title: Medical tourism in plastic surgery: ethical guidelines and practice standards for perioperative care.
abstract: BACKGROUND
  The goal of this review was to identify the safety and medical care issues that surround the management of patients who had previously undergone medical care through tourism medicine. Medical tourism in plastic surgery occurs via three main referral patterns: macrotourism, in which a patient receives treatments abroad; microtourism, in which a patient undergoes a procedure by a distant plastic surgeon but requires postoperative and/or long-term management by a local plastic surgeon; and specialty tourism, in which a patient receives plastic surgery from a non-plastic surgeon.
  
  
  METHODS
  The ethical practice guidelines of the American Medical Association, International Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and American Board of Plastic Surgeons were reviewed with respect to patient care and the practice of medical tourism.
  
  
  CONCLUSIONS
  Safe and responsible care should start prior to surgery, with communication and postoperative planning between the treating physician and the accepting physician. Complications can arise at any time; however, it is the duty and ethical responsibility of plastic surgeons to prevent unnecessary complications following tourism medicine by adequately counseling patients, defining perioperative treatment protocols, and reporting complications to regional and specialty-specific governing bodies.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
authors.affiliation: Department of Plastic Surgery, Georgetown University Hospital, Washington, DC, USA, mattiorio@gmail.com.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Iorio
authors.forename: Kapil
authors.initials: K
authors.lastname: Verma
authors.forename: Samaneh
authors.initials: S
authors.lastname: Ashktorab
authors.forename: Steven P
authors.initials: SP
authors.lastname: Davison
mesh_terms: D004992:Ethics, Medical; D006801:Humans; D015187:Lipectomy; D016462:Mammaplasty / Q000941:ethics / Q000592:standards; D057193:Medical Tourism / Q000941:ethics*; D019990:Perioperative Care / Q000941:ethics* / Q000592:standards*; D017410:Practice Guidelines as Topic; D019651:Plastic Surgery Procedures / Q000941:ethics* / Q000592:standards*; D059039:Standard of Care