In the United States, there are accrediting agencies that certify medical facilities and medical providers. U. S. hospitals have peer review boards to further evaluate the doctor’s surgical skill in given procedures. Doctors must obtain hospital privileges to perform a specific procedure at hospitals in America. Surgery abroad is not necessarily as standardized.
Other countries may or may not have governing agencies to oversee qualifications and credentials. The training of doctors in other countries may be dramatically different than in the United States. After becoming a doctor, the extra training to become a plastic surgeon varies widely as well. Uncertainty in medical skill means uncertainty of results. Many facilities abroad are privately owned and operated — not necessarily subject to a certification process.
Most other countries do not have a rigorous approval process for medical technology and devices, which the FDA provides in the United States. For procedures outside the U. S. it may be difficult to evaluate the medical facility, skill of the doctor and staff, the procedure, or the devices used in procedures.