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Hery D, Schwarte B, Patel K, Elliott JO, Vasko S. Plastic Surgery Tourism: Complications, Costs, and Unnecessary Spending? Aesthet Surg J Open Forum 2023; 6:ojad113. [PMID: 38213470 PMCID: PMC10783483 DOI: 10.1093/asjof/ojad113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
Background The liability of plastic surgery tourism in patient health and postoperative resource allocation is significant. Procedures completed within the context of medical tourism often lack rigorous quality assurance and provide limited preoperative evaluation or postoperative care. Not only does this jeopardize the patient's well-being, but it also increases the financial burden and redirects invaluable resources domestically through often unnecessary diagnostic tests and hospitalizations. Objectives This manuscript will examine the complications and associated costs following plastic surgery tourism and highlight unnecessary expenses for patients with outpatient complications. Methods A retrospective review was conducted of all patients 18 years or older who underwent destination surgery and were seen within 1 year postoperatively in consultation with plastic surgery at our health system between January 11, 2015 and January 7, 2022. Patient admissions were reviewed and deemed necessary or unnecessary after review by 2 physicians. Results The inclusion criteria were met by 41 patients, of whom hospitalization was deemed necessary in 28 patients vs unnecessary in 13 patients. The most common procedures included abdominoplasty, liposuction, breast augmentation, and "Brazilian butt lift." The most common complications were seroma and infection. Patients deemed to have a necessary admission often required at least 1 operation, were more likely to need intravenous antibiotics, were less likely to have the diagnosis of "pain," necessitated a longer hospitalization, and incurred a higher cost. The total financial burden was $523,272 for all 41 patients. Conclusions Plastic surgery tourism poses substantial health risks, the morbidities are expensive, and it strains hospital resources. Level of Evidence 5
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Affiliation(s)
- Danielle Hery
- Corresponding Author: Dr Danielle Hery, OhioHealth Riverside Methodist Hospital, 3535 Olentangy River Rd, Columbus, OH 43214, USA. E-mail:
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Gilardi R, Galassi L, Del Bene M, Firmani G, Parisi P. Infective complications of cosmetic tourism: A systematic literature review. J Plast Reconstr Aesthet Surg 2023; 84:9-29. [PMID: 37320953 DOI: 10.1016/j.bjps.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 04/16/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cosmetic tourism has increased dramatically over the years. We performed a systematic review of the literature to find reports of infective complications following cosmetic surgery, focusing on epidemiology, clinical, and surgical management. In addition, we identified cosmetic tourism trends in terms of mobilization from the country of origin and travel destinations. METHODS A search on PubMed, Embase, and Web of Science was performed between March and August 2022. The search was not restricted based on study date. Only English manuscripts were assessed. Reviews, short communications, letters, and correspondences were excluded after reviewing their references for potentially relevant studies. Articles related to non-cosmetic surgeries were also excluded from the study. RESULTS We identified 152 articles, of which 31 were duplicates and 47 were excluded based on title/abstract assessment. Three non-English manuscripts, 13 reviews, 12 letters to the editor, and 10 articles that did not feature clinical cases were also rejected. Thirty-six articles were included for analysis. We found 370 patients with infective complications following cosmetic surgery. The severity of complications was stratified according to the Clavien-Dindo classification. Most reports were from the United States (56.5%), followed by Switzerland and the United Kingdom. Travel destinations included the Dominican Republic (34.3%), Turkey, and Colombia. CONCLUSION Infective complications commonly occurred after abdominoplasties in patients who underwent cosmetic surgeries in Latin America or Asia. Most infective complications required management with surgical procedures that involved the administration of local, regional, or general anesthesia. Gluteal augmentations were the fourth most common cosmetic procedures; however, they were associated with the highest number of severe cases, which required intensive care treatment.
