Q) I have been told that it is dangerous to have surgery in Mexico because they have no ICU, but I’ve been considering getting breast implants at a clinic there. Do all US plastic surgery offices have an ICU or are they only found in hospitals? A) Generally, it is not the best choice to get plastic surgery outside of the US. It’s not a question of whether or not there’s an intensive care unit (ICU) at the clinic. (Incidentally, in the US, “quad A” certification is the gold standard of patient safety for office-based surgical suites.) There are certain standards of care here in the US that you will not find elsewhere. I’m not sure what they are in a clinic in Mexico. Studies have shown that complication rates are high among patients who have undergone breast implant surgeries in other countries. Part of the problem is that you won’t be followed by the surgeon who performed your procedure. In the event of complications, the same studies indicate that you’ll have a hard time finding a local plastic surgeon willing to correct them. To assure that your plastic surgeon has gone through appropriate plastic surgery training, go to an American Society of Plastic Surgeons (ASPS) member. A physician needs at least six years of surgery experience and training, with three of those years specific to plastic surgery, in order to be an active ASPS member. They follow a strict code of ethics and are required to take continuing education courses that include techniques on patient safety. If money is an issue, you may want to consider finding a resident’s clinic at a medical school. The prices there are generally considerably lower.