Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 153 No. 4 (2023)

Complications arising from aesthetic surgery procedures in foreign countries and Switzerland

  • Carmen E. Hummel
  • Holger J. Klein
  • Pietro Giovanoli
  • Nicole Lindenblatt
DOI
https://doi.org/10.57187/smw.2023.40077
Cite this as:
Swiss Med Wkly. 2023;153:40077
Published
17.04.2023

Summary

BACKGROUND: Cosmetic surgery tourism has increased in popularity in recent years, with arising complications and post-operative follow-up care often managed in the client’s home country, thereby burdening the Swiss health care system.

METHODS: We retrospectively reviewed patients with complications after cosmetic surgeries abroad and in Switzerland who were treated at the University Hospital Zurich between 2015 and 2019. Data were collected from medical records and reviewed for patient characteristics, procedures, complications, and treatment modalities.

RESULTS: A total of 228 patients (207 females and 21 males) were identified with female mean age of 40.9±12.0 years and male mean age of 34.3±8.9 years. Most complications were observed for procedures performed in Europe (69%) with only thirty-six patients (16%) experiencing complications due to a procedure undertaken in Switzerland. Breast surgery was the most frequently performed procedure (60%), followed by body contouring (17%) and facial surgery (12%). The most common complications occurring after surgeries abroad were pain and discomfort (19%) as well as aesthetic dissatisfaction (18%), followed by wound breakdown (14%) and infection (11%). Most patients (76%) were treated as outpatients and the treatment of all patients over the observed period cost the healthcare system $ 795,574.

CONCLUSIONS: There is an ongoing trend of cosmetic surgery tourism leading to an increasing number of patients with complications requiring aftercare in Switzerland. In contrast to previous research, more men are seeking cosmetic surgery abroad and the most common complications, such as wound healing disorders and infection, descreased in favor of aethetic dissatisfaction, possibly indicating ameliorated patient aftercare abroad.

