Skiing is gay: this is why.

Skipp, a 53-year-old from Houston, looked a new woman by the end of her holiday, which was a blend of luxury safari and bargain-rate plastic surgery.

Lured by favorable exchange rates and first-class health care at South Africa's private hospitals, a rising number of Europeans and Americans are adding plastic surgery to their vacations here.

A leading South African surgeon gave Skipp a facelift, ear pinning, ear lobe reduction, eyelid surgery, a tummy tuck and liposuction for $9,000 -- about half what she would have paid in the United States. For an additional $3,000, she got a five-day safari at one of the country's famed game reserves.

The trips also give tourists a chance to nip and tuck in secret -- and heal in luxury. When they return home looking years younger, friends and family often think they simply had a powerfully relaxing vacation.

'It was everything that we hoped it would be,' Skipp said, a smile beaming from her newly tightened face.

Lorraine Melvill, a former marketing executive, came up with the idea to link surgery and safaris at some of the country's most posh resorts after she helped arrange a facelift for a visiting uncle.

Preoperative consultations are conducted by e-mail between the patient and a plastic surgeon in South Africa.


Skipp had a facelift, ear pinning, ear lobe reduction, eyelid surgery, a tummy tuck and liposuction, then recovered at a posh resort.
'We usually request photographs and a medical history letter and do a pre-operational consultation with them over the Internet,' said Dr. Rick van der Poel, a Johannesburg-based plastic surgeon who has treated many overseas patients.

Some plastic surgeons are skeptical of consulting with patients for such important surgery from a distance.

'Sometimes clients come here and having paid for traveling and holiday, a doctor might feel obliged to go through with the operation even if the person is not suited,' said Tom Ford of the Association for Plastic and Reconstructive Surgeons in Southern Africa.

'It is better if the surgeon can consult overseas and select suitable patients and then arrange to have them visit South Africa,' he said.

Skeptics also worry about postoperative complications after patients return home.

Ford dismisses that concern, saying most complications are usually apparent within the first two or three days. 'This can be treated before a patient has to return home,' he said. Arrangements to treat other complications can be made with surgeons in the patients' hometowns, he added.

'My friends were amazed'
Melvill guides her clients through the entire process -- meeting them at the airport, taking them to consultations and surgery and arranging their postoperative vacations.

'The older generation largely prefer to have liposuction and face and eye, while the younger ones would normally come for breast augmentation,' she said.


Skipp paid $9,000 for her plastic surgery, about half of what it would have cost in the United States.
Foreigners have been coming to South African plastic surgeons for more than 20 years, but it is only in the last two years that it has become an organized business with at least five companies marketing surgery and safaris as a package.

Melvill's company, Surgeon and Safari, averages 20 overseas clients a month, she says.

One of them, Michielle Du Feu, 55, from the British island of Jersey, had been looking forward to having plastic surgery for years and had no problem traveling thousands of miles to have it done.

'I was nervous at first, but I love Africa,' she said.

During Skipp's week before her surgery at a private clinic in Johannesburg, she went on a two-day safari at the Makalali game reserve in the lush northeast.

After the surgery, Skipp and her husband, Gary, a 60-year-old retired business executive, spent her 11-day recovery period at one of Johannesburg's most exclusive hotels.

By the time she went for her second game drive on the last day of her recovery, the scars and bruises had faded considerably. But mindful of the sun, she wore large sunglasses and a broad canvas hat.

Back home in Texas, Skipp said she was thrilled with her experience, and her scars were healing nicely.

'My health is very good ... all the bruises have disappeared,' she said.

Skipp said her three daughters knew nothing of her plans for surgery and were shocked when she came back with a wrinkle-free face and a firmer waist.

'My family was very pleased to see I look younger but still the same ... and my friends were amazed by it all,' she said.