Cosmetic Surgery Tourism Research Articles

Unveiling the True Price: Assessing the Economic Impact of Cosmetic Surgery Tourism on a Single Tertiary Center in Bahrain

Abstract Background In light of the escalating cost of cosmetic surgery in Bahrain, the burgeoning “Cosmetic Surgery Tourism” sector has captured the attention of many Bahrainis. Neighboring countries aggressively promote affordable packages on numerous social media platforms, luring individuals with the allure of a vacation experience. However, insufficient postoperative care abroad has far-reaching implications that jeopardize both patient well-being and the integrity of the healthcare system. Objectives This study aims to assess the present patterns of complications related to cosmetic surgery tourism and the resulting financial burden on the Bahraini healthcare system. Methods A retrospective cost analysis and chart review were performed for all patients who presented with complaints associated with cosmetic surgeries between January 2018 and September 2023. After identifying patient demographics, procedure characteristics, admission data, length of stay, and intervention needs, a comprehensive cost analysis was conducted. Results A total of thirty patients manifested complications. Complications associated with abdominoplasty were the most prevalent. Iran emerged as the most frequented destination, with Egypt and Turkey following in order of prevalence. Surgical-site infections constituted the most common complications. Required interventions included admission for intravenous antibiotics, hyperbaric wound care, implant removal, and critical care admission. The projected expense to the hospital was 65,970 BHD (175,000 USD), equating to an average expenditure of 2,200 BHD (5,852 USD) per patient. Conclusions The allure of cost-effective cosmetic treatments often leads to complications that impose substantial economic burdens. The study concludes with policy recommendations to balance individuals’ freedom to seek healthcare abroad with long-term sustainability and equitable access to Bahrain's healthcare system.

뷰티의료관광의 기대, 지각된 가치 및 행동의도: DSC (관광목적지-자아일치도)의 조절효과를 중심으로

Purpose: In-depth research has been conducted, focusing on the beauty as one of the pursuits of tourists, particularly in the context of cosmetic surgery tourism. Beauty medical tourism should provide not only excellent medical services but also tourism programs at destination where enhance effective treatment. Therefore, this research argued the significance of destination brand management by verifying that tourist’s self-congruity is related with variables such as expectation, perceived values and behavioral intention. Methods: Based on the Meaning Transfer Theory (MTT) and the Destination Self-Congruity (DSC) theory, research model was designed. A survey was conducted targeting Chinese women tourists who share a substantial portion of the South Korean beauty medical tourism market. Total 340 valid samples were collected for a month from April in 2023. Using SPSS 18.0 and Smart PLS 4.0 packages, measurement model’s reliability and validity were tested. Structure model’s model fit and path analysis were conducted. Results: The empirical analysis revealed several significant findings: Expectation of beauty medical tourism had a significant impact on perceived values (Hypothesis 1). Perceived values of medical tourism significantly influenced behavioral intention (Hypothesis 2). Beauty medical tourism DSC had significant moderating effects on perceived values, and behavioral intention, partially. (Hypothesis 3). In specific, DSC have moderating effect, leading external perceived value to behavioral intention. Conclusion: To induce potential medical tourists to visit, how to brand the beauty of DSC, or medical tourism destinations where medical services are provided, and how to match this with potential tourists self-congruity are the key to realizing beauty medical tourism.

Domestic and International Cosmetic Tourism Complications Presenting to a US Tertiary Hospital.

Cosmetic surgery tourism has become a significant global industry. Often patients who develop postoperative complications present for care in their US home state. In this study we evaluated patients who either traveled abroad or to other states within the United States for cosmetic surgeries and later came with complications for treatment at the authors' center. We sought to compare rates of complications between patients who underwent cosmetic surgery internationally and domestically. In this retrospective cross-sectional study we reviewed patients who presented from June 2014 to June 2022 with concerns related to cosmetic surgeries performed in another state or abroad. Binary logistic regressions were performed to assess differences in outcomes between domestic and international cases, including complications, interventions, and admissions. One-hundred twenty-three patients (97.6% female, mean age 34.0 ± 8.7 years, range 16-62 years) sought 159 emergency department consultations. The most common procedures included abdominoplasty (n = 72) and liposuction (n = 56). Complications included wound dehiscence (n = 39), infection (n = 38), and seroma (n = 34). Over one-half of patients required intervention. Twenty-nine patients (23.6%) required hospital admission. On multivariate regression analyses, incidence of seroma (P = .025) and oral (P = .036) and intravenous antibiotic prescriptions (P = .045) was significantly greater among the international cohort than the domestic, and all other complication variables were nonsignificant. There were no other significant differences in operative interventions or hospital admissions between international and domestic cohorts. Compared to domestic tourism cases, international tourism cases were associated with significantly higher rates of seroma formation and antibiotic use. There were no significant differences otherwise in overall complications, including infections, operative interventions, or hospital admissions.