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Affiliation(s)
- Roberta Gilardi
- Division of Plastic & Reconstructive Surgery, San Gerardo Hospital of Monza, Italy
| | - Luca Galassi
- Division of Vascular Surgery, San Gerardo Hospital of Monza, Italy
| | - Massimo Del Bene
- Division of Plastic & Reconstructive Surgery, San Gerardo Hospital of Monza, Italy
| | - Guido Firmani
- Faculty of Medicine and Psychology, Sapienza University of Rome - Department of Plastic Surgery Sant'Andrea Hospital, Rome, Italy
| | - Paola Parisi
- Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute IRCCS Rome, Italy.
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Marallo M, Staudinger-Knoll A, Rubin JP. Medical Tourism and Budget Brazilian Butt Lifts: A High Cost to US Healthcare Systems and a Danger to Patients. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4913. [PMID: 37020988 PMCID: PMC10069829 DOI: 10.1097/gox.0000000000004913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/14/2023] [Indexed: 04/05/2023]
Affiliation(s)
- Michael Marallo
- From the Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - J. Peter Rubin
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
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Complications of Aesthetic Surgical Tourism Treated in the USA: A Systematic Review. Aesthetic Plast Surg 2023; 47:455-464. [PMID: 36315261 PMCID: PMC9619012 DOI: 10.1007/s00266-022-03041-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/21/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Medical tourism has grown increasingly popular in the past few decades. Cosmetic surgery centers have developed in vacation locales, offering procedures at lower prices. However, surgeons and patients alike are often unprepared for management of complications after patients return to the USA. The aim of this study is to provide an overview of US cosmetic surgery tourism patients and the complications faced by US healthcare providers. METHODS A systematic review was performed using the Web of Science, Cochrane, Embase, Scopus, and PubMed databases up to February 2022; included articles were full-text, English language, and reported complications of patients receiving postoperative care in the USA after cosmetic surgery abroad. Two independent reviewers performed screening for article eligibility with a 3rd for conflict resolution. Patient demographics, procedure characteristics, and outcomes were extracted and aggregated. RESULTS Twenty studies were included, describing 214 patients. Most patients were female (98.1%, n = 210), middle-aged, and Hispanic. The most common destination country was the Dominican Republic (82.7%, n = 177) and the most common surgical procedure was abdominoplasty (35.7%, n = 114). Complications were mainly infectious (50.9%, n = 112) and required prolonged treatment periods often greater than two months, with high rates of hospitalization (36.8%) and surgical management (51.8%). CONCLUSIONS Cosmetic surgery tourism is a growing industry with adverse implications for the US healthcare system and patients themselves. This review aims to serve as a reference to prepare plastic surgeons for the scope of complications associated with cosmetic tourism and improve counseling to better prepare patients for the financial and health risks. LEVEL OF EVIDENCE III 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.
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Lyons S, Salgaonkar S, Flaherty GT. International stem cell tourism: a critical literature review and evidence-based recommendations. Int Health 2021; 14:132-141. [PMID: 34415026 PMCID: PMC8890798 DOI: 10.1093/inthealth/ihab050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 01/08/2023] Open
Abstract
Stem cell tourism is an emerging area of medical tourism activity. Frustrated by the slow translation of stem cell research into clinical practice, patients with debilitating conditions often seek therapeutic options that are not appropriately regulated. This review summarises recent developments in the field of stem cell tourism and provides clinicians with the information necessary to provide basic pretravel health advice to stem cell tourists. PubMed and Scopus databases were consulted for relevant publications, using combinations of the terms 'stem cell', 'tourism', 'regenerative medicine', 'international', 'travel medicine' and 'environmental health'. The leading countries in the international stem cell tourism market are the USA, China, India, Thailand and Mexico. As the majority of clinics offering stem cell therapies are based in low- and-middle-income countries, stem cell tourists place themselves at risk of receiving an unproven treatment, coupled with the risk of travel-related illnesses. These clinics do not generally provide even basic travel health information on their websites. In addition to often being ineffective, stem cell therapies are associated with complications such as infection, rejection and tumorigenesis. Physicians, researchers, regulatory bodies, advocacy groups and medical educators are encouraged to work together to improve patient and physician education and address current legislative deficiencies.