References

  1. Klein HJ , Simic D , Fuchs N , Schweizer R , Mehra T , Giovanoli P , et al. Complications After Cosmetic Surgery Tourism. Aesthet Surg J. 2017 Apr;37(4):474–82. https://doi.org/10.1093/asj/sjw198 DOI: https://doi.org/10.1093/asj/sjw198
  2. Global-Survey-2019.pdf. Accessed March 31, 2021. https://www.isaps.org/wp-content/uploads/2020/12/Global-Survey-2019.pdf
  3. Hanefeld J , Lunt N , Smith R , Horsfall D . Why do medical tourists travel to where they do? The role of networks in determining medical travel. Soc Sci Med. 2015 Jan;124:356–63. https://doi.org/10.1016/j.socscimed.2014.05.016 DOI: https://doi.org/10.1016/j.socscimed.2014.05.016
  4. Chen LH , Wilson ME . The globalization of healthcare: implications of medical tourism for the infectious disease clinician. Clin Infect Dis. 2013 Dec;57(12):1752–9. https://doi.org/10.1093/cid/cit540 DOI: https://doi.org/10.1093/cid/cit540
  5. Foley BM , Haglin JM , Tanzer JR , Eltorai AE . Patient care without borders: a systematic review of medical and surgical tourism. J Travel Med. 2019 Sep;26(6):taz049. https://doi.org/10.1093/jtm/taz049 DOI: https://doi.org/10.1093/jtm/taz049
  6. Paraskou A , George BP . The market for reproductive tourism: an analysis with special reference to Greece. Glob Health Res Policy. 2017 Jun;2(1):16. https://doi.org/10.1186/s41256-017-0037-8 DOI: https://doi.org/10.1186/s41256-017-0037-8
  7. Bookman MZ , Bookman KR . Medical Tourism in Developing Countries. Palgrave Macmillan, US; 2007. https://doi.org/10.1057/9780230605657 DOI: https://doi.org/10.1057/9780230605657
  8. Sun-Sea-Final-Report.pdf. Accessed July 30, 2020. http://1n1xkd2j1u702vcxsr1pe3h6.wpengine.netdna-cdn.com/files/2012/11/Sun-Sea-Final-Report.pdf
  9. Eissler LA , Casken J . Seeking health care through international medical tourism. J Nurs Scholarsh. 2013 Jun;45(2):177–84. https://doi.org/10.1111/jnu.12014 DOI: https://doi.org/10.1111/jnu.12014
  10. Alleman BW , Luger T , Reisinger HS , Martin R , Horowitz MD , Cram P . Medical tourism services available to residents of the United States. J Gen Intern Med. 2011 May;26(5):492–7. https://doi.org/10.1007/s11606-010-1582-8 DOI: https://doi.org/10.1007/s11606-010-1582-8
  11. Penney K , Snyder J , Crooks VA , Johnston R . Risk communication and informed consent in the medical tourism industry: a thematic content analysis of Canadian broker websites. BMC Med Ethics. 2011 Sep;12(1):17. https://doi.org/10.1186/1472-6939-12-17 DOI: https://doi.org/10.1186/1472-6939-12-17
  12. Melendez MM , Alizadeh K . Complications from international surgery tourism. Aesthet Surg J. 2011 Aug;31(6):694–7. https://doi.org/10.1177/1090820X11415977 DOI: https://doi.org/10.1177/1090820X11415977
  13. Venditto C , Gallagher M , Hettinger P , Havlik R , Zarb R , Argenta A , et al. Complications of Cosmetic Surgery Tourism: Case Series and Cost Analysis. Aesthet Surg J. 2021 Apr;41(5):627–34. https://doi.org/10.1093/asj/sjaa092 DOI: https://doi.org/10.1093/asj/sjaa092
  14. BAG B für G. Tarifsystem TARMED . Accessed January 9, 2022. https://www.bag.admin.ch/bag/de/home/versicherungen/krankenversicherung/krankenversicherung-leistungen-tarife/Aerztliche-Leistungen-in-der-Krankenversicherung/Tarifsystem-Tarmed.html
  15. BAG B für G. Tarifsystem SwissDRG . Accessed May 9, 2021. https://www.bag.admin.ch/bag/de/home/versicherungen/krankenversicherung/krankenversicherung-leistungen-tarife/Spitalbehandlung/Tarifsystem-SwissDRG.html
  16. Thacoor A , van den Bosch P , Akhavani MA . Surgical Management of Cosmetic Surgery Tourism-Related Complications: Current Trends and Cost Analysis Study of the Financial Impact on the UK National Health Service (NHS). Aesthet Surg J. 2019 Jun;39(7):786–91. https://doi.org/10.1093/asj/sjy338 DOI: https://doi.org/10.1093/asj/sjy338
  17. GlobalStatistics2016-1.pdf. Accessed March 31, 2021. https://www.isaps.org/wp-content/uploads/2017/10/GlobalStatistics2016-1.pdf
  18. 2016-ISAPS-Results-1.pdf. Accessed March 31, 2021. https://www.isaps.org/wp-content/uploads/2017/10/2016-ISAPS-Results-1.pdf