The cost of cosmetic surgery tourism complications to the NHS: A retrospective analysis

IntroductionMedical tourism refers to the process of patients travelling outside of their native country to undergo elective surgical procedures and is a rapidly expanding healthcare phenomenon [1–3]. Whilst a multitude of established Private Healthcare Providers (PHPs) offer cosmetic surgical procedures within the United Kingdom (UK), a growing number of patients are opting to travel outside of the UK to undergo cosmetic surgery. AimTo assess the number of patients presenting to the Canniesburn Plastic Surgery Unit, with cosmetic surgery tourism complications, from outside of the UK, and the associated costs to NHS Scotland over a five-year period. MethodsA retrospective case review of a prospectively maintained trauma database, which records all acute referrals, was undertaken analysing patients referred from January 1st 2019 to December 31st 2023 inclusive. Results81 patients presented over five years with complications of cosmetic surgery tourism. The most common presenting complaints were wound dehiscence (49.4%) or wound infection (24.7%). The total cost to NHS Scotland was £755,559.68 with an average of £9327.90 per patient. ConclusionThis is the largest single centre cohort of cosmetic surgery tourism complications reported within the NHS to date; with rates on the rise, demand grows for increased patient information regarding healthcare tourism risks, a national consensus on the extent of NHS management and urgent international collaboration with policymakers is required to address this issue across borders.

Complications arising from aesthetic surgery procedures in foreign countries and Switzerland

Cosmetic surgery tourism has increased in popularity in recent years, with arising complications and post-operative follow-up care often managed in the client's home country, thereby burdening the Swiss health care system. We retrospectively reviewed patients with complications after cosmetic surgeries abroad and in Switzerland who were treated at the University Hospital Zurich between 2015 and 2019. Data were collected from medical records and reviewed for patient characteristics, procedures, complications, and treatment modalities. A total of 228 patients (207 females and 21 males) were identified with female mean age of 40.9±12.0 years and male mean age of 34.3±8.9 years. Most complications were observed for procedures performed in Europe (69%) with only thirty-six patients (16%) experiencing complications due to a procedure undertaken in Switzerland. Breast surgery was the most frequently performed procedure (60%), followed by body contouring (17%) and facial surgery (12%). The most common complications occurring after surgeries abroad were pain and discomfort (19%) as well as aesthetic dissatisfaction (18%), followed by wound breakdown (14%) and infection (11%). Most patients (76%) were treated as outpatients and the treatment of all patients over the observed period cost the healthcare system $ 795,574. There is an ongoing trend of cosmetic surgery tourism leading to an increasing number of patients with complications requiring aftercare in Switzerland. In contrast to previous research, more men are seeking cosmetic surgery abroad and the most common complications, such as wound healing disorders and infection, descreased in favor of aethetic dissatisfaction, possibly indicating ameliorated patient aftercare abroad.

Costs Versus Complications: Public Perspectives on International Cosmetic Surgery Tourism.

