Domestic and International Cosmetic Tourism Complications Presenting to a US Tertiary Hospital

Abstract Background Cosmetic surgery tourism has become a significant global industry. Often patients who develop postoperative complications present for care in their US home state. Objectives In this study we evaluated patients who either traveled abroad or to other states within the United States for cosmetic surgeries and later came with complications for treatment at the authors’ center. We sought to compare rates of complications between patients who underwent cosmetic surgery internationally and domestically. Methods In this retrospective cross-sectional study we reviewed patients who presented from June 2014 to June 2022 with concerns related to cosmetic surgeries performed in another state or abroad. Binary logistic regressions were performed to assess differences in outcomes between domestic and international cases, including complications, interventions, and admissions. Results One-hundred twenty-three patients (97.6% female, mean age 34.0 ± 8.7 years, range 16-62 years) sought 159 emergency department consultations. The most common procedures included abdominoplasty (n = 72) and liposuction (n = 56). Complications included wound dehiscence (n = 39), infection (n = 38), and seroma (n = 34). Over one-half of patients required intervention. Twenty-nine patients (23.6%) required hospital admission. On multivariate regression analyses, incidence of seroma (P = .025) and oral (P = .036) and intravenous antibiotic prescriptions (P = .045) was significantly greater among the international cohort than the domestic, and all other complication variables were nonsignificant. There were no other significant differences in operative interventions or hospital admissions between international and domestic cohorts. Conclusions Compared to domestic tourism cases, international tourism cases were associated with significantly higher rates of seroma formation and antibiotic use. There were no significant differences otherwise in overall complications, including infections, operative interventions, or hospital admissions. Level of Evidence: 3