I’ve seen some people come back from medical tourism with debilitating injuries and infections. Unless reconstructive, cosmetic surgery should initiate a psychology/psychiatry consult. Same thing with gender reassignment surgeries. With medications you are taught to go least side effects, least risk, and least cost before gradations of advanced treatment. It’s a ramp up (with exceptions based on acuity). So if someone is dissatisfied with their body image, it’s more appropriate to enact psychological interventions over perhaps years before physical interventions are even considered. The popularity of elective medical tourism, despite the risks (including death), is indicative of a larger mental health problem perpetuated by social media and intellectual decline.