(LifeWire) -- Colleen Hiltbrunner spent two years researching her dream trip to South Africa. But she wasn't looking for the perfect safari lodge. She was hunting for the right cosmetic surgeon.
When she told her family, it wasn't an easy sell. "South Africa? You're going to get some kind of witch doctor," she recalls her father saying.
"But I told him they perfected some of the first heart surgeries down there. To me, South Africa had the most reputable surgeons."
Hiltbrunner, of Colorado Springs, Colorado, traveled to Johannesburg in 2004 for a face-lift, upper arm lift and eyelid surgery. And she and her husband -- who hadn't taken a vacation in 20 years -- went on a luxury safari, included in the package by medical-travel agency Surgeon and Safari.
"Medical tourism" may sound strange, but patients are discovering they can get some cosmetic surgeries abroad for less than the U.S. price. And many surgeries include sightseeing packages.
The roster of countries in which hospitals and surgeons are marketing their services to foreigners is growing. South Africa, Argentina, Thailand, Brazil, Costa Rica, India and Singapore have become major players.
Robert Painter, a travel writer from Albuquerque, New Mexico, journeyed last year to Argentina for dental surgeries -- and tango lessons: "If I'm going to be stuck somewhere for two weeks at a time, twice, Buenos Aires has got to be the best possible place," he says
Painter's procedures were organized by Plenitas, a medical-travel facilitator in Buenos Aires, which booked him at a hotel with a dance studio in the back.
He wasn't the only guest getting surgery: "While I was there, there was a young lady who was also having implants -- though not of the dental type."
Cost-cutting pros and cons
Cosmetic, or elective, procedures aren't covered by insurance, so cost remains the motivating factor for most medical tourists. Surgeries in many countries cost half or even one-fifth what they would in the U.S. -- including airfare, hotel and excursions. "A full face-lift that would cost $20,000 in the U.S. runs about $1,250 in South Africa," a 2005 article in U-Daily, the University of Delaware's online news service noted.
Faith Richter, of Hope Sound, Florida, got a face-lift in Bangkok, Thailand. Her trip was organized by New York City's Med Journeys.
"In the U.S., it would have cost $20,000 for the procedure alone, with no time in the hospital," she says. In Bangkok, Richter was in the hospital four days, and the total cost of her 19-day trip, including sightseeing and airfare for two, was $10,600.
Painter estimates he saved $18,000 on his surgeries. "Cost was the primary factor," he says. "The only factor."
Medical costs abroad are less than in the U.S. for many reasons -- favorable exchange rates, lower salaries and fewer medical lawsuits, which means lower malpractice-insurance costs.
But the International Society of Aesthetic Plastic Surgery warns against low-cost surgery. "Get bargains on your shoes and laundry detergent, not on your face," says spokesman Tony Staffieri.
"Researching the quality of doctors should be a patient's primary consideration, but it isn't always," he says. "Some people think 'tummy tuck and shopping.' This is not makeup; it's somebody cutting you."
Some medical professionals fear that patients will overlook the severity of invasive surgeries and fail to ask the right questions. More casual attitudes toward plastic surgery -- spurred by lunch-break Botox treatments and same-day liposuctions, paired with temptingly cheap alternatives and vacation packages -- increase the risk of bad outcomes.
Even stateside, cosmetic surgery can have tragic results. "First Wives Club" author Olivia Goldsmith died during a chin-tuck in 2004, and this year Kanye West's mother, Donda, died after a tummy tuck and breast reduction. However, a 2004 study published in the official medical journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery, found that "deaths occurring at office-based surgery facilities (in the U.S.) are rare -- less than a quarter of a percent."
Medical tourism experts counter criticism by saying that cheaper prices don't necessarily mean lower quality of care.
"In general, it is the hospitals and facilities that have justifiable claim to 'world-class' status or to meeting or exceeding U.S. standards that are competing for patients from the United States and other countries," says Jeff Schult, author of "Beauty from Afar: A Medical Tourist's Guide to Affordable and Quality Cosmetic Care Outside the U.S."
The authors of a 2006 "New England Journal of Medicine" article confirm the high standards of internationally accredited hospitals: "We doubt (...) that the average U.S. hospital can offer better outcomes for common complex operations."
"Almost 80 percent of the doctors we use have been trained in the U.S. or U.K.," says Tim Wallace, vice president of sales and marketing for Med Journeys. "It gives the American consumer a degree of confidence."
Richter, a registered nurse, agrees that standards are high abroad. "After the surgery, the nurses were there for me 100 percent," she says. "At home, we're so understaffed and overburdened, and inundated with paperwork."
When Painter visited U.S. dentists, "I felt like I was being processed for a home loan," he says. "In Argentina, I had three dentists working on me at once."
While medical tourism continues to increase in popularity, it's still not mainstream. When Richter left for Bangkok, she "didn't tell a soul, not even my seven children, who are almost all in the medical field. They would have had a stroke.
"At Thanksgiving, though, they were all saying, 'You really do look good.'" E-mail to a friend
LifeWire provides original and syndicated content to web publishers. Neil Edward Schlecht writes about travel, food and wine. He lives in Litchfield County, Connecticut.