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Affiliation(s)
- Samantha Lyons
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Ireland.,Faculty of Health Sciences, University of Ottawa, Ontario, Canada
| | - Shival Salgaonkar
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - Gerard T Flaherty
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Ireland.,School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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Henry N, Abed H, Warner R. The Ever-Present Costs of Cosmetic Surgery Tourism: A 5-Year Observational Study. Aesthetic Plast Surg 2021; 45:1912-1919. [PMID: 33625528 DOI: 10.1007/s00266-021-02183-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/07/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Cosmetic surgery tourism is an ever-growing industry. Despite its associated risks, an increasing number of patients are presenting to NHS services with resulting complications. This study aims to evaluate the current presentation patterns for complications in cosmetic surgery tourism, and the financial burden to the NHS reported by a single UK level one trauma centre in Birmingham, UK. METHODS From 2015 to 2020, all patients presenting to the department of plastic surgery with complications of cosmetic surgery performed outside of the UK were included. Data were collected for patients' characteristics including demographics, performed procedures, complications and treatment. A cost analysis was performed for each patient using published "National Schedule of NHS Costs." RESULTS A total of 26 patients presented to our hospital within the study period. All patients were female, with the mean age being 35.1 years (range 22-55years). A total of 32 cosmetic procedures were undertaken, with the majority performed in Turkey (n = 14). Abdominoplasty was the most common procedure, followed by gluteal enhancement surgery. The total financial cost to the NHS from all cosmetic surgery-related complications was £152,946, with an average cost per patient of £5,882.54 (range £362-£26,585). CONCLUSION Patients seek out medical tourism for multiple reasons including cost savings, shorter waiting times and surgical expertise. The costs displayed should predominantly be viewed as a reflection of the detrimental effect these complications can have on patients' lives. Global governing bodies should focus efforts on educating patients and raising awareness on this ever-prevalent issue. LEVEL OF EVIDENCE IV 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 .
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Affiliation(s)
- Nader Henry
- Department of Plastic Surgery, University Hospitals Birmingham, Mindelsohn Way, Birmingham, B15 2TH, United Kingdom.
| | - Haneen Abed
- Department of Plastic Surgery, University Hospitals Birmingham, Mindelsohn Way, Birmingham, B15 2TH, United Kingdom
| | - Robert Warner
- Department of Plastic Surgery, University Hospitals Birmingham, Mindelsohn Way, Birmingham, B15 2TH, United Kingdom
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Medical Tourism in Aesthetic Breast Surgery: A Systematic Review. Aesthetic Plast Surg 2021; 45:1895-1909. [PMID: 33876284 PMCID: PMC8054849 DOI: 10.1007/s00266-021-02251-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/16/2021] [Indexed: 02/07/2023]
Abstract
Introduction Medical tourism is expanding on a global basis, with patients seeking cosmetic surgery in countries abroad. Little information is known regarding the risks and outcomes of cosmetic tourism, in particular, for aesthetic breast surgery. The majority of the literature involves retrospective case series with no defined comparator. We aimed to amalgamate the published data to date to ascertain the risks involved and the outcomes of cosmetic tourism for aesthetic breast surgery on a global basis.