Introduction: The purpose of this study was to understand the perceptions of potential complications and motivations among patients willing to travel internationally for cosmetic surgery and to gain insight into public perceptions of cosmetic surgery tourism by surveying a large, cross-sectional sample of the general public. Methods: A cross-sectional survey was performed through Amazon Mechanical Turk regarding cosmetic surgery tourism in adults 18 years and older and currently residing in the United States (US). Results: A total of 484 responses were analyzed. Of those, 45.2% of participants would consider having plastic surgery. Among these participants, 67.1% would consider traveling outside of the US to receive cosmetic surgery. Participants who reported Hispanic or Latino ethnicity had increased odds of considering surgery abroad (OR 3.1, 95% CI 1.1-8.7, P = .030). Participants reported that the top advantages of traveling outside of the US for surgery were the price of surgery internationally, a shorter waiting list for surgery, and privacy during recovery. The top disadvantages were the risk of complications, lack of follow-up or continuity care after surgery, and distance from home. Although the risk of complications was acknowledged as the top disadvantage, the perceived safety of receiving plastic surgery abroad was not related to willingness to consider having surgery abroad (P = .268). Conclusion: These findings support the need for continued awareness of patients considering international travel for cosmetic surgery and increased education of the general public regarding the safety of cosmetic surgery tourism and the importance of selecting board-certified plastic surgeons and accredited facilities.

High Morbidity of Mycobacterial Infections Following Cosmetic Surgery Tourism

Background Medical tourism is an increasingly popular practice among cosmetic surgery patients. These procedures place patients at risk of infection by rapidly growing Mycobacterium. Rapidly growing Mycobacterium (RGM) is a relatively rare infection within developed nations. Management options vary, although all pose significant morbidity to patients. We present 2 cases treated at our institution and a comprehensive literature review of RGM infection in patients who have undergone cosmetic surgery in developing nations, analyzing its associated morbidity. Methods This is a review of institutional records for patients with RGM infections after cosmetic surgery tourism was performed. A comprehensive literature search was conducted to identify reports of similar cases. Individual treatment courses were reviewed and descriptive statistics performed for management and associated morbidities. Results Two patients underwent abdominoplasty in a developing nation and later presented to our institution with mycobacterial infection. They underwent a combined 7 procedures, received a combined 3 years of antibiotic therapy, and accounted for 1 line-associated deep venous thrombosis and line-associated bacteremia. Thirty-five similar cases were identified by literature review. Patients underwent an average of 2.4 surgical procedures and received antibiotics for an average of 8.7 months. At least half of the patients (51%) required medication adjustment due to adverse effects or expense. Further morbidities encountered were financial hardship, psychological distress, and scar hypersensitivity. Conclusion Patients who undergo cosmetic surgery as medical tourists are placed at risk of infection by rapidly growing mycobacterial species. Management is highly morbid, and they are often left with extensive surgical scarring and unanticipated additional out-of-pocket expense.

Book Reviews

Kafui Ablode Attoh, Rights in Transit: Public Transportation and the Right to the City in California’s East Bay (Athens, GA: University of Georgia Press, 2019), 155 pp., 7 illustrations. $28.95Ruth Holliday, Meredith Jones, and David Bell, Beautyscapes: Mapping Cosmetic Surgery Tourism (Manchester: Manchester University Press, 2019), 232 pp. £80 (hardback).Gökçe Günel, Spaceship in the Desert: Energy, Climate Change, and Urban Design in Abu Dhabi (Durham, NC: Duke University Press, 2019), 272 pp., 31 illustrations. $26.95.

Why Do Canadians Travel Abroad for Cosmetic Surgery? A Qualitative Analysis on Motivations for Cosmetic Surgery Tourism.

Background: Canadians are increasingly engaging in medial tourism. The purpose of this study was to review Canadians’ experiences with travelling abroad for cosmetic surgery, including primary motivations for seeking care outside of Canada. Methods: A qualitative analysis was conducted using semistructured interviews following a pre-determined topic guide. People who had undergone cosmetic surgery outside of Canada were interviewed. The interviews were transcribed and coded to determine motivational themes. Patients were recruited until thematic saturation was achieved. Results: Thematic saturation was achieved after recruitment of 11 patients. The most common motivational themes identified in this study for seeking cosmetic surgery outside of Canada included cost, post-operative care provided, marketing/customer service, and word-of-mouth. Member checking and theory triangulation were validation techniques used to verify identified themes. Mexico was the most common location for cosmetic tourism. The most common procedures were breast augmentation, mastopexy, and abdominoplasty. Participants gathered pre- and post-operative information primarily through pamphlets and contact with surgeons’ offices. Follow-up was only available for half of the participants in this study, and only 5 of the participants felt that they had received informed consent. Conclusions: The majority of participants engaged in cosmetic tourism due to cost reasons and the level of post-operative care provided.

