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Plastic surgery tourism?

More and more people are traveling overseas for low cost surgery. Many have come back looking great and feeling fine. But others have not. They've gotten cut rate plastic surgery from doctors they know little about. And they've lived to regret it. NBC's Victoria Corderi reports.
/ Source: Dateline NBC

In today's nip-and-tuck world, it seems more and more people long for extreme makeovers. For most, though, it'sa costly fantasy that's way out of reach. But not for these women. They thought they'd found a way to make it happen.

Maria Morel, a mother of three from Newark, N.J., had been dropping hints about plastic surgery to her family for a long time.

Sonia Wilmoth, a 37-year-old secretary and mother from Boston, says she was so ashamed of her flabby belly and stretch marks she wouldn't even undress in front of her husband. Sonia says she was such an avid fan of makeover shows, she even called the plastic surgeons on television.

And these two best friends also had the same wish. Allyn Segura, a single mother living in Miami, and Yvonne Tamayo, an immigration consultant in New York, talked about plastic surgery on the phone constantly.

So how did the women find a way to make their surgical dreams come true on a budget? All they had to do was become part of the multi-million-dollar lipotourism trade, a business built around two ideas: foreign doctors who offer cut-rate surgery and Americans who are willing to go overseas to go under the knife.

Who wouldn't be tempted by the idea of sun, fun and surgery at unbeatable prices? Consider this: A tummy tuck in the United States would set you back at least $6,000, but in Costa Rica it's only $2,000. A facelift in the U.S. costs up to $9,000. In Malaysia it costs a third of that. And a breast augmentation in the U.S. costs $7,000, but in the Dominican Republic, only $2,000.

In fact, the Dominican Republic is fast becoming the Caribbean Mecca of lipotourism. Eighty percent of the plastic surgery patients there come from abroad lured by low prices and a seductive climate. But as the lipotourism in the Dominican Republic grows, some American doctors are concerned about the quality of care patients who go there receive. And, as we found, choosing one questionable doctor can lead to tragic consequences

You can find ads for clinics in the Dominican Republic on Web sites, but much of the business is drummed up by word of mouth in an unusual setting that is anything but clinical -- mom and pop beauty salons.

Dateline went to one in Manhattan with our hidden cameras last November. There were dozens of women jammed in the salon, many of them waiting for an appointment. And it wasn't just any appointment. They were prepared to wait for hours, if they had to. They had paid the manager of the salon $15 to meet a plastic surgeon who was pitching his clinic in the Dominican Republic.

And business is good. The salon owner tells us about the doctor's busy schedule. She was a walking talking advertisement for the doctor's work.

While they waited to meet him, many of the women were just as open to talking about the surgery they want. There was lots of laughter and anticipation among the women, but what we didn't hear wasanyone talking about what could go wrong.

Sonia, the secretary from Boston also got a recommendation for a plastic surgeon from her hairdresser.

Sonia: “She goes, ‘Oh listen, I'll give you the guy that does me.’ I said what do you mean? ‘You know my plastic surgeon in the Dominican Republic.’”

Sonia couldn't believe what the doctor told her over the phone.

Sonia: “He said he would do the tummy tuck, the lipo in the back, and breast uplift all for $3000. American dollars.”

What a deal, her very own extreme, and extremely cheap makeover. Procedures that would have cost upwards of $15,000 in the United States would be 80 percent cheaper in the Dominican republic. She was in and within weeks was on a plane to get her dream surgery. There was no research, it was based totally on the word of the hairdresser. Sonia says word of mouth was enough, along with the price tag.

Allyn and Yvonne, the two best friends, were also pretty confident that nothing bad would happen to them when they set out for the Dominican Republic last July. Allyn, a former nurse, had a list of questions to ask three doctors, who had been recommended by friends, family and of course, people at the beauty salon.

The friends decided on the last surgeon they interviewed. They say he answered all their questions and seemed very concerned. They say he accepted credit cards. And they were wowed by his prices -- $2,500 apiece for a tummy tuck and extensive liposuction, surgery which would have cost them upwards of $15,000 in the United States.

Meanwhile Maria Morel, the mother of three from New Jersey, was planning to go ahead with her surgery, too, and she was going to make it a top-secret operation. She wanted to surprise her family with her new body.

Last November, according to her family, Maria said she was going on a business trip to the Dominican Republic. When she got there, she immediately checked into a clinic for a tummy tuck and liposuction. Her plan didn't quite unfold the way she'd imagined. Instead of surprise, her family is now feeling stunned.

Lipotourism is booming in the Dominican Republic. More than 1,000 Americans have surgery there every year. And while many have success, others find that their bargain basement surgery may come with hidden, even life-threatening costs.

Dr. Scott Spear is president of the American Society of Plastic Surgeons. 

Dr. Scott Spear: “It’s really is scary to me that someone would get on an airplane and fly to a foreign country where there's no resort to help if there's a problem.”

Last May, Sonia from Boston flew to a clinic in the Dominican Republic after being promised a great deal.  She says her problems began even before the surgery was over. She says she woke up twice during the surgery.

Sonia: “During the surgery. I literally felt their hands inside my stomach.”

When Sonia came to she says she was shaking uncontrollably and numb. She realized she was in trouble. An infection began destroying the skin around her incision. She turned to plastic surgeon Dr. Loren Borud for help. Borud says the Dominican doctor performed more surgery than Sonia's body could handle.

Dr. Loren Bourd: “Anyone who does that operation should know those technical points. This should never happen. Should never happen.”

