Agus Roy Rusly Hariantana Hamid
Plastic Surgery, Reconstruction and Aesthetic Division, IGNG Ngoerah General Hospital, Denpasar, Indonesia

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PLASTIC SURGERY MEDICAL TOURISM IN SOUTHEAST ASIA: MARKET DYNAMICS, DESTINATION STRATEGIES, AND INDONESIA'S COMPETITIVE POSITION Anak Agung Istri Ayu Detritha Sarasmartha Putri; Agus Roy Rusly Hariantana Hamid; I Gusti Putu Hendra Sanjaya; Gede Wara Samsarga; Shita Diwyani Sudarsa; Astri Lestari Suyata
Jurnal Rekonstruksi dan Estetik Vol. 11 No. 1 (2026): Jurnal Rekonstruksi dan Estetik, June 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jre.v11i1.86972

Abstract

Highlights: Plastic surgery medical tourism is driven by lower costs, shorter waiting times, quality care, and the appeal of combining treatment with travel. Thailand, South Korea, and Malaysia lead through strong government support, international accreditation, and integrated services. Indonesia, especially Bali, has strong potential but needs improvements in accreditation, language skills, and coordinated national promotion. Abstract: Introduction: Medical tourism has become a rapidly growing global industry, and plastic surgery medical tourism has gained substantial popularity due to cost advantages, accessibility, perceived quality of care, and the opportunity to combine treatment with leisure travel. This review focuses on plastic surgery medical tourism in Southeast Asia, with South Korea included as a non–Southeast Asian benchmark because of its advanced development in this field. Methods: This narrative review synthesized peer‑reviewed articles, policy documents, and institutional reports (e.g., WHO, ISAPS, JCI) published from 2010–2025. Literature was searched in December 2025 using PubMed and Google Scholar, followed by a four‑stage screening process. A thematic comparative analysis was conducted across three Southeast Asian destinations (Thailand, Malaysia, and Indonesia), with South Korea serving as a benchmark market for plastic surgery medical tourism. Results: Plastic surgery medical tourism is mainly driven by cost, shorter waiting times, accreditation and quality assurance, specialist availability, and integration of healthcare with tourism services. Within Southeast Asia, Thailand and Malaysia lead through stronger coordination, branding, and streamlined patient pathways, while South Korea exemplifies a highly coordinated, branding‑intensive model. Indonesia, especially Bali, has strong potential with competitive pricing and tourism appeal but faces challenges in governance, accreditation, and patient navigation. Conclusion: Plastic surgery medical tourism represents a strategic opportunity for economic and health sector development. Strengthening government involvement, international promotion, hospital accreditation, infrastructure, and human resource capacity is essential to enhance competitiveness and sustainability.
DELAYED EPITHELIALIZATION AFTER COMPOSITE GRAFT NECROSIS IN FINGERTIP RECONSTRUCTION: A RARE SALVAGE PHENOMENON Ocly Davira Putri Laisnima; Agus Roy Rusly Hariantana Hamid; I Gusti Putu Hendra Sanjaya; Shita Diwyani Sudarsa; Astrinita Lestari Suyata; Gede Wara Samsarga
Jurnal Rekonstruksi dan Estetik Vol. 11 No. 1 (2026): Jurnal Rekonstruksi dan Estetik, June 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jre.v11i1.88194

Abstract

Highlights: Delayed epithelialization occurred beneath a clinically necrotic composite graft, enabling unexpected salvage of a fingertip injury without complex secondary reconstruction. Delayed debridement and necrotomy preserved regenerating tissue and resulted in favorable outcomes in an Allen type III injury. Apparently nonviable composite grafts may still function as a temporary scaffold for epithelial regeneration in selected cases. Abstract: Introduction: Composite grafting is a commonly used technique for fingertip reconstruction after distal digital amputations, but graft necrosis remains a major complication that often requires secondary procedures. This report describes a rare salvage phenomenon involving delayed epithelialization beneath a necrotic composite graft. Case Illustration: A 25‑year‑old male sustained an Allen type III crush injury of the right index fingertip with comminuted distal phalanx fracture. Initial management in the emergency department consisted of wound irrigation, debridement, composite grafting of the amputated segment, and pin fixation under local anesthesia, in accordance with the patient’s preference to avoid surgery in the operating room and to preserve fingertip length. Discussion: Despite progressive graft necrosis, the patient declined early debridement. Three months post-injury, delayed debridement and necrotomy were performed under regional anesthesia. Intraoperatively, epithelialization was unexpectedly identified in the deep tissue layers beneath the necrotic graft. The wound was managed with moist dressings and topical gentamicin. One week post-debridement, a 0.5 × 0.5 cm wound demonstrated crusting and epithelialization without infection. At subsequent follow-up, the patient exhibited minimal pain, restored sensibility, normal joint motion, preserved grip strength, and nail regrowth. Conclusion: Delayed epithelialization beneath necrotic composite grafts is rare. Careful delayed debridement may preserve tissue and avoid secondary reconstruction in selected cases.