567 The Ever-Present Costs of Cosmetic Surgery Tourism; A 5-Year Observational Study

Abstract Introduction Cosmetic surgery tourism is an ever-growing industry. An increasing number of patients are presenting to NHS services with complications from their surgery. This study aims to evaluate the current presentation patterns for complications in cosmetic surgery tourism, as well as the financial burden to a single UK level one trauma centre in Birmingham, UK. Method Between 2015 and 2020, all patients presenting to the department of plastic surgery with complications of cosmetic surgery performed outside of the UK were included. A cost analysis was performed for each patient using published ‘National Schedule of NHS Costs.’ Results A total of 26 patients presented to our hospital within the study period. 32 cosmetic procedures were undertaken, with the majority performed in Turkey (n = 14). Abdominoplasty was the most common procedure, followed by gluteal enhancement surgery. The total financial cost to our hospital from all cosmetic surgery-related complications was £152,946, with an average cost per patient of £5,882.54 (range £362 - £26,585). Conclusions Patients seek out medical tourism for multiple reasons. The costs displayed should predominantly be viewed as a reflection of the detrimental effect these complications can have on patients’ lives. Global governing bodies should focus efforts on educating patients and raising awareness on this ever-prevalent issue.

The Ever-Present Costs of Cosmetic Surgery Tourism: A 5-Year Observational Study.

Cosmetic surgery tourism is an ever-growing industry. Despite its associated risks, an increasing number of patients are presenting to NHS services with resulting complications. This study aims to evaluate the current presentation patterns for complications in cosmetic surgery tourism, and the financial burden to the NHS reported by a single UK level one trauma centre in Birmingham, UK. From 2015 to 2020, all patients presenting to the department of plastic surgery with complications of cosmetic surgery performed outside of the UK were included. Data were collected for patients' characteristics including demographics, performed procedures, complications and treatment. A cost analysis was performed for each patient using published "National Schedule of NHS Costs." A total of 26 patients presented to our hospital within the study period. All patients were female, with the mean age being 35.1 years (range 22-55years). A total of 32 cosmetic procedures were undertaken, with the majority performed in Turkey (n = 14). Abdominoplasty was the most common procedure, followed by gluteal enhancement surgery. The total financial cost to the NHS from all cosmetic surgery-related complications was £152,946, with an average cost per patient of £5,882.54 (range £362-£26,585). Patients seek out medical tourism for multiple reasons including cost savings, shorter waiting times and surgical expertise. The costs displayed should predominantly be viewed as a reflection of the detrimental effect these complications can have on patients' lives. Global governing bodies should focus efforts on educating patients and raising awareness on this ever-prevalent issue. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cosmetic surgery treatment injuries: the New Zealand experience both at home and from cosmetic surgery tourism

Objective: This article attempts to understand the number of complications arising in patients returning to New Zealand from cosmetic surgery tourism destinations with reference to the number of patients with complications from cosmetic surgery undertaken in New Zealand. Methods: Data were requested under the New Zealand Official Information Act 1982 from the Accident Compensation Corporation (ACC) regarding the number of claims for treatment injury following cosmetic surgery undertaken both in New Zealand and overseas for the period 1 July 2014 to 30 June 2019. Also, a prospective audit was conducted of patients admitted to Middlemore Hospital over the one-year period March 2018 to March 2019 for complications arising as a result of cosmetic surgery tourism. Results: A total of 1048 claims were made to the ACC for treatment injuries arising from cosmetic surgery in New Zealand and from overseas treatment over the five-year period to 30 June 2019. Of these, 738 were accepted by the ACC, with the leading three events being breast reduction/reconstruction, breast implant/augmentation and septorhinoplasty. Bariatric surgery, vein treatment/sclerotherapy, orthodontics and isolated septoplasties were excluded by the ACC as not being ‘cosmetic surgery’. The ACC valued the total cost of treatment of these accepted claims at NZ$6.3 million dollars. Conclusion: Data outlining the complications arising from cosmetic surgery in New Zealand and overseas indicate a concerning burden of care required for patients who have had cosmetic surgery overseas.

Complications of Cosmetic Surgery Tourism: Case Series and Cost Analysis.

