Iowa City, Iowa — Though the trend of medical tourism — Americans seeking affordable medical treatment abroad — appears to be less widespread than in the past, a significant portion of medical-tourism companies regularly refer clients seeking cosmetic surgery, IowaIndependent.com reports.

In a survey of the 50-plus U.S. companies that specialize in medical tourism, University of Iowa researchers found that respondents have each referred an average of only about 300 patients to medical facilities outside the United States. About two-thirds of the companies say they have sent patients abroad for cosmetic surgery.

The most common medical-tourism destination is India, survey respondents say, and orthopedic operations are the most commonly sought procedures.