Methods A systematic review of PubMed, Google Scholar, EMBASE, the Cochrane library and OVID Medline was conducted using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines. Keywords such as “medical tourism”, “cosmetic tourism”, “tourism”, “tourist”, “surgery”, “breast” and “outcomes” were used. Seven hundred and seventy-one titles were screened, and 86 abstracts were reviewed leaving 35 full texts. Twenty-four of these met the inclusion criteria and were used to extract data for this systematic review. Results One hundred and seventy-one patients partook in cosmetic tourism for aesthetic breast surgery. Forty-nine percent of patients had an implant-based procedure. Other procedures included: mastopexy (n=4), bilateral breast reduction (n=11) and silicone injections (n=2). Two-hundred and twenty-two complications were recorded, common complications included: wound infection in 39% (n=67), breast abscess/ collection in 12% (n=21), wound dehiscence in 12% (n= 20) and ruptured implant in 8% (n=13). Clavien–Dindo classification of the complications includes 88 (51%) IIIb complications with 103 returns to theatre, 2 class IV complications (ICU stay) and one class V death of a patient. Explantation occurred in 39% (n=32) of implant-based augmentation patients. Conclusions Aesthetic breast surgery tourism is popular within the cosmetic tourism industry. However, with infective complications (39%) and return to theatre rates (51%) significantly higher than expected, it is clear that having these procedures abroad significantly increases the risks involved. The high complication rate not only impacts individual patients, but also the home country healthcare systems. Professional bodies for cosmetic surgery in each country must highlight and educate patients how to lower this risk if they do choose to have cosmetic surgery abroad. In this current era of an intra-pandemic world where health care is already stretched, the burden from cosmetic tourism complications must be minimised. Level of Evidence III 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.
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Cutaneous Mycobacterial Infections in Returning Travelers. CURRENT TROPICAL MEDICINE REPORTS 2021. [DOI: 10.1007/s40475-021-00228-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Villegas-Alzate FJ, Villegas-Mesa JD. Pregnancy after transverse plication lipoabdominoplasty, undermining halted at umbilicus, liposuction without restrictions, umbilicoplasty with a skin graft, and low transverse scar localization (TULUA). Literature review and case report. REVISTA COLOMBIANA DE OBSTETRICIA Y GINECOLOGÍA 2021; 71. [PMID: 33515444 DOI: 10.18597/rcog.3567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/20/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To report the case of a pregnant woman with a history of transverse plication abdominoplasty (TULUA) and to conduct a review of the available literature on the impact of this intervention on the course of gestation and vice versa. METHODS Case report of a 23-year-old pregnant woman with a history of TULUA abdominoplasty performed eight months before pregnancy. A literature search was conducted in Medline, Cochrane Library, SciELO, LILACS, BVS and Google Scholar, with no restriction by language or date of publication. Studies of any design were included, including case reports. Book chapters and clinical practice guidelines were excluded. RESULTS Overall, 1,158 studies were identified, of which 13 case reports or case series met the inclusion and exclusion criteria, for a total of 111 patients. No reports of TULUA before pregnancy were found. Age at the time of delivery ranged between 19 and 37 years and all births were at term, with newborns of adequate birth weight. Eleven studies described the route of delivery, including 7 cases of cesarean section and 4 vaginal deliveries. Two studies described the development of cervical prolapse, one at 15 weeks of gestation and the second at the time of labor. Three patients experienced impaired abdominal wall nerve block during the cesarean section. Regarding cosmetic results after delivery, there is a paucity of data about potential relapse in the form of skin laxity or diastasis. However, satisfactory cosmetic results were reported in two cases. CONCLUSIONS There is a paucity of literature on the topic of pregnancy following abdominoplasty, and it is limited to case reports. The literature suggests that abdominoplasty could increase the frequency of cervical prolapse and cesarean section, although the impact on perinatal outcome is not clear. It appears that abdominal wall repair is maintained. Additional studies focusing on perinatal outcomes in women with abdominoplasty and the impact of gestation on the results of the intervention are required.