Cosmetic surgery tourism is increasing exponentially. Patients seek cosmetic procedures within the United States and abroad, lured by lower cost procedures, shorter waiting lists, and affordable airfare and hotel accommodations. Unfortunately, operations are often performed by non-board-certified plastic surgeons, sometimes not even by plastic surgeons. Preoperative counseling, frequently limited to a video-chat with an office secretary, provides inadequate discussion regarding potential complications. Postoperative care is careless and rarely involves the operating surgeon. Complications are frequent, with management falling into the hands of plastic surgeons unfamiliar with the patient's care. Furthermore, the physician, rather than the patient or hospital, faces the largest cost burden. The authors sought to explore their institution's experience treating complications of cosmetic tourism and investigate associated costs. The retrospective review of 16 patients treated for complications related to cosmetic surgery tourism plus cost analysis revealed a substantial discrepancy between money saved by undergoing surgery abroad and massive costs accrued to treat surgical complications. The most common complication was infection, often requiring surgery or IV antibiotics on discharge. Mean cost per patient was $26,657.19, ranging from $392 (single outpatient visit) to $154,700.79 (prolonged admission and surgery). Overall, the hospital retained 63% of billed charges, while physicians retained only 9%. The greatest amount paid by any single patient was $2635.00 by a patient with private insurance. Cosmetic tourism has severe medical repercussions for patients and complications that burden hospitals, physicians, and the US medical system. Physicians treating the complications suffer the greatest financial loss.

Beauty and Elegance: Value Co-Creation in Cosmetic Surgery Tourism

This study presents an emerging trend in medical tourism, cosmetic surgery tourism (CST). We explore tourists’ perceptions of CST for medical service quality as an antecedent to tourists’ emotional attachment, trust, and intentions to visit, which is underexplored in CST. This study examines the mediating role of value co-creation in influencing behaviors of CST-seeking tourists to experience a better quality of life. Using a sample drawn from 279 tourists, comprised of Australian, Japanese, and Chinese nationalities at two international airports in China, findings show that perceived medical service quality positively influences tourists’ emotional attachment, trust, and intentions to visit directly and through the mediating role of value co-creation across the three nationalities. CST-seeking tourists’ inputs in value co-creation may positively influence their behaviors, which are vital antecedents to promoting CST business. Implications for future research are discussed.

Passport to Plastics: Cosmetic Surgery Tourism, Medical Malpractice, and the Automatic Establishment of Personal Jurisdiction by Way of the Joint Commission International

