Aesthetic Tourism: The Real Cost of Discount Plastic Surgery

 

Introduction:
Medical tourism — the practice of travelling internationally or domestically to obtain medical treatment.

Aesthetic surgery tourism— a subset of medical tourism which has exponentially gained popularity and rapidly emerged as a crisis for patients, hospitals, and involved physicians.

International Society of Aesthetic Plastic Surgery (ISAPS)

In 2023 — 15.8 million procedures done worldwide, 1.8 million done in the U.S. Among the top 5 most popular procedures worldwide and nationally — Liposuction, abdominoplasty, breast surgery. Patients in the U.S. travel for aesthetic surgery in hopes of discounted procedures, faster scheduling, affordable flights and hotel arrangements. Third party websites, or 'medical tourism brokers used often by patients seeking surgery abroad. Connect individuals to hospitals/doctors in another country. Remain largely unregulated. Have a limited discussion of surgical risk.

 

Purpose

Aesthetic surgery tourism is on the rise, but long-term costs and complications have not been fully evaluated. Our single-center retrospective study recorded outcomes in patients presenting with complications after traveling for aesthetic surgery.

Methods

Retrospective chart review—  patients between 2021 and 2024 presenting to the Henry Ford Health (HFH) Emergency Department (ED) with complications after aesthetic surgery abroad.

Medical record numbers were obtained from providers.

Compiled data— type of surgery, location, complications, number of ED visits, interventions, and admission length of stay (LOS).

Financial data— patient charges and hospital costs obtained through HFH Finance Department.

Patient charges were recorded as prior to insurance reimbursement. 

 

Results

A total of 44 patients were seen by HFH Plastic Surgery with complications after aesthetic surgery tourism. 

Surgery type — 54.5% abdominoplasty (ABD), 40.9% liposuction (Lipo), 25% had Brazilian butt lift (BBL), 15.9% breast, 2.3% jaw surgery (Facial), and 2.3% buttock implant. (figure 1)

Complications — infection (52.3%), pulmonary embolism (6.8%), seroma/fluid collection (52.3%), abscess (18.2%), wound dehiscence (20.5%), foreign body/retained suture/retained drain (6.8%). (figure 2)

Locations— Miami (63.7%); International (22.7%) including Dominican Republic, Columbia, Turkey, and Korea; locally with a non-board-certified (NBC) surgeon (9.1%), and other US state (4.5%).

Interventions—Average ED visits: 1.75. Average LOS: 3.16 days. Patients requiring operating room or bedside intervention was 25% and 61.4% respectively.

Financial data — Retrieved for 41 patients. Total hospital cost was $282,936.06, and average per patient was $6,900.88. Total patient charges were $1,435,962.35, and average per patient was $35,023.47 (figures 3 and 4).

Discussion

At face value, travelling for aesthetic surgery can seem like a trustworthy and safe option to patients.

Although aesthetic surgery tourism can be a more affordable option for some patients in the short term, it can:

Jeopardize patient safety, Place an increasing financial burden on the healthcare system.

Potential interventions: Increase awareness before travel at preoperative clearance appointments. Provide options to consult a U.S. Board-Certified Plastic Surgeon for a second opinion

For the Future: A national database to track aesthetic surgeries done abroad and rates of complications can better inform patients and physicians of potential consequences.

Conclusion

The real cost of discount plastic surgery is hidden in the events that follow. It is crucial to educate patients on risks, complications, and hidden cost associated with traveling both domestically and internationally for aesthetic surgery.