American Society of Plastic Surgeons
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Medical Tourism for Cosmetic Surgery High Risk of Complications, High Costs for Treatment

Patients who travel to other countries for cosmetic surgery are at risk of serious and costly complications after they return home, suggests a study in the July issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). Treatment for infections and other complications of medical tourism may cost the United States health care system $1.3 billion per year, according to the report by Oren M. Tepper, MD, and colleagues of Montefiore Medical Center, Albert Einstein College of Medicine, New York. Tepper is the director of craniofacial and aesthetic surgery at Montefiore Health System and assistant professor of surgery at Albert Einstein College of Medicine.

High Complication Rates and Costs of Going Abroad for Cosmetic Surgery

In a 36-month review of records at their medical center, the researchers identified 42 patients with complications after medical tourism. The patients were 41 women and one man, averaging age 35. Abdominoplasty ("tummy tuck") was the most common procedure, followed by liposuction, buttock augmentation and breast augmentation. Most patients underwent multiple procedures and many had multiple complications.

  • 30 patients had infection as at least one of their complications, some of the infections involved unusual types of bacteria (such as Mycobacteria)
  • 11 patients had abscesses
  • 8 had reopening of an incision (dehiscence)
  • A few patients suffered blood clot-related complications, kidney infection and other serious problems
  • 20 patients were admitted to the hospital
  • 13 required surgery

The average cost of treating the complications was about $18,000, most of which was paid for by Medicaid. Dr. Tepper and colleagues conservatively estimate that Medicaid pays about $730 million per year due to complications for medical tourism, commercial insurance pays about $360 million and Medicare pays about $120 million.

In interviews, eight out of 18 patients were not pleased with the results of their procedure and most said they would not go abroad for subsequent procedures. Patients overestimated the U.S. cost of their cosmetic surgery by about $9,000, compared to average costs reported by the ASPS. An estimated 15 million Americans seek medical care abroad each year and that figure is expected to increase in the future.

Dr. Tepper said, "Patients may receive suboptimal care because of different standards in surgeon training and in surgical facility accreditation in the destination countries. Even travel itself may contribute to complication risks."

He added, "Patients need to be better educated on the risks and complications of aesthetic surgery, both domestically and abroad so they can make more informed decisions in the future. In addition, hospitals and the health care industry need to create incentives to encourage patients to seek cosmetic procedures domestically, reduce the risk to patients and also minimize the financial burden on our health care system."

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

Click here to read "Population Health Implications of Medical Tourism"

Article: "Population Health Implications of Medical Tourism" (doi: 10.1097/PRS.0000000000003459)

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