Less than three months later, lipotourists and best friends Allyn and Yvonne checked into a Dominican plastic surgery clinic for their surgical overhaul. Were they making the right decision? That question was soon answered for both women.

Allyn wound up in a hospital in Miami, battling a massive infection. It turns out Allyn's surgeon had left her belly button floating inside her stomach instead of reattaching it. It deteriorated, causing an infection.

Meanwhile, her friend Yvonne was admitted to a hospital in New York City with a rare bacteria in her blood.

Dr. Tornambe: “The infection that she had when she came back from her initial surgery could have killed her.”

They weren't the only lipotourists who returned to the United States with life threatening complications. Last year U.S. health officials identified an unusual and virulent bacteria in 16 women who'd had plastic surgery in the Dominican Republic. The centers for disease control warned doctors all over the country to be on the lookout. And that prompted New York City's Health Department to take a dramatic step, issuing a warning for people not to travel to the Dominican Republic for cosmetic surgery.

But not everyone heard or listened to that warning. Maria Morel flew from New Jersey to the Dominican Republic last November and checked into a clinic for her long awaited surgery. But when Maria called her husband from a recovery room at the clinic he said something seemed seriously wrong with her breathing.

Her family says Maria asked to see a lung specialist. Instead they say she got an oxygen tank. Six days later, Maria was dead.

Trabys, her eldest daughter, still can't make sense of it and Jose, her husband of 28 years is haunted by what was done to his wife. Within two weeks of Maria's death, the Morel family marched to the prosecutor's office in Santo Domingo and demanded the doctor be investigated.

The doctor is Edgar Contreras, and he's the same doctor who operated on Sonia from Boston, Allyn from Miami and Yvonne from New York. He's a celebrity in the Dominican Republic, as famous for his work on beauty queens as he is for his medical record. It turns out Maria Morel was not the first person to die after visiting his clinic.

In 1998 one of his patients, a woman from Puerto Rico died from multiple complications after surgery. Six months later, another woman died of a heart attack brought on by the strain of too much surgery.

The cases caused a media frenzy, and in 1999 Dr.Contreras was charged with two counts of involuntary homicide even though he said the women died of natural causes. The cases have yet to come to trial and the doors of his clinic have stayed open for business to unsuspecting patients like Maria Morel, Allyn, Sonia and Yvonne.

We wanted to find out more about Dr. Contreras and the services he offers lipotourists, so we made an appointment.

We flew to the Dominican Republic, taking with us Dr. Loren Borud, Sonia Wilmoth's plastic surgeon. Borud says he's concerned about complications he is seeing from some surgery performed there.

Dr. Borud: “There's significant judgment problems and significant technical problems that are occurring there.”

Corderi: “I can hear the plastic surgery society in the DR saying, you know, of course American doctors are saying that because they're losing business.”

Dr. Borud: “We're not having problems not having enough patients to operate on here in America. We're almost ethically bound to identify a problem that we think is really malpractice.”

Borud accompanied me when I met with Dr. Contreras to give his professional impression of the appointment

Dr. Borud: “He was perfectly willing to take the time and answer all of our questions.”

What Contreras did not do, Borud said, was ask me about my medical history. As a test, I told him I was taking a drug that should have disqualified me as a patient. It thins the blood and may cause excessive bleeding during the surgery. Dr. Contreras said it didn't matter. I could do surgery the next day.

Dr. Borud: “If this were the only evaluation that would be quite negligent.”

A few days later we took our cameras into the clinic after hours. This is the emergency room where Contreras told us patients who develop complications are treated. It's a tiny L-shaped room with no apparent medical equipment.

And to get there a critically ill patient would have to sit or stand in this narrow elevator, too small to accommodate a gurney.

During our investigation we met former patients from the United States who told us they were repulsed by conditions at the clinic. One woman says she was prescribed a skin cream for her scars that is not even intended for humans.

Perhaps most surprising is that Dr. Contreras is practicing at all. According to a 1999 court order obtained by Dateline NBC, Contreras' license in the Dominican Republic is suspended. We took the document to Roxana Reyes, an attorney at the prosecutor's office.

Corderi: “That shows you according to the law he should not be practicing medicine.”

Roxana Reyes: “Yes that's it.”

Corderi: “So why is he practicing medicine?

Reyes: “The problem is we don't have enough people to watch the thing.”

Corderi: “Isn't it just a matter of driving to the clinic, closing the doors and putting a lock on it? He seems to be laughing at the law.”

Reyes: “If he continues practicing without permission, he is violating the law.”

We wanted to talk to Dr. Contreras but he  turned down our repeated requests for an interview. Instead he told Dominican journalists Dateline NBC was pressuring the prosecutors office on behalf of American plastic surgeons who were unhappy about losing business to the Dominican Republic. Contreras also told reporters that Maria Morel died from natural causes.

Days later, a judge decided Contreras should be jailed until he stands trial for involuntary homicide for the death of Marial Morel. He was taken into custody until his family posted bail.

Even though American surgeons we spoke with said Dr. Contreras may be an extreme example, they say it's important for people to research any surgeon they are considering, both here and abroad.

Scott Spear: “You know one difference between us and automobile -- you can throw the car away and buy a new one. But you're stuck with your body. You should make decisions about your body very carefully.”

But that advice comes too late for the Morel family particularly three year old Jose who is still waiting for his mother to come home.

Trabys: “It hurts every time he asks me like where's Mommy and I have to tell him she's dead. I know how much he misses his mother.”