A one-way ticket to surgical complications

Survey shows need for increased awareness of dangers of medical tourism

August 8, 2011
American Society for Aesthetic Plastic Surgery (ASAPS)

Medical tourism, in which patients travel abroad for surgery, is a rapidly expanding global phenomenon, particularly for cosmetic surgery. However, despite the increasing number of plastic surgery patients who seek procedures outside of the United States, there has been little data reported on outcomes, follow-up or complication rates. In response, researchers from Nassau University Medical Center in New York conducted a survey of U.S. plastic surgeons to help define the scope of the problem, particularly in relation to complication rates, finding that there is a need for improved public awareness and education regarding medical tourism. The results of the study were published in the article "Complications from International Surgery Tourism," which appears in the August issue of the Aesthetic Surgery Journal.

"We found from this survey that plastic surgeons are seeing increasing numbers of medical tourism patients who return with complications. Medical tourism patients are often lured by the apparent lower cost of surgery elsewhere or by the availability of procedures that are not approved here in the U.S. However, these patients may not be well informed about the importance of outcomes and the risk of complications," said Kaveh Alizadeh, M.D., MSc, FACS, co-author of the study. "When patients return to the U.S., it can become a costly scenario if they develop complications and the procedure or patient is not covered by medical insurance. Plastic surgeons can help amend this by educating their patients on the potential pitfalls of cosmetic surgery tourism."

Dr. Alizadeh and co-author Mark M. Melendez, M.D., MBA surveyed 2,000 American Society of Plastic Surgeons (ASPS) members concerning their experience treating medical tourism patients with complications who returned to the US for resolution of their issues.Of 368 respondents, the majority (80.4%) had experience with patients who had traveled abroad for cosmetic procedures, and over half (51.6%) reported noticing an increasing trend over the last five years in the number patients presenting with complications from surgical tourism. The majority of these patients had undergone either breast augmentation or body contouring procedures. More than half required multiple operations upon seeking treatment for their complications and at least one patient required over a month of hospitalization in a surgical intensive care unit. The largest percentage (31%) of complications occurred as a result of infection. Other common complications reported by respondents were dehiscence, contour abnormality, and hematoma. Compensation for complication treatment was highly variable, as not all patients or procedures were covered by insurance.

"This survey clearly shows the dangers of medical tourism and implies the need to strengthen awareness for patients, physicians and policy makers. I encourage all plastic surgeons who encounter patients considering surgery abroad to offer them a copy of guidelines on this topic from the American Society for Aesthetic Plastic Surgery (ASAPS), International Society of Aesthetic Plastic Surgery (ISAPS) or ASPS," said Foad Nahai, M.D., Editor-in-Chief of Aesthetic Surgery Journal, who also provided a commentary on the article. "This may serve as a starting point for a conversation in which the patient understands that plastic surgery tourism is not as simple as he or she might have thought and drops the notion of seeking care abroad. At the very least, the patient will leave the visit with a better understanding of questions to ask, risks to consider, and his or her personal responsibility regarding follow-up care."