This report originally aired on June 24, 2005.
She had sweated and struggled for years, but Tammy Vredenburg couldn't seem to win the battle of the bulge. Having given birth to six children, including triplets, she said her body had been through the wringer.
"I had a C-section when I was 17, and it was done vertically. So, I have what looks like a double loaf of bread on the front of my stomach," she told "20/20's" Deborah Roberts.
Her husband, a Coast Guard officer, said he loved her as she was, but it was not enough for Vredenburg, 38. "I think that he'll love me just the way that I am even more when I love myself more," she said.
Lori Brown and her sister Linda Firth, from Nashville, Tenn., weren't happy with their bodies either.
Like lots of women their ages, Brown and Firth, who were 40 and 48 years old when "20/20" met them, wrestled with self-image and weight.
By adulthood, Brown's weight had ballooned to nearly 300 pounds. Four years before we met her, she had gastric bypass surgery, which was covered by her insurance. She dropped an astounding 119 pounds, but she still had lots of excess skin. So, she began looking into cosmetic surgery.
After Brown heard a quote of $35,000 from a Tennessee plastic surgeon, the procedure was out of the question. She was an office assistant — she couldn't afford it.
Firth, a dog groomer, was also saddled with stomach flab since she had given birth 30 years earlier.
Though the two sisters had never met Vredenburg, and they lived hundreds of miles apart, the women wound up on the same Internet site — as they surfed the Web to find affordable cosmetic surgery prices.
What they found online opened up a whole new world of possibilities.
They all learned that Costa Rica — the land of volcanoes, beaches, rain forests — was also the land of low-priced cosmetic surgery. The country is now one of the hottest spots for average Americans looking for an extreme makeover.
Just a quick plane ride away from many American cities, Costa Rica offers what America cannot: inexpensive medical care and affordable recovery resorts. That was all the three women needed to see.
"It's so much cheaper there, I'm going to get some lipo done. And before you know it, well, I think I'll get a breast augmentation. What the heck. I'm there anyways," Firth said.
And because Firth had brought her sister, the doctor had offered a discount.
Brown said she planned to have a thigh lift, a tummy tuck, an arm lift and a breast lift with implants — all for $7,000. That's about a quarter of what that laundry list of procedures would cost in the United States.
The women checked the references of the surgeons who were performing the procedures — Luis Da Cruz and Federico Macaya — and felt confident about the doctors' credentials.
Still, even the best credentials can't guarantee perfect results. News reports describe horror stories abroad and in the United States. "20/20" has reported a case of one American woman who died from cosmetic surgery.
But danger was the last thing on the minds of the three women, and they were soon off to sunny Costa Rica to fulfill their beauty dreams.
Many people worry that if cosmetic surgery is so much cheaper in Costa Rica, that it has to be substandard, but Da Cruz, who worked on the two sisters, assures his patients they'll receive quality care.