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

[BACKGROUND] 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.

[METHODS] 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.

[RESULTS] 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.

[CONCLUSIONS] 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.