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Affiliation(s)
- Francisco Javier Villegas-Alzate
- Médico, cirujano plástico, Unidad de Cirugía Plástica, Clínica San Francisco, Tuluá (Colombia). Docente de posgrado, Universidad del Valle, Cali
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Campbell A, Restrepo C, Navas G. Patient Satisfaction with Medical Tourism: A Review of 460 International Plastic Surgery Patients in Colombia. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3230. [PMID: 33425575 PMCID: PMC7787340 DOI: 10.1097/gox.0000000000003230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/14/2020] [Indexed: 11/26/2022]
Abstract
Cosmetic surgery is at the forefront of an exploding medical tourism industry. Patients are able to research options globally through the internet, and increasing numbers are seeking improved service, quality, and value through surgery overseas. Little work has been done to measure the patient experience when traveling for surgery and, to our knowledge, this is the largest study of its kind to examine patient satisfaction with medical tourism. METHODS We retrospectively reviewed patient satisfaction surveys completed by 460 consecutive international patients receiving cosmetic surgery at a private plastic surgery practice in Cartagena, Colombia, between February 2016 and April 2018. RESULTS Overall patient satisfaction was excellent, with 98.2% responding that they would refer us to friends and family. Patient satisfaction ratings across all other items was also very high (range: 97.1%-100%) for information provided, the surgeon, the staff, facilities, and payment. CONCLUSIONS Excellent patient satisfaction is possible with medical tourism if the patient perceives and receives value through effective results, a pleasant experience, and favorable costs. These successes in plastic surgery medical tourism highlight the potential for significant continued growth in this sector as a whole.
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Affiliation(s)
- Alex Campbell
- From the Premium Care Plastic Surgery, Cartagena, Colombia
- Plastic Surgery, Penn State Hershey, Hershey, Pa
| | - Carolina Restrepo
- From the Premium Care Plastic Surgery, Cartagena, Colombia
- Plastic Surgery, Penn State Hershey, Hershey, Pa
| | - Genesis Navas
- From the Premium Care Plastic Surgery, Cartagena, Colombia
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Ali KF, Mikhael A, Zayouna C, Barakat OA, Bena J, Lansang MC. Medical Tourism and Diabetes Care: Experience from a Tertiary Referral Center. Endocr Pract 2020; 26:1125-1130. [PMID: 33471714 DOI: 10.4158/ep-2020-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/18/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Medical tourism, a form of patient mobility across international borders to seek medical services, has gained significant momentum. We aimed to assess the outcomes of medical tourism consultations on chronic diseases, more specifically diabetes mellitus, amongst a cohort of international patients, originating from different healthcare systems, and referred to the United States for medical care. METHODS We identified international adults with established diabetes mellitus, referred globally from 6 countries to the United States between 2010 and 2016 for medical care, and were seen at the Cleveland Clinic Foundation (CCF). Group 1 included adults seen by an endocrinology provider during their CCF medical stay, whilst group 2 included those not seen by an endocrinology provider. To assess the impact of our consultations, changes in hemoglobin A1c (HbA1c) were assessed between visit(s). RESULTS Our study included 1,108 subjects (771 in group 1, 337 in group 2), with a mean age (± SD) of 61.3±12.7 years, 62% male, and a median medical stay of 136 days (interquartile range: 57, 660). Compared to group 2, group 1 had a higher baseline mean HbA1c (8.0 ± 1.8% [63.9 mmol/mol] vs. 7.1 ± 1.4% [54.1 mmol/mol]; P<.001). After 1 visit with endocrinology, there was a significant decrease in mean HbA1c from 8.44 ± 1.98% (68.3 mmol/mol) to 7.51 ± 1.57% (58.5 mmol/mol) (P<.001). Greatest reductions in mean HbA1c were -1.47% (95% CI: -2.21, -0.74) and -1.27% (95% CI: -1.89, -0.66) after 3 and 4 visits, respectively (P<.001). CONCLUSION Short-term diabetes mellitus consultations, in the context of medical tourism, are effective.
