Bermudians are flying all the way to the Dominican Republic in search of cheaper cosmetic surgery procedures such as Brazilian butt lifts, liposuction and tummy tucks.

“About 30 per cent of my clients have had cosmetic work done in the DR,” said Ana Javier, owner of AJ Serenity wellness and aesthetics clinic.

For the past three years she has offered medical massage, facials, microneedling and other aesthetic treatments. She is now adding medical tourism to her list.

“We will arrange your travel to the Dominican Republic, your recovery house and your flight back,” said Ms Javier, a Dominican married to a Bermudian.

She is working in conjunction with Scottscraft, who launched the first direct charter between Bermuda and the DR last December. They have held two test flights and plan to launch the route properly later this year.

“There were three people on the first flight going there for cosmetic surgery, and two on the second,” Ms Javier said. She has an entire group arranged for December.

After several years of working as a mobile service, she opened last year in her current location near Berry Hill Road in Paget.

“I wanted a quiet, relaxing, safe environment for my clients,” she said.

Her office is surprisingly remote. You have to know where you are going to find it, and once you are there, you will doubt yourself. There is no sign. The trees are high so no one can see into the property. This is all deliberate.

“Any type of beauty procedure is a secret in Bermuda,” Ms Javier said. “People do it, but they do not want anyone to know.”

She only takes one client at a time, so that they do not bump into each other in the waiting room.

Ms Javier also sees clients who have had other types of surgery, including those undergoing cancer treatment. Medical massage can help remove fluid from the body after surgery and loosen scar tissue.

She often finds cosmetic surgery clients to be woefully underprepared for the procedures.

“They are sometimes shocked when I tell them how long recovery takes,” she said.

A Brazilian butt lift – where fat is transferred from one part of the body to the buttocks – can take two to three months of healing.

“For something like breast augmentation they might need six to ten massages after surgery,” Ms Javier said. “Unfortunately, some doctors are not as good at explaining the process.”

There is sometimes no follow-up care and she finds herself trying to step in to make sure patients have all the information they need afterwards.

Some post-surgical clients need to wear compression garments for a period of time.

“Sometimes they come in and say they feel like they are dying,” she said. “They do not want to wear the garments.”

Ms Javier suggested people book their cosmetic surgeries in the winter, when it is cooler.

“Summer is the worst time for surgery, but it is also my busiest time,” she said.

She became interested in medical massage after hurting her knee playing volleyball in the DR.

“I had physical therapy and massage after surgery,” she said. “I found the massage was helping more than the physical therapy. It helps to heal the body but it also helps with the emotional side of things.”

She said massage after surgery tended to be “more intense” than ones you get for relaxation.

To get her qualification for massage therapy in the DR, she had to first qualify as an assistant nurse, since she would be dealing with post-surgical patients. Then she did a year and a half in a medical massage school.

After working for a plastic surgeon for several years, she came to Bermuda and worked in a local hotel.

“I was looking for my niche,” she said. “I was not happy, so I said I needed to open my own place.”