Aftershocks: Beware of unlicensed 'healing houses'

The allure of being able to recuperate from a plastic surgery procedure in the comfort of a five-star hotel – but with a staff of experienced medical personnel – is as undeniable as it is pricey. Resulting from the growing popularity of medical tourism, a cottage industry of recovery houses has emerged that targets patients traveling for cut-rate medical procedures like Brazilian butt lifts (BBLs) with the promise of recovery in luxury for those far from home.

These facilities, which are often noted in media reports on gluteal fat grafting (aka BBL) procedures in hotspots like Miami or Los Angeles, offer anything from lavish recovery suites and lymphatic massages to meals prepared by chefs and prescription pickup. The accompanying price points vary right along with these amenities and packages – with many demanding several hundred dollars per night.

While not all posh surgical aftercare facilities are cause for concern, some may pose serious health risks when they focus more on comfort than care.

Surgery centers, recovery houses, healing houses: what do the names mean?

Healing houses, recovery houses, surgical aftercare facilities – the list of postoperative care centers is seemingly never-ending. If you're confused about what the terms mean and how to find a safe facility to recuperate after your procedure, you're not alone. While the terms might be used interchangeably, recovery houses, healing houses and surgical aftercare facilities are not the same.

Identifying whether a recovery house, recovery center or healing house is reputable is a gray area. Unlike surgical centers and hospitals, they aren't regulated and don't require any specific type of accreditation to operate. Adding to the confusion, a nurse or other medical professional may serve as the face of a recovery house, but that doesn't necessarily mean a medical professional will be taking care of you.

"When you go to these recovery centers, you want to actually make sure they are run by licensed physicians, providers, nurses, and that they're clean," said Smita Ramanadham, MD. "A lot of times, unfortunately, that's not the case, and you're sort of left in this room with lots of other patients and people that are taking care of you who don't have the right degrees or licenses to do so."

Onsite staff for any recovery facility should include a licensed medical professional, such as a medical assistant (MA), licensed practical nurse (LPN), registered nurse (RN) or nurse practitioner (NP).

"It's usually not medical personnel that are running them," said Josef Hadeed, MD, of the healing houses you see in the media. "They have these facilities, homes – whatever you want to call them – where the patient will go after surgery, and it may not even be a healthcare provider with them, if at all. I don't think they receive much medical attention or care there."

In other words, if a medical emergency should arise, it would be up to the patient to get to a physician or emergency room. The best-case scenario if an issue arises, however, is having trained medical personnel onsite and the board-certified plastic surgeon who has been involved in your case from the very beginning available.

"It is very important to have your plastic surgeon close by after surgery in case there are any complications or emergencies that arise," said Hadeed.

It's important to note that not all aftercare facilities are created equal. While some pose a risk because they aren't being run by trained physicians, there are some that are worth looking into if you need help after your BBL.

"There's actually quite a few of those types of facilities in L.A.," said Hadeed, who utilizes surgical aftercare facilities at his practice for patients with medical issues and higher-volume BBLs.

"Usually those are staffed by nurses, so you have trained medical personnel that are staying with the patient 24/7," he said. "In some instances, there's even add-on services. For example, you can request to have sequential compressive devices brought to the room, that the nurse empties the drains every so often, does wound checks or help the patient get out of bed and walk around the room with assistance. It offers more personalized attention and care to the post-op patient."

Medical tourists traveling for BBLs or any cosmetic surgical procedure are often far away from the comfort and support found at home, so research becomes even more critical. If you are considering staying in an aftercare facility, talk with your board-certified plastic surgeon about your options and see if they work in tandem with a particular location equipped with certified staff.

How do patients know who is board-certified?

It's a common saying among plastic surgeons that patients should always do their homework before getting any type of elective surgery. There are risks involved with any surgical procedure – and that knowledge is especially crucial for patients seeking BBL, where complications can quickly turn deadly if performed by someone without the proper training and experience.

The first step when getting any plastic surgery procedure is finding out if your doctor is certified by the American Board of Plastic Surgery (ABPS). Before even stepping into a surgeon's office, check their website for the ABPS logo or go to the ABPS website to confirm your surgeon is board-certified (ASPS members are required to be certified by ABPS or their country's equivalent).

"The most important thing is to find a board-certified plastic surgeon who is experienced in these procedures," said Ramanadham. "I always tell patients that the first question they should be asking their surgeon is if they're board-certified – and by what body are they certified."

In the United States, the stamp of approval from ABPS shows that your surgeon has undergone a rigorous board certification process by the only plastic surgery board recognized by the American Board of Medical Specialties (ABMS). If your surgeon is board-certified, it means he or she has at least six years of surgical training and experience, with at least three years specifically dedicated to plastic surgery.

Ramanadham adds that if it's any board other than ABPS, the patient should do more research.

"What you don't want to do is go to a surgeon that might not have the many years of training that plastic surgeons have – and don't have the oversight, yearly maintenance and accreditation that we have to go through," she said.

What to expect post recovery

There is much more to the cosmetic surgery healing process than portrayed on TikTok videos by your favorite influencer or even in many of the before and after photos posted on social media.

"We often get sucked into the social media world where you sort of just see the before, you see the after and you forget or don't see what happens in between," said Ramanadham.

Likewise, when it comes to the healing houses that you see online, looks can be deceiving.

"The most important thing is making sure there's trained medical personnel on site," said Hadeed. "I wouldn't recommend for any patient to go to a facility where they're going to be left to fend for themselves or there is someone who is not medically trained looking after them."

"This is real surgery," said Ramanadham – and with real surgery comes real risk. Prior to any surgical procedure make sure your plastic surgeon is board-certified, and if you do plan to stay at a postop recovery facility, make sure the staff that will be taking care of you are certified to do so.