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Affiliation(s)
- Khawla F Ali
- Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic, Cleveland, Ohio; Royal College of Surgeons in Ireland-Medical University of Bahrain, Muharraq, Bahrain.
| | - Alexandra Mikhael
- Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic, Cleveland, Ohio
| | - Christine Zayouna
- Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic, Cleveland, Ohio
| | - Omar A Barakat
- Royal College of Surgeons in Ireland-Medical University of Bahrain, Muharraq, Bahrain
| | - James Bena
- Section of Biostatistics, Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - M Cecilia Lansang
- Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic, Cleveland, Ohio
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Raggio BS, Brody-Camp SA, Jawad BA, Winters RD, Aslam R. Complications Associated with Medical Tourism for Facial Rejuvenation: A Systematic Review. Aesthetic Plast Surg 2020; 44:1058-1065. [PMID: 32040602 DOI: 10.1007/s00266-020-01638-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 01/30/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Medical tourism for cosmetic surgery has become increasingly popular in recent years. The existing literature has identified poor outcomes associated with general cosmetic tourism; however, the complications associated with cosmetic tourism for facial rejuvenation remain poorly understood. The aims of this study are to delineate the risk profile associated with medical tourism for facial rejuvenation. METHODS A systematic review of PubMed, MEDLINE, and Embase was performed through January 2019 using the PRISMA guidelines. Search terms included combinations of keywords including medical tourism and plastic surgery and other related nomenclature. Articles published in English relevant to medical tourism for facial rejuvenation and its associated complications were examined. RESULTS We identified six retrospective studies including 31 patients who had obtained facial rejuvenation procedures abroad and experienced treatment-associated complications. Twenty-five of 26 listed patients (96%) were female (age range 33-62 years). Departure nations included the USA, Switzerland, England, Ireland, Australia, and Thailand. Destination nations included the Dominican Republic, Cyprus, the USA, Colombia, Thailand, India, and China. Procedures included blepharoplasty, facelift, rhinoplasty, chin lift, and injections with botulinum toxin and dermal fillers. Complications included abscess, poor cosmesis, facial nerve palsy, and death. CONCLUSIONS We present the first study to systematically review the complications associated with medical tourism for facial rejuvenation. No definitive conclusions can be made given the paucity of relevant data, its clinical and statistical heterogeneity, and small sample size. Additional research is warranted to help inform patients who seek facial rejuvenation procedures abroad and to better understand the health system implications associated with cosmetic tourism for facial rejuvenation. LEVEL OF EVIDENCE V 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.
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Affiliation(s)
- Blake S Raggio
- Department of Otolaryngology, Tulane University Medical Center, 1430 Tulane Ave, #8659, New Orleans, LA, 70112, USA.
| | - Sabrina A Brody-Camp
- Department of Otolaryngology, Tulane University Medical Center, 1430 Tulane Ave, #8659, New Orleans, LA, 70112, USA
| | - Basit A Jawad
- Department of Otolaryngology, Tulane University Medical Center, 1430 Tulane Ave, #8659, New Orleans, LA, 70112, USA
| | - Ryan D Winters
- Department of Otolaryngology, Tulane University Medical Center, 1430 Tulane Ave, #8659, New Orleans, LA, 70112, USA
- Department of Otorhinolaryngology, Ochsner Clinic Foundation, New Orleans, USA
| | - Rizwan Aslam
- Department of Otolaryngology, Tulane University Medical Center, 1430 Tulane Ave, #8659, New Orleans, LA, 70112, USA
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Early Surgical Management of Medical Tourism Complications Improves Patient Outcomes. Plast Reconstr Surg 2020; 145:1147-1154. [PMID: 32332529 DOI: 10.1097/prs.0000000000006728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Complications from medical tourism can be significant, requiring aggressive treatment at initial presentation. This study evaluates the effect of early surgical versus conservative management on readmission rates and costs. METHODS A single-center retrospective review was conducted from May of 2013 to May of 2017 of patients presenting with soft-tissue infections after cosmetic surgery performed abroad. Patients were categorized into two groups based on their management at initial presentation as either conservative or surgical. Demographic information, the procedures performed abroad, and the severity of infection were included. The authors' primary outcome was the incidence of readmission in the two groups. International Classification of Diseases, Ninth Revision; International Classification of Diseases, Tenth Revision; and CPT codes were used for direct-billed cost analysis. RESULTS Fifty-three patients (one man and 52 women) presented with complications after procedures performed abroad, of which 37 were soft-tissue infections. Twenty-four patients with soft-tissue infections at initial presentation were managed conservatively, and 13 patients were treated surgically. The two groups were similar in patient demographics and type of procedure performed abroad. Patients who were managed conservatively at initial presentation had a higher rate of readmission despite having lower severity of infections (OR, 4.7; p = 0.037). A significantly lower total cost of treatment was shown with early surgical management of these complications (p = 0.003). CONCLUSIONS Conservative management of complications from medical tourism has resulted in a high incidence of failure, leading to readmission and increased costs. This can contribute to poor outcomes in patients that are already having complications from cosmetic surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.
