title: Complications After Cosmetic Surgery Tourism.
abstract: Cosmetic surgery tourism characterizes a phenomenon of people traveling abroad for aesthetic surgery treatment. Problems arise when patients return with complications or need of follow-up care.
  
  
  
  To investigate the complications of cosmetic surgery tourism treated at our hospital as well as to analyze arising costs for the health system.
  
  
  
  Between 2010 and 2014, we retrospectively included all patients presenting with complications arising from cosmetic surgery abroad. We reviewed medical records for patients' characteristics including performed operations, complications, and treatment. Associated cost expenditure and Diagnose Related Groups (DRG)-related reimbursement were analyzed.
  
  
  
  In total 109 patients were identified. All patients were female with a mean age of 38.5 ± 11.3 years. Most procedures were performed in South America (43%) and Southeast (29.4%) or central Europe (24.8%), respectively. Favored procedures were breast augmentation (39.4%), abdominoplasty (11%), and breast reduction (7.3%). Median time between the initial procedure abroad and presentation was 15 days (interquartile range [IQR], 9) for early, 81.5 days (IQR, 69.5) for midterm, and 4.9 years (IQR, 9.4) for late complications. Main complications were infections (25.7%), wound breakdown (19.3%), and pain/discomfort (14.7%). The majority of patients (63.3%) were treated conservatively; 34.8% became inpatients with a mean hospital stay of 5.2 ± 3.8 days. Overall DRG-related reimbursement premiums approximately covered the total costs.
  
  
  
  Despite warnings regarding associated risks, cosmetic surgery tourism has become increasingly popular. Efficient patients' referral to secondary/tertiary care centers with standardized evaluation and treatment can limit arising costs without imposing a too large burden on the social healthcare system.
  
  
  
  4.
authors.affiliation: University Hospital Zurich, Zurich, Switzerland.
authors.forename: Holger J
authors.initials: HJ
authors.lastname: Klein
authors.affiliation: University Hospital Zurich, Zurich, Switzerland.
authors.forename: Dario
authors.initials: D
authors.lastname: Simic
authors.affiliation: University Hospital Zurich, Zurich, Switzerland.
authors.forename: Nina
authors.initials: N
authors.lastname: Fuchs
authors.affiliation: University Hospital Zurich, Zurich, Switzerland.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Schweizer
authors.affiliation: University Hospital Zurich, Zurich, Switzerland.
authors.forename: Tarun
authors.initials: T
authors.lastname: Mehra
authors.affiliation: University Hospital Zurich, Zurich, Switzerland.
authors.forename: Pietro
authors.initials: P
authors.lastname: Giovanoli
authors.affiliation: University Hospital Zurich, Zurich, Switzerland.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Plock
mesh_terms: D000293:Adolescent; D000328:Adult; D003695:Delivery of Health Care / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics; D007902:Length of Stay / Q000191:economics*; D057193:Medical Tourism; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics*; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000191:economics; D012017:Referral and Consultation / Q000191:economics; D012189:Retrospective Studies; D063728:Secondary Care Centers / Q000592:standards; D013557:Switzerland; D062606:Tertiary Care Centers / Q000592:standards; D055815:Young Adult