Passport to Plastics:Cosmetic Surgery Tourism, Medical Malpractice, and the Automatic Establishment of Personal Jurisdiction by Way of the Joint Commission International* Elizabeth Astrup (bio) Introduction For centuries, tourists have visited lands near and far in search of experiences unavailable in their home countries.1 From golfing the best courses in the world, to yoga retreats in remote locations, many tourist activities provide experiential opportunities along with health and wellness benefits. Currently, an increasing number of individuals are opting to cross international borders to receive medical treatments, often at reduced costs.2 While many scholars use the term health tourism to encompass all health and wellness travel purposes,3 this note uses the term medical tourism to distinguish tourism for the specific purpose of medical treatments or procedures. Medical tourism is [End Page 347] considered one of the fastest-growing tourism sectors and is creating significant growth in economies across the globe.4 Like other developing areas of study, initial studies have only scratched the surface of medical tourism. Rather than analyzing these trends from a different perspective, this note draws on patterns from various nations to propose new methods of protecting patient rights, namely the right to sue in the event of medical malpractice abroad. Specifically, this note will propose the establishment of personal jurisdiction over accredited international healthcare facilities by way of an accrediting US organization. Part I will discuss the origins of medical tourism, explain how and why medical tourism became a booming industry, explore the intersection of medical tourism and medical malpractice, and discuss general principles of jurisdiction. Part II will analyze and compare policies from around the world—including the United States, Brazil, South Korea, and Thailand—concerning medical tourism, cosmetic surgery, and medical malpractice litigation. And finally, Part III will analyze the benefits of and advocate for Joint Commission International (JCI) accreditation, automatically establishing personal jurisdiction over foreign health care providers and facilities for litigants to bring suit in the United States; then provide a secondary proposal of the JCI serving as an appeals board for medical malpractice claims occurring at JCI-accredited healthcare providers. An Overview of Medical Tourism This section aims to provide a 10,000-foot view of the medical tourism industry's complexities by discussing the origin and history of medical tourism, general principles of medical malpractice claims as they relate to cosmetic surgery and medical tourism, and jurisdictional problems relating to medical malpractice litigation. This note details these issues before delving into current policies and trends in medical tourism, cosmetic surgery, and medical malpractice litigation worldwide. History of Medical Tourism Medical tourism is not a new fad. Around 70 AD, the Romans built a reservoir, a series of baths, and a temple around Aquae Sulis in [End Page 348] present-day Bath, England.5 These structures indicate that the baths were meant to serve healing purposes rather than mere relaxation.6 The baths still attract tourists from all over the world, even after nearly two thousand years. Moreover, in the eighteenth and nineteenth centuries, Europeans and Americans alike traveled to remote destinations in search of treatments for common deadly diseases such as tuberculosis.7 More recently, Americans have crossed borders to obtain certain medications at reduced costs.8 Alternatively, individuals living abroad have flocked to the United States to seek treatment for several reasons, including state-of-the-art facilities, a dependable accreditation system, and medical professionals that have been trained within the United States.9 The phenomenon of traveling abroad for surgery, however, is fairly new and becoming increasingly common. As the market for medical tourism has expanded, patients across the globe have opted to hop on planes, trains, and ships to seek care in other nations for a variety of reasons. Numerous medical tourism firms—essentially travel agencies that coordinate medical procedures abroad for travelers—have made the process of seeking and obtaining care easier.10 In 2017, more than 1.4 million Americans traveled to a different country for medical treatment, while the overall number of medical tourists worldwide was estimated to be somewhere between 14 and 16 million.11 As healthcare costs continue to rise in the United States, American...

Complications of Cosmetic Surgery Abroad - Cost Analysis and Patient Perception.

Cosmetic surgery tourism is rapidly becoming more prevalent in the United Kingdom. We aim to identify the motivational factors underlying patients' decisions to go abroad for their treatment and gather information about the ensuing complications. A retrospective review (January 2013-August 2017) was conducted of patients seen at a single major trauma center for complications from cosmetic surgery performed overseas. Cost analysis was performed based on national tariffs. Complications were grouped based on Clavien-Dindo classification and the Clinical Commissioning Group cost. A telephone survey was conducted to evaluate reasons for travel, details of complications, and impression of healthcare at home and abroad. A total of 20 patients (one male, 19 females) with a mean age 36 years (23-59 years) were included. Lower cost was the most popular reason for travel, followed by lack of expertise and friend's recommendation. Abdominoplasty (n = 9) had the highest number of complications followed by gluteal augmentation (n = 7). All major complications were due to gluteal augmentation (n = 4). The cost was for minor (n = 8, £3,448), intermediate (n = 8, £18,271), and major (n = 4, £42,083.59) complications. We raise serious concerns about the lack of regulation in cosmetic tourism and the absence of patient follow-up abroad. A particular concern was all gluteal augmentation cases had major complications. An international consensus to regulate surgical practice abroad is crucial to protect patients' interests and promote safe cosmetic surgery.

한류스타 이미지와 의료관광 서비스품질이 미용성형 태도와 미용성형 관광의도에 미치는 영향 연구: 잠재 중국인 여성을 대상으로

This study is to examine the effects of Halyu-star image and medical tourism service quality attributes on cosmetic surgery attitude and behavioral intention. An onsite survey was conducted for Chinese females, who have never visited South Korea for cosmetic surgery tourism. A total of 319 samples were collected and used for analysis in this study.BR The results of this study indicate that Halyu-star image had a significant impact on cosmetic surgery attitudes. Also, medical tourism service quality was classified into two factors: medical tangibles and medical reliability. Both medical tangibles and medical reliability had a significant impact on cosmetic surgery attitude which in turn had a significant impact on behavior intension for cosmetic surgery. Based on the finding, theoretical and practical implications are drawn.

Surgical Management of Cosmetic Surgery Tourism-Related Complications: Current Trends and Cost Analysis Study of the Financial Impact on the UK National Health Service (NHS).