  19. Wednesday J . 12, MoreAddThis28 ASB to F to T to L to. More Men Undergo Plastic Surgery as the Daddy-Do-Over Trend Rises in Popularity. American Society of Plastic Surgeons. Accessed May 9, 2021. https://www.plasticsurgery.org/news/press-releases/more-men-undergo-plastic-surgery-as-the-daddy-do-over-trend-rises-in-popularity
  20. isaps-global-survey_2021.pdf. Accessed February 1, 2023. https://www.isaps.org/media/vdpdanke/isaps-global-survey_2021.pdf
  21. ISAPS-Global-Survey-Results-2018-1.pdf. Accessed March 31, 2021. https://www.isaps.org/wp-content/uploads/2020/10/ISAPS-Global-Survey-Results-2018-1.pdf
  22. 2014-ISAPS-Results-3-1.pdf. Accessed March 31, 2021. https://www.isaps.org/wp-content/uploads/2017/10/2014-ISAPS-Results-3-1.pdf
  23. ISAPS_2017_International_Study_Cosmetic_Procedures_NEW.pdf. Accessed September 18, 2019. https://www.isaps.org/wp-content/uploads/2019/03/ISAPS_2017_International_Study_Cosmetic_Procedures_NEW.pdf
  24. Cosmetic surgery in men. doi:https://doi.org/10.1002/tre.761 DOI: https://doi.org/10.1002/tre.761
  25. Hopkins ZH , Moreno C , Secrest AM . Influence of Social Media on Cosmetic Procedure Interest. J Clin Aesthet Dermatol. 2020 Jan;13(1):28–31. [cited 2023 Jan 29] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028372/
  26. Brightman L , Ng S , Ahern S , Cooter R , Hopper I . Cosmetic tourism for breast augmentation: a systematic review. ANZ J Surg. 2018 Sep;88(9):842–7. https://doi.org/10.1111/ans.14326 DOI: https://doi.org/10.1111/ans.14326
  27. Pereira RT , Malone CM , Flaherty GT . Aesthetic journeys: a review of cosmetic surgery tourism. J Travel Med. 2018 Jun;25(1): https://doi.org/10.1093/jtm/tay042 DOI: https://doi.org/10.1093/jtm/tay042
  28. Miyagi K , Auberson D , Patel AJ , Malata CM . The unwritten price of cosmetic tourism: an observational study and cost analysis. J Plast Reconstr Aesthet Surg. 2012 Jan;65(1):22–8. https://doi.org/10.1016/j.bjps.2011.07.027 DOI: https://doi.org/10.1016/j.bjps.2011.07.027
  29. BAG B für G. Ambulant vor Stationär. Accessed May 9, 2021. https://www.bag.admin.ch/bag/de/home/versicherungen/krankenversicherung/krankenversicherung-leistungen-tarife/Aerztliche-Leistungen-in-der-Krankenversicherung/ambulant-vor-stationaer.html
  30. Adabi K , Stern CS , Kinkhabwala CM , Weichman KE , Garfein ES , Tepper OM , et al. Early Surgical Management of Medical Tourism Complications Improves Patient Outcomes. Plast Reconstr Surg. 2020 May;145(5):1147–54. https://doi.org/10.1097/PRS.0000000000006728 DOI: https://doi.org/10.1097/PRS.0000000000006728
  31. Livingston R , Berlund P , Eccles-Smith J , Sawhney R . The Real Cost of “Cosmetic Tourism” Cost Analysis Study of “Cosmetic Tourism” Complications Presenting to a Public Hospital. Eplasty. 2015 Jul;15:e34. [cited 2022 May 19] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522144/
  32. Schwartz KL , Morris SK . Travel and the Spread of Drug-Resistant Bacteria. Curr Infect Dis Rep. 2018 Jun;20(9):29. https://doi.org/10.1007/s11908-018-0634-9 DOI: https://doi.org/10.1007/s11908-018-0634-9
  33. Khawaja T , Kirveskari J , Johansson S , Väisänen J , Djupsjöbacka A , Nevalainen A , et al. Patients hospitalized abroad as importers of multiresistant bacteria-a cross-sectional study. Clin Microbiol Infect. 2017 Sep;23(9):673.e1–8. https://doi.org/10.1016/j.cmi.2017.02.003 DOI: https://doi.org/10.1016/j.cmi.2017.02.003
  34. Cusumano LR , Tran V , Tlamsa A , Chung P , Grossberg R , Weston G , et al. Rapidly growing Mycobacterium infections after cosmetic surgery in medical tourists: the Bronx experience and a review of the literature. Int J Infect Dis. 2017 Oct;63:1–6. https://doi.org/10.1016/j.ijid.2017.07.022 DOI: https://doi.org/10.1016/j.ijid.2017.07.022
  35. Spitalfinanzierung. Kanton Zürich. Accessed September 5, 2021. https://www.zh.ch/de/gesundheit/spitaeler-kliniken/spitalfinanzierung.html
  36. Statistik B für . Spitäler. Accessed May 19, 2021. https://www.bfs.admin.ch/bfs/de/home/statistiken/gesundheit/gesundheitswesen/spitaeler.html

Most read articles by the same author(s)