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Plastic Surgery Abroad Can Lead to Severe Complications after Returning to the US

Created Mar 29 2018, 02:18 PM by Wolters Kluwer Health
  • Plastic and Reconstructive Surgery

March 29, 2018 – Patients traveling to developing countries for plastic surgery procedures may experience severe complications—requiring extensive and costly treatment after they return to the United States, reports a study in the April issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

The costs of treating complications due to medical tourism often fall on the patient's public health insurance coverage, according to the report by ASPS Member Surgeon Dennis Orgill, MD, PhD, and colleagues of Brigham and Women's Hospital-Harvard Medical School. Added to previous reports, their experience suggests that complications resulting from plastic surgery procedures performed in other countries poses "a substantial public health problem in the US."

Complications from Medical Tourism – Plastic Surgeons Share Their Experience

The researchers analyzed their department's experience in treating patients with complications related to plastic surgery in a developing country. From 2010 to 2017, the department treated a total of 78 such patients. Almost all were women; the average age was 53 years. The most common plastic surgery procedures were abdominoplasty ("tummy tuck") and breast augmentation.

The most common complications were pain, surgical site infections, and wound healing problems. Twelve patients required hospitalization. Others required long-term wound care or repeated visits to treat infections or wound-related issues.

Three patients still had surgical drains in place, which they were instructed to remove themselves when ready. Three patients had hernias following abdominoplasty. Four patients had received breast implants that they did not consent to, including one patient who was unaware that she had breast implants. Other patients had more typical complications, such as contracture (hardening) of the tissues around breast implants, implant rupture, scarring problems, and dissatisfaction with cosmetic results.

Fifty-nine percent of the patients traveled to the Dominican Republic to have their plastic surgery. That reflects the high Dominican population of Boston; most patients who traveled to the Dominican Republic reported their ethnicity as Dominican. The researchers write: "Many think of medical tourism as wealthy patients traveling to receive care at higher quality medical institutions abroad, whereas we see a group who return to their home countries to undergo elective plastic surgery procedures at a lower price."

On assessment of financial coverage, 62 percent of patients were insured under the Massachusetts Medicaid program and another 10 percent by Medicare. Dr. Orgill comments, "Cosmetic surgery done in developing countries can carry substantial risks of complications, causing a burden on patients, surgeons, and the US healthcare system."

The authors point out some limitations of their relatively small single-center study, including the fact that it included only patients who saw a doctor in the plastic surgery department.

"We hope that this study will bring attention to this emerging issue and encourage others to report any results related to medical tourism treatment and patterns," Dr. Orgill and coauthors conclude. "We hope that the global plastic surgery community will promote better solutions to these complex issues."

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

Click here to read “Plastic Surgery Complications from Medical Tourism Treated in a U.S. Academic Medical Center.”

DOI: 10.1097/PRS.0000000000004214

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About Plastic and Reconstructive Surgery

For more than 70 years, Plastic and Reconstructive Surgery® (http://www.prsjournal.com/) has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair and cosmetic surgery, as well as news on medico-legal issues.

About ASPS

The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

About Wolters Kluwer

Wolters Kluwer is a global leader in professional information, software solutions, and services for the health, tax & accounting, finance, risk & compliance, and legal sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

Wolters Kluwer, headquartered in the Netherlands, reported 2017 annual revenues of €4.4 billion. The company serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,000 people worldwide.

Wolters Kluwer Health is a leading global provider of trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students with advanced clinical decision support, learning and research and clinical intelligence. For more information about our solutions, visit http://healthclarity.wolterskluwer.com and follow us on LinkedIn and Twitter @WKHealth.

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