Josef Woodman, author of Patients Beyond Borders: Everybody's Guide to Affordable, World-Class Medical Tourism, estimates that more than 150,000 Americans went abroad for medical care in 2006. Many are uninsured, self-employed or looking to defer the average $10,000 to $12,000 in insurance premiums a family of four now pays a year. Some need joint replacements or stem cell therapies not yet approved by the FDA.Others want to return from an overseas vacation with larger breasts and flatter stomachs. All are searching for quality health care at discount prices, sometimes finding savings of up to 90 percent. Foreign hospitals are more than willing to cut through the red tape and offer Americans fast, efficient services in state-of-the-art facilities complete with luxury suites, on-call concierges and personal chauffeurs. Time to sightsee? Just icing on the cake.

Medical tourism, or traveling for medical care, is not a new phenomenon. The ancient Greeks came from across the Mediterranean to Epidauria, sanctuary of the healing god Asklepios. Roman Britons went to Bath to heal. Today, Americans with a valid passport have their choice. India, Thailand, Singapore and Hong Kong are popular medical travel destinations. Costa Rica, Argentina, South Africa and Brazil, specializing in elective and plastic surgery, are leading the pack in cosmetic tourism. Shuttles even run between border states and Mexico for Americans looking for root canals and dental crowns at dirt-cheap prices.

Though the options are seemingly endless, buyers ought to beware. Ingrid Lomas, the CEO of Surgical Attractions, a South Africa-based cosmetic tourism company, warns patients to look beyond the price tag. “If I were entrusting my body to someone for surgery, I wouldn’t go automatically with the cheapest option. I might do that if I was getting a room refurbished, but it’s not a good option for your body.”

Medical tourists should also consider why services are inexpensive: Is it a more favorable exchange rate or a lack of malpractice insurance that accounts for the discount? Hospital oversight rules vary in each country and postprocedure care is limited to phone calls and e-mails once you return home. Frustrated patients have little recourse to sue foreign doctors from the U.S.

Medical tourists flock to countries where travelers are often cautioned against drinking the water. There, the view from the back of a limo on the way to the hospital can provide quite a culture shock. Bangalore’s infamous traffic---cars, motorcycles, auto rickshaws, even cows and monkeys all racing like an out-of-control amusement park ride–--was John Mattos’ first vision of India. After a few days of sightseeing, he had some advice for future Wockhardt patients: “Bring your own wet wipes,” he said. “Lots of them”.

Sometimes the destination itself inspires people to get a little nip and tuck. Caryn Joyce, a 49-year-old administrator from Atlanta, was planning to use a free ticket to South Africa when she learned about Surgical Attractions.