Costa Rica was among the first well-known destinations for modern medical travel, dating back to the 1970s and early 1980s when some pioneering plastic surgeons and dentists first began serving international clients. Among them was Dr. Miguel Alfaro, who, like many Costa Rican surgeons, came to medical school in the United States and was trained in general and plastic surgery at the University of Colorado; the University of Missouri and the University of Michigan. He returned to Costa Rica in 1976 and worked for years for the country’s public health care system, while building his private practice in plastic surgery on the side. Most recently, Alfaro has been chairman of the Department of Surgery at Hospital San Juan de Dios in San José, Costa Rica.