Cheaper out of state. Certainly it is tempting to find a great price for cosmetic surgery outside of this country. However, you are essentially risking your own well being. It is best to view surgery as a journey that continues after your surgery rather than something that ends right after surgery. You should be as informed and educated as you can whether or not your surgery is in this country or not.
Pick wisely. If you leave the country become very well informed about the surgeon, the facility for surgery and the health standards of where you journey. The us standards are much higher than nearly every country. You are risking your health and well being to save a few bucks. Also make sure to factor in the cost of travel and lodging for at least 8-14 days.
Don't chose by cost. You shouldn't choose your rhinoplasty surgeon just on cost. Instead you should find a surgeon who is well trained and has good experience and results. Certainly you can get a cheaper surgery out of the us or canada but what will you do if you have problems afterward?
Cheaper but riskier. You may be able to get a rhinoplasty out of the country for a fee that is less, but the risks are much greater. Standards of care (surgical equipment, operating facilities, anesthesia, etc) may not be adequate. In addition, follow up could be compromised or reduced, especially if you have some complications. Saving up and spending a little more now could save you a lot of trouble in the future.
Medical Tourism. It may be but as the saying goes: caveat emptor (buyer beware). You often get what you pay for.