Ginger Kramp of Andalusia, Alabama, traveled thousands of miles by herself to a strange country where she didn’t speak a word of the language and didn’t particularly trust the food. Then she had a major operation. “I can’t believe I did it,” she said from a hotel in Vitória, Brazil, where she was recovering from plastic surgery. “I’m so happy!”

Kramp’s health insurance paid for her original weight-loss surgery in the United States, but she wasn’t covered for the procedure to trim away the excess skin left sagging afterwards. Estimates from stateside surgeons came in the $56,000-$86,000 range, leaving the travel agent and pastor’s wife in a quandary. “I could never do this in the states,” she said.

Kramp spent 18 months investigating her options. Then she filled her suitcase with canned food, cashed in some frequent flyer miles and headed down South America way. Her entire trip, including the surgery and personalized attention by the bilingual staff of a specialized travel company called MedPlasticBrazil, rang in for less than $10,000. And Kramp seemed more than happy with the outcome: “I only wish my husband were here to see the results.”

Kramp’s story is hardly unique. Women from the US, Europe and other rich countries with high medical costs are flocking to have their tummy tucks and liposuctions done for less in places like Brazil, South Africa, Thailand, Mexico, Costa Rica and Argentina.