I joined after reading this. I wanted to respond since I had this confusion as well. After having gone through the process, there is an easy answer.
When you elect to have surgery of any kind overseas be it plastic or health-related, you are often met with a fee and/or down payment. This is done as a means to not lose revenue if someone decides to not show or flights get delayed. They schedule operations in advance and it is often hard to book late notice operations so they end up losing money. This is a safety net that shows the client is serious and if for whatever reason they do a "no show", they are not losing money for the time scheduled for that person.