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Population Health Implications of Medical Tourism

Adabi, Kian, B.A.; Stern, Carrie S., M.D.; Weichman, Katie E., M.D.; Garfein, Evan S., M.D.; Pothula, Aravind, M.D.; Draper, Lawrence, M.D.; Tepper, Oren M., M.D.

Plastic and Reconstructive Surgery: July 2017 - Volume 140 - Issue 1 - p 66-74
doi: 10.1097/PRS.0000000000003459
Cosmetic: Special Topics
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Background: Fifteen million U.S. patients each year seek medical care abroad; however, there are no data on outcomes and follow-up of these procedures. This study aims to identify, evaluate, and survey patients presenting with complications from aesthetic procedures abroad and estimate their cost to the U.S. health care system.

Methods: A single-center retrospective review was conducted. A cohort of patients presenting with complications from aesthetic procedures performed abroad was generated. Demographic, complication, and cost data were compiled. Patients were surveyed to assess their overall experience.

Results: Over a 36-month period, 42 patients met inclusion criteria (one man and 41 women), with an average age of 35 ± 11.4 years (range, 20 to 60 years). Comorbidities included four active smokers, two patients with hypertension, and one patient with diabetes. Average body mass index was 29 ± 4.4 kg/m2 (range, 22 to 38 kg/m2). Procedures performed abroad included abdominoplasty (n = 28), liposuction (n = 20), buttock augmentation (n = 10), and breast augmentation (n = 7), with several patients undergoing combined procedures. Eleven patients presented with abscesses and eight presented with wound dehiscence. Eight of the 18 patients who were surveyed were not pleased with their results and 11 would not go abroad again for subsequent procedures. Average cost of treating the complications was $18,211, with an estimated cost to the U.S. health care system of $1.33 billion. The main payer group was Medicaid.

Conclusions: Complications from patients seeking aesthetic procedures abroad will continues to increase. Patients should be encouraged to undergo cosmetic surgery in the United States to improve patient outcomes and satisfaction and because it is economically advantageous.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Bronx, N.Y.

From the Montefiore Medical Center, Albert Einstein College of Medicine.

Received for publication October 8, 2016; accepted January 18, 2017.

Presented at Plastic Surgery The Meeting 2016: Annual Meeting of the American Society of Plastic Surgeons, in Los Angeles, California, September 23 through 27, 2016.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to PRSJournal.com and click on “Plastic Surgery Hot Topics” in the “Digital Media” tab to watch. On the iPad, tap on the Hot Topics icon.

Oren Tepper, M.D., Albert Einstein College of Medicine, Montefiore Health System, 1250 Waters Place, Tower II, Bronx, N.Y. 10461, otepper@monterfiore.org

Copyright © 2017 by the American Society of Plastic Surgeons