San José, Costa Rica, since 1956

Cosmetic Surgery Patients Choose

With top-quality doctors, low prices, short wait times and recovery clinics as welcoming as family on Christmas Eve, Costa Rica is fast becoming the place to have cosmetic surgery done. Factor in the country’s famous beaches and rain forests, and visitors get the perfect opportunity to incorporate cosmetic surgery with a world-class vacation, all for a bargain price.

People from around the world and of all ages come to Costa Rica for a wide array of cosmetic surgery procedures, which cost about half what they do in the United States, according to 10-year cosmetic surgeon José Cohen of the Rosenstock Lieberman Clinic in San José (2223-9933,

“I think a lot of people come here for the price difference, and it also has to do with the privacy factor – it’s more private, they can get away, and it’s kind of a vacation,” Cohen says.

While some surgeries are so drastic that it would be impossible for others not to notice the difference, foreign patients can at least enjoy private recovery time here while they have swelling and bandages, Cohen says.

Other surgeries may go unnoticed by others, he adds, but what really matters is what’s important to the patient.

“Some people who come to me, specifically for liposuction, are already quite thin,” Cohen says. “They just need you to fix something small, like a slight double chin or some love handles they can’t quite get rid of themselves.”

Cohen says approximately 65 to 70 percent of his clients are from outside Costa Rica.

Recovery Resorts

One of the things that make Costa Rica a great plastic surgery destination is its growing selection of recovery centers, says Argentine Ruben Martin, owner of CheticaRanchMedicalRecoveryCenter in the mountains northeast of San José (, 2268-6133).

Set on 80 acres of beautiful countryside, Chetica Ranch offers private cabins, which Martin says are essential to a recovering patient’s comfort.

“Tourists don’t want to come to Costa Rica and see people with bandages and swelling,” he says. “And the patients don’t want to feel self-conscious. So it’s better to know that everyone here is a patient, and they can share their stories and so on.”

Each cabin has all the amenities of a small house so that “people can feel as though it’s their home, not a hospital room,” Martin says.

He decorates and builds all the cottages, while his wife, Lorena, manages most other aspects of the facility.

“My wife is Chetica – she is the assistant, the doctor, the psychologist, the shoulder to cry on,” Martin says.

Chetica provides transportation to and from the airport and doctor’s appointments, home-cooked meals, computer access and free calling to Canada and the United States. Its dining room, named the Buena Vista Social Club, has more than 400 DVDs and books for guests to enjoy.

Martin doesn’t see anything wrong with having plastic surgery done.

“I think plastic surgery is here to stay,” he says. “The doctors here are so unbelievable. They’re artists. You should see the changes in people.”

Chetica Ranch guest Vicky Escott, 63, from British Columbia, Canada, has experienced a remarkable change in her physique, and her life. Three years ago, she was 200 pounds heavier, and tired after 40 years of dealing with her weight problem.

In February 2006, Escott went to Mexico to have gastric bypass surgery – a procedure that makes the stomach smaller and allows food to bypass part of the small intestine – knowing that soon after she would need cosmetic surgery to remove all the excess skin. She is now staying at Chetica Ranch while she undergoes several procedures.

“A week ago, I had a lower-body lift and got rid of the bat wings on my arms,” Escott says. “Next week I’ll get my thighs and breasts done.”

Escott says she did a substantial amount of research before choosing Costa Rica. “Cost was one of the factors, and it was a country we wanted to see,” she says. “And I also did a lot of research about the doctors.” After a gastric bypass, the patient starts by eating only two tablespoons of food per meal and then works his or her way up to a cup and half, Escott says. Though this may sound difficult, she says you are never hungry because your stomach pouch is so small.

The surgeons divide your small intestine so part of the food goes through your old stomach and part goes through your new stomach, which is unable to absorb fats and sugars. This prevents patients from gaining weight back afterwards.

Hormone Replacement

Another procedure with proven drastic results is hormone replacement therapy, offered here by Costagenics medical spa at the White House Hotel in the hills of San Antonio de Escazú, west of San José (, 2588-0110).

In addition to small cosmetic procedures such as Botox and face-lifts, Costagenics offers surgical insertion of growth hormones, testosterone and estrogen in pellet form.

While in the United States hormone replacement is commonly done via injections every two weeks (at a cost of approximately $700 to $800 per month), Costagenics offers an alternative method that allows the hormones to be released at a slower rate. Small pellets are surgically inserted into the lower abdomen, with the effects lasting three to four months.

Costagenics’ Leslie Mesén says the procedure produces dramatic results, particularly when combined with exercise and a healthy lifestyle.

“It works to heal your liver, your kidneys, your heart, your brain, your skin, your everything,” Mesén says.

Mesén relates how fellow Costagenics doctor Walter Morgan underwent the procedure at the age of 63 and transformed his body within three months, going from an average older man to a tanned Arnold Schwarzenegger type by incorporating exercise and a healthy diet with testosterone replacement.

Both male and female patients receive growth hormone pellets, as well as either testosterone or estrogen. Because men require more testosterone pellets than women do estrogen pellets, the prices differ, Mesén says. For men, the insertion costs $2,200 to $2,950 every four months, while the cost for women is approximately $1,800 every four months.


Common Procedures

The country’s brigade of cosmetic surgeons offers all manner of procedures, from face-lifts to breast enhancement to liposuction. A description of some of the more popular procedures follows, courtesy of José Cohen of the Rosenstock Lieberman Clinic in San José.


Face-lift: As people age, the effects of gravity, sun exposure and the stresses of daily life start to show in their faces. Deep creases form between the nose and mouth, the jawline grows slack and jowly, and folds and fat deposits appear around the neck. The main goal of a face-lift is to give a younger and fresher look while preserving the natural facial characteristics of the patient. It works for anyone at any age. The procedure costs roughly $2,800 to $3,200 in Costa Rica, compared to about $7,000 to $9,000 in the United States.


Breast enhancement: This is one of the most frequently performed surgeries in the world. It is normally chosen by women who feel their breasts are too small or have lost volume or changed shape as a result of weight loss, childbirth or aging. Cohen stresses that worldwide studies have demonstrated that breast augmentation does not increase the risk of cancer. The procedure runs about $2,500 here, compared to roughly $5,000 to $8,000 in the United States.


Breast reduction: Breast reduction may give women with large breasts relief from a variety of problems, from back and neck pain and irritated skin to skeletal deformities and breathing difficulties. These patients often complain of painful grooves in their shoulders produced by their breasts. In these cases, the ideal procedure is a reduction mammaplasty in which the surgeon reduces the size of the breast and then sculpts it to give it the best possible shape. The procedure costs approximately $2,200 to $2,500 in Costa Rica, while in the United States it may run about $5,000 to $6,000.


Liposuction: This procedure is used to remove unwanted fat cells from different areas of the body. One of the most commonly requested cosmetic surgeries in the world, liposuction can be performed at virtually any age and on any part of the body – neck, cheeks, jowls, abdomen, buttocks, thighs, hips, knees, ankles, calves and arms. In Costa Rica, the procedure can cost roughly $1,000 to $4,000, depending on how much area is treated, compared to $2,500 to $10,000 in the United States.



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