A new you: vacationers seeking better bodies head to Latin America to relax and recover.

As Cuban retail wholesaler Miriam Fernandez reached her late 50s, she yearned for a younger look. Following the advice of an Ecuadoran friend who beat the signs of aging with cosmetic surgery, Fernandez traveled to Quito from Miami for a long vacation and a short cosmetic procedure.

Fernandez chose the surgeon recommended by her friend and paid about US$3,500 for a facelift and an eyelift. The same procedure would have test her more than $10,000 in the United States. "If I have to do it again, I would go back," she says.

Several countries in Latin America, such as Brazil and Colombia, have a long-standing cosmetic-surgery culture. Costa Rica, however, stands out as a makeover mecca not only because of medical standards comparable to those in the United States but also because of marketing power. Several agencies in the country link doctors and international patients by offering medical packages, usually over the Internet, that include surgery, medication and transportation.

They also connect patients to tour agencies so they can travel around the country after the operation. Carolina Aguilar, director of Costa Rica Health Escapes, an agency dedicated to this service, says that they are currently treating 20 patients a month, up from eight patients monthly three years ago.

Rodrigo Araya, a cosmetic surgeon at Cima San Jose Hospital, a private clinic in the capital of Costa Rica, says combining surgery and vacation is not such an odd idea. "Part of coming to Costa Rica for cosmetic surgery is also to visit our beaches, volcanoes, rivers and forests," says Araya "[Patients] want to combine plastic surgery with Omir vacation and relax a bit." About 60% of plastic surgery patients at Cima San Jose come from the United States and 10% from Europe, especially Germany, Switzerland and Italy, says Araya.

The clinic lodges patients in a private hotel designed to provide post-operative care, including all meals, transportation to and from the hospital and daily medical supervision. Many private surgeons in Costa Rica also put patients in touch with travel agencies.

Most patients, surgeons and travel agents meet up on Internet sites that coordinate medical service for international patients. In some cases, however, patients do not have a direct relationship with their surgeon. Instead, they arrive in the country and are treated in small, private offices rather than fully-equipped hospitals, says cosmetic surgeon Luis Da Cruz at San Jose's Clinica Biblica, who strongly advises against such practices. "Medical service should not be sold in a commercial way," says Da Cruz. He recommends that patients first make direct contact with a trustworthy surgeon, and then plan a vacation around their recovery.

Confidential. It's a trend that's been tracked by the World Health Organization (WHO) for a decade, although patient-doctor confidentiality makes it hard to pinpoint the number of people seeking plastic surgery in the region. North Americans tend to travel to Central and South America for cosmetic surgery and dental work when their economy is strong and their dollars go farther, says the WHO. Services can be bought at a fraction of the price along with a vacation, and patient identity remains completely confidential.

While surgeons in the United States acknowledge that Latin America has many qualified surgeons and well-equipped private hospitals, some say lax regulations in the region increase the risk of complications. "A month doesn't pass by that I don't take care of a disaster from Latin America," says Eduardo Barroso, a cosmetic surgeon and president of the Miami Society of Plastic Surgery.

Barroso also says that there is a lot of hype about cosmetic surgery in Latin America because patients are embarrassed to comment on negative results. "But, if you paid half, you tell everyone about your good results," he says.

Although U.S. surgeons say buyer beware when shopping for plastic surgery in Latin America, doctors such as Costa Rica's Da Cruz argues that spending more doesn't mean getting better attention. "It's not that it is cheaper [in Costa Rica]," he says, "but that in your country it is too expensive."