Elective  Medicine includes any traditional or non-traditional medical treatment that a person chooses to undergo without any significant underlying medical reason, such as cosmetic surgery. For many years people have been coming to Costa Rica for elective procedures, especially for cosmetic surgeries performed by surgeons equally qualified to those found in the States, and for a considerable cost savings. Cosmetic surgery continues to become more and more popular.

For example, a poll of over 1,000 adults was conducted in the summer of 1997 on behalf of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). In response to the question “If you were to undergo facial plastic surgery, what procedure would you consider?” 23% said a facelift.

Overall, people between the ages of 45 and 54 were the most likely to say that they would consider having a facelift (29%).

The top five facial surgeries considered by those polled were facelifts (23% of all respondents), nasal surgeries (18%), skin resurfacing (17%), eyelid surgeries (9%), and liposuction (1%).

Dr. S. Randolph Waldman, a Lexington, Kentucky facial plastic surgeon and vice president of AAFPRS, believes the survey statistics reflect current trends. Waldman believes safer procedures, with quicker recovery times, have also pushed the plastic surgery boom. “Surgeries have improved because of better training and better anesthesia,” he said. “Generally, there are very few procedures where you can’t get back into a social situation within about two weeks.”

Thinking about an eye tuck, a face lift, or a collagen injection? “Check for the experience of the surgeon with the procedure you’re considering,” Waldman advises. “Experience is the best teacher. Not a piece of paper, but experience.” He says those considering facial plastic surgery should shop around before settling on a specific surgeon. If you can, consult with previous clientele as to their satisfaction with a specific surgeon’s work. The testimonials of former patients can provide insight into physician skill and long-term surgical results.

Statistics from the World Health Organization’s “The World Health Report 1995″ place Costa Rica third in life expectancy in the world, sandwiched neatly behind Japan and France and ahead of Great Britain and the United States; and with a per capita income about one tenth that of the other four. Certainly, some reasons for this can be found in the Costa Rican less-than-frenetic lifestyle, the healthy, fresh, non-preservative-laden foods of the country, the tropical climate–Costa Rica seems to be a healthy place to live. But if one looks simply at the life issues, so are many other places on the globe. Costa Rica is a healthy place to live because its government continues a long- time commitment to affordable access for each and every citizen to one of the finest health care systems in the world.

Again Costa Rica leads the way in medical care in Latin America. And, it’s not far behind the U.S. in pursuing innovative and state of the art medical procedures.

On November 10, 1997, doctors at the public hospital Calderon Guardia, operated on the right lung of a seven-month fetus still in the mother’s womb. This intrauterine operation, performed by Dr. Gerardo Escalante López* chief of fetal medicine at the hospital, is a first for Costa Rica and, apparently, all of Latin America. In fact, only fifteen other operations of this nature have been performed worldwide. Both fetus and mother are now doing well and the baby, to be called María Consuelo, is developing normally.

The intrauterine operation was performed to remove a congenital malformation (cyst) which was detected on the right lung of the fetus at five months. If allowed to continue to grow, the cyst would have crowded out vital organs and eventually killed the fetus. The operation entailed significant risk for the fetus. The technique involved piercing the back of the fetus with a catheter 25mm in length and 3mm in diameter. Once the catheter was in place, the liquid in the cyst was drained and a very small valve was inserted to allow continued drainage of excess liquid into the fetal sac where it will be absorbed naturally.

Post-operative monitoring insured that the internal organs of the fetus were returning to their correct positions and that the fetus was again developing normally. Immediately after birth the baby will be transferred to the children’s hospital where the decision will be made by a team of neonatal specialists whether to remove the valve or operate to remove the remaining body of the now deflated cyst. Prognosis for eventual complete recovery and normal development of Maria Consuelo is excellent.

That such a highly complex and advanced operation could be performed in Costa Rica may surprise people living in other “developed” countries. However, those familiar with the excellence of the Costa Rican medical system are not at all surprised; such quality care is routinely expected of the many dedicated and well-trained medical professionals who make up our world-class health care system.

*Dr. Gerardo Escalante López and his wife, Dr. Delia Ribas Valdés, are the co-directors of the Costa Rican Infertility Institute (Instituto Costarricense de Infertilidad). Both are dedicated professionals with training and skills found in the finest international medical institutions.

Costa Rica also boasts physicians who have left traditional medical practice to study alternative methods of treatment and healing. Popular disciplines are acupuncture and Naturopathic medicine. They have had exceptional successes with homeopathic weight control and in helping those plagued by chronic pain syndrome (CPS).

For the medically threatened obese person, physicians such as Dr. Manuel Piza and his clinic Servicios Medicos Saint Michel are trained and experienced to help regain control. Dr. Piza has been extremely successful in the medical and surgical treatment of obesity (people weighing at least 50 pounds over their suggested body wieght). With obesity being the second leading “secondary” cause of ill health (according to the CDC in Atlanta), Dr. Piza’s speciality is very important in today’s health care system.

While tried-and-true procedures are readily available, many newer treatments, i.e. deep laser peels and laser skin treatments, are also available and also delivered by well-trained, experienced cosmetic surgeons. As an example, the Laser Medical Center offers a wide variety of laser skin treatments, from complete facial resurfacing to the removal of tattoos and birthmarks. Using the most modern laser equipment, Dr. Carlos Vargas Scott (educated, trained and certified in the U.S.) has many years of successful experience with cosmetic lasers.

Below are some cost comparisons taken from price averages in the United States suggested by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). These comparisons are just that, comparisons. Actual costs of the cosmetic procedure will depend on the candidate and the surgeon. Note that the cost averages given for Costa Rica are all-inclusive while those for the U.S. are for the surgery only and do not include hospitalization, anesthesia, etc. In certain cases, e.g. breast reconstruction after a mastectomy, there is a very high probability that the procedure would be covered by health insurance.