetic tourism,
several of whom officially recognize the industry as an export and receive government
tax breaks (Bell et al, 2011). “Many governments, international agencies, private health
providers and even some medical practitioners see it as a means of economic
development that may cross-subsidize domestic health access” according to Hall (2011,
p.9). Tourism is seen as an export for numerous countries; thus, the inflow of cosmetic
tourism provides a source of much needed revenue for many local economies. Aside from
the health care professionals involved in taking care of the patient, local restaurants,
hotels, transportation, attractions, and local shops can also benefit from the increasing
inflow of tourists due to cosmetic tourism. Bell suggests that “Such workers, and the
economic and social processes in which they are implicated, are not incidental to the
phenomenon of surgical holidays; they in part help to constitute it” (Bell et al, 2011, p.
145). The number of tourists seeking cosmetic makeovers has continued to expand
rapidly in many parts of the developed world. It is estimated that over 500,000 Americans
travelled abroad to receive medical treatment in 2006 (Moody, 2007). Travelling for the
purpose of ‘health’ and well-being has been around for hundreds of years, however, in
more recent years the medical tourism industry has experienced rapid growth especially
in the cosmetic subsector (Bell et al, 2011).
Breadth of Impact to Date
Unfortunately travelling abroad for medical services has had some negative
publicity. Horror stories of tourists having surgical procedures done by fraudulent and
uncertified doctors have flooded the news. One horror story that surfaced was the case of
a hospital on one of the Greek Islands forgetting to administer pre-operation medicine to
pre-operational patients (Bell et al, 2011). One story about a woman who traveled to
South America for a tummy tuck that went horribly wrong received so much attention
that it aired on television. This woman experienced intense pain for several weeks, with
multiple infected, open lacerations while the foreign surgeon refused to take
responsibility for his botched surgical procedure. Quality of care and qualified medical
practitioners are a common concern for hesitant adopters of cosmetic tourism. Many
foreign health centers have achieved international accreditation from organizations such
as the Medical Tourism Association and the Joint Commission International both of
which rate and review foreign hospitals and healthcare centers for tourists. In order to
avoid surgical complications abroad, potential candidates to conduct thorough research
prior to traveling.
As the cosmetic tourism sector develops further, the pool of available information
for potential candidates is likely to expand in size and validity. It should be a top concern
for tourism industry organizations to further research ‘accredited’ medical centers as well
as preform audits on medical practitioners abroad to minimize medical malpractice.
Having the procedure preformed at a recognizable hospital and ensuring the surgeon is a
qualified professional can avoid horror stories such as the ones mentioned above.
However, the candidate must realize that using non-accredited surgeons abroad may still
be qualified, but may not necessarily have the quality of training North American and
other well-developed countries provide. Increased bio-security becomes a concern for
cosmetic tourism because patients deliberately travel to medical environments, which
have the potential to expose themselves to new pathogens and microbiologic flora and
fauna (Hall, 2011).
Aside from the obvious health concerns associated with medical tourism lies a notso-evident socio-economic byproduct. Sadly, in many countries with a medical tourism
industry, the treatment of foreign patients often comes before locals. If the medical
center is privatized, then the surgeon is setting the price and booking their own
appointments, resulting in the prioritization of patients with the highest willingness to pay.
This can be seen in other forms of tourism. For example, there are strict regulations
enforced by the Mexican government in order to prevent locals from ‘disrupting’ foreign
tourists and to secure the demand for tourism; a major driver of economic wealth.
Medical tourism is a lucrative business for many periphery nations because it has the
potential to “increase gross domestic product, upgrade services, generate foreign
exchange and create a more favorable balance-of-trade situation, and boost
tourism”(Buzinde, Yarnal, 2012, p.784). Unfortunately, this is commonly at the expense
of the locals in the host country. The “availability of health care resources for local
people; inequalities within the health care systems of host nations; human resource
allocation, relating to the percentage of educated local people who service local
communities versus those who cater to foreign clientele; and lastly, economic and social
benefits to host nation versus socio-economic exploitation” are all negative byproducts of
medical and cosmetic tourism (Buzinde, Yarnal, 2012, p. 785). The questions
surrounding morality surface surrounding the issue of exporting medical services while
local populations remain suffering with little or no medical care (Hall, 2011).
Clearly there are many moral issues surrounding cosmetic tourism in postcolonial
regions such as Costa Rica, Thailand, Mexico; the most popular dental and cosmetic
destinations (Bell et al, 2011). On the other hand, international medical professionals
may seek additional training in the United States, which could not only facilitate the
demand for cosmetic tourism but also increase the quality of care for local people.
Although there is much negativity associated with exporting cosmetic medical service
and local communities may lack sufficient healthcare, inbound cosmetic tourists are still
providing economic stimulation. The destination image also has the potential to improve
a destinations image. If international tourists are willing to put their health in the hands
of foreign practitioners, then that destination is likely to improve their brand image, in the
medical subsector specifically. Other forms of tourism may benefit as well because
cosmetic tourists receiving medical attention often plan their trip to include more
traditional types of tourism. For example, patients receiving dental implants in Mexico
are likely to stay post or pre surgery to experience the destinations beauty and visit
popular attractions such as the Mayan Ruins. Multi-purpose types of tourism therefore
can become very hazy. Travelling for the purpose of receiving cosmetic surgery may be
the initial driver of cosmetic tourism, but providing the holiday experience is still a
crucial driver of GDP for many post colonial countries.
Anticipated Future Evolution & Impact
There is always going to be negative publicity regarding traveling abroad for the
purposes of undergoing a cosmetic procedure because the topic itself is extremely
controversial. The trends surrounding the increasing emphasis media places on “flawless
beauty” in societies such as North America will continue to trigger people’s obsession
with being perfect. Unfortunately many patients still fail to conduct the necessary
research surrounding accredited healthcare facilities qualified medical professionals,
which result in exaggerated media negativity towards cosmetic tourism. Since price has
always proven to play a major factor in consumer’s buying decision, people will research
the availability of different price points for the particular procedure(s) they are interested
in; naturally this will lead them to discovering the large cost savings available in foreign
countries. Shorter waiting periods in postcolonial countries have also attracted cosmetic
tourists. As the industry develops regulations surrounding local welfare and foreign
medical policy are likely to become increasingly stringent. As a result, the
commoditization of the cosmetic tourism industry will allow opportunities for developing
countries to strengthen their tourism industry and allow them to capture a larger share of
the tourism industry.
References
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theoretical approach to medical tourism. Social Science & Medicine, (74), 783787. Retrieved from
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