Cosmetic surgery tourism is thriving. Lower costs and all-inclusive cosmetic surgery holiday packages have led to more patients seeking cheaper aesthetic surgery abroad. However, limited postoperative care results in patients frequently presenting to UK National Health Service hospitals with postoperative complications requiring surgery. The authors sought to identify current trends and the financial impact of surgically managed complications from cosmetic surgery tourism. A retrospective review of consecutive surgically managed patients attending a London Teaching Hospital between 2006 and 2018 with complications following cosmetic surgery abroad was performed. Patient demographics, procedure characteristics, and length of stay were determined and a comprehensive cost analysis was performed. Twenty-four patients presented with complications. Twenty-two were females aged a mean of 36 years (range, 25-58 years). Gluteal enhancement was the most common procedure (38%) and infection (92%) was the primary complication. Most procedures were undertaken in Turkey (29%) and performed in the last 5 years (63%). Twenty-one patients were inpatients and mean length of stay was 8 days (range, 1-49 days); abdominoplasty patients stayed the longest. The total cost to the hospital was $406,233, leading to an average cost per patient of $16,296 (range, $817-$41,778). Complications from abdominoplasty resulted in the highest cost per patient of $20,404. Cosmetic surgery tourism is on the rise as patients travel for cheaper aesthetic surgery. There is urgent need to better address this issue to help reduce the growing financial strain on the National Health Service, safeguard patients, and optimize the use of valuable resources.

Breast Implant Mycobacterial Infections: An Epidemiologic Review and Outcome Analysis.

Epidemiologic evidence of periprosthetic mycobacterial infections is limited. The recent boom in cosmetic surgery tourism has been associated with a rise of surgical-site infections in returning patients. This review aims to explore available data, examine trends of documented periprosthetic mycobacterial infections, and analyze outcomes of management techniques. A search in the Biosis, Embase, LILACS, MEDLINE, and Web of Science databases from inception until December of 2017 for "Breast Implants" and "Mycobacterial Infections" and equivalents was performed. Data were pooled after two screening rounds following full-text retrieval and cross-referencing. Forty-one reports describing 171 female patients who had breast prosthesis-related mycobacterial infections were identified. Bibliometric case-based analysis revealed a rise of periprosthetic mycobacterial infections in developing countries since the start of the millennium. The mean patient's age was 37.9 years and the majority of patients had undergone bilateral breast augmentation. Most patients presented with breast pain or tenderness, after an average incubation period of 9 months. Mycobacterium fortuitum was isolated from 90 cases (52.6 percent). Immediate explantation with or without delayed reimplantation was the most commonly used surgical strategy, complemented by combination antimicrobial therapy for an average of 4.6 months. The mean follow-up time was 39.7 months, during which recurrence was observed in 21 of 171 patients (12.3 percent). The emergence of periprosthetic mycobacterial infections in relation to cosmetic medical tourism alerts clinicians to the importance of educating the public about the associated risks. In addition, this study identifies risk factors associated with recurrence of periprosthetic mycobacterial infections.

Aesthetic journeys: a review of cosmetic surgery tourism.

Medical tourism has witnessed significant growth in recent years. The emerging trend towards international travel for cosmetic surgical interventions has not previously been reviewed. The current review aims to critically address the scale and impact of cosmetic surgical tourism and to delineate the complication profile of this form of medical tourism. Articles published in the English language on the PubMed database that were relevant to surgical tourism and the complications of elective surgical procedures abroad were examined. Reference lists of articles identified were further scrutinized. The search terms used included combinations of 'surgery abroad', 'cosmetic surgery abroad', 'cosmetic surgery tourism', 'cosmetic surgery complications' and 'aesthetic tourism'. This article critically reviews the epidemiology of cosmetic surgical tourism and its associated economic factors. Surgical complications of selected procedures, including perioperative complications, are described. The implications for travel medicine practice are considered and recommendations for further research are proposed. This narrative literature review focuses on the issues affecting travellers who obtain cosmetic surgical treatment overseas. There is a lack of focus in the travel medicine literature on the non-surgery-related morbidity of this special group of travellers. Original research exploring the motivation and pre-travel preparation, including the psychological counselling, of cosmetic surgical tourists is indicated.