Surgery in two countries: how continuity of care works

A surgeon who splits time between two countries is not always in the country where a patient is recovering. The review treats this as the most pressing problem, and describes how the authors deal with it. Dr Sanjog operates in Bangalore on a monthly schedule, so it applies to his practice.

• A qualified local plastic surgeon. The review describes a fully qualified resident plastic surgeon who takes part in the operation and takes full responsibility for the patient once the operating visit ends, including any complications, under a formal written arrangement rather than a friendly understanding. At Aesthetica Veda in Bangalore, this is Dr Vybhav Deraje, who is thanked in the review's acknowledgement.
• You are told beforehand. You consent to a named surgeon, so the review says the handover is fair only when it is disclosed before surgery and the surgeon taking over is fully qualified.
• Video follow-up supports; it does not replace. Structured video follow-up with standardised photographs is well supported in the plastic surgery literature, but some patients still need a physical examination. The safety net is in-person examination by the local surgeon.
• Records either surgeon can use. Notes, consent forms and photographs are organised so a surgeon in either country can pick up the case, keeping to the stricter standard where the two countries differ.
• Fewer return visits where results are equivalent. The authors prefer absorbable sutures and drainless techniques when they give an equivalent result, because each removes a mandatory return visit. They do not claim these are better in the abstract.

The review lists the risks of this way of working and the safeguards that answer them. These questions turn that list into things a patient can ask. They are this page's framing, not the review's recommendations — and they are worth asking of any surgeon, including Dr Sanjog.

1. Will I be assessed before the operating day? Ask whether you will have a video consultation and, ideally, an in-person assessment before a date is booked. Photographs alone are not an assessment.
2. Who takes responsibility for me after the operating visit? The review's answer is a fully qualified local plastic surgeon under a written arrangement. Ask who that is, and whether it is written down.
3. Will I be told before surgery that someone else may manage a complication? You consent to a named surgeon. The review says a handover is fair only when it is disclosed before surgery and the surgeon taking over is fully qualified.
4. Is the surgeon registered in each country where they operate, with cover in both? Two registrations mean two sets of requirements, and indemnity policies are usually written for one country. Ask about both.
5. How are operating lists planned? The authors describe a cap on cases per visit set in advance, a late-evening flight, and at least six hours between landing and the first incision. Ask how a visit is paced.
6. Could my operation be staged or declined because of the visiting window? Long or multi-area operations need close review at the time the surgeon is leaving, and the review names thigh lift, because of its well-recognised rate of wound dehiscence, as the clearest example. A surgeon who says no to some cases is applying the review's own caution.
7. Can the surgeon who takes over read my records? Notes, consent forms and photographs should be organised so a surgeon in either country can pick up the case. Where the two systems differ, the review keeps to the stricter standard.
8. Does the surgeon own a share of the clinic, and is that disclosed? An equity stake gives a reason to want a fuller list, and in a short window overbooking is the main risk. The review names this conflict of interest openly.

• A narrative review and reflective commentary, not a clinical trial or a case series. The authors searched PubMed and Google Scholar and say it is not a systematic review.
• A description of two practices: Dr Sanjog's Dubai-to-Bengaluru practice and Dr Parashar's Dubai-to-Delhi NCR practice.
• No outcome data. The authors say that data on patients treated by mobile surgeons does not exist and is needed. The review does not show that this way of working is safer, or better, than a single-site practice.
• A description, not a recommendation. The authors say it suits only a narrow group of surgeons and does not scale as its economics might tempt one to assume.
• Disclosed interests. The paper declares that Dr Sanjog holds an equity stake in Aesthetica Veda Clinic, Bengaluru, and is employed as a specialist plastic surgeon at Cocoona Centre for Aesthetic Transformation, Dubai, which Dr Parashar owns. Dr Parashar also holds an equity stake in Aesthetics Redefined by Cocoona, Gurugram. The authors name the resulting conflict of interest in the text.

Sharma S, Parashar S. Cross-border Aesthetic Surgery Practice: Advantages, Pitfalls and Mitigation. International Journal of Aesthetic Plastic Surgery. 2026 (published online 26 October 2026); pages 1–5. doi:10.1177/30499240261497493

Open the review (DOI) · SAGE Journals

Authors' ORCID: Sanjog Sharma 0000-0001-5835-1768 · Sanjay Parashar 0009-0007-4138-2411. The references behind each statement are listed in the paper; this page summarises it and does not reproduce it.