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Asher CM, Fleet M, Jivraj B, Bystrzonowski N. Cosmetic Tourism: a Costly Filler Within the National Health Service Budget or a Missed Financial Opportunity? A Local Cost Analysis and Examination of the Literature. Aesthetic Plast Surg 2020; 44:586-594. [PMID: 31832735 DOI: 10.1007/s00266-019-01571-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 11/30/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Cosmetic tourism is a global commodity, but patients seeking treatment for complications of international cosmetic tourism appear to be on the rise. We calculate the financial burden to a single NHS trust and summarise the literature, reviewing the implications of cosmetic tourism and summarising available guidance to assist surgeons in this ethically challenging, but expanding, field. METHODS Hospital episodes for patients with complications from cosmetic tourism between January 2016 and March 2017 were retrieved using the patient management system. The coding department provided the episode costs. A literature search was conducted using Medline, EMBASE and HBE identifying 273 English abstracts. The abstracts were reviewed for relevance followed by assessment of the 48 selected full articles by all authors and 17 papers contained relevant, new information. RESULTS Eleven patients underwent management for complications of cosmetic surgery, most commonly infection, with a sum of 29 inpatient episodes and total cost of £259,732. DISCUSSION Our study illustrates the management of complications of cosmetic surgery carries a high cost. This is not an experience limited to just this trust in the UK. Internationally, healthcare systems are evolving to raise the safety profile for cosmetic tourists, some going the extra mile to accommodate healthcare tourists, reaping the financial reward. Following the examination of the literature, we query whether NHS trusts should heighten their presence as providers of private services on the international market, eliminating numerous medical-ethic concerns associated with substandard cosmetic tourism. LEVEL OF EVIDENCE V 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.
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Affiliation(s)
- Christian M Asher
- Chelsea & Westminster NHS Trust, 369 Fulham Rd, Chelsea, London, SW10 9NH, UK.
| | - Malik Fleet
- Chelsea & Westminster NHS Trust, 369 Fulham Rd, Chelsea, London, SW10 9NH, UK
| | - Bejaan Jivraj
- Imperial College School of Medicine, Kensington, London, SW7 2DD, UK
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15
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Foley BM, Haglin JM, Tanzer JR, Eltorai AEM. Patient care without borders: a systematic review of medical and surgical tourism. J Travel Med 2019; 26:5528799. [PMID: 31281926 DOI: 10.1093/jtm/taz049] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/31/2019] [Accepted: 06/19/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Medical tourism (MT) is an increasingly utilized modality for acquiring medical treatment for patients globally. This review assimilates the current literature regarding MT, with particular focus on the applications, ethics and economics. METHODS A systematic review of MEDLINE and PubMed Central databases for publications relating to MT from 2005 to 2018 yielded 43 articles for this review. RESULTS Patients seeking elective bariatric, cosmetic and orthopedic surgery abroad are motivated by significantly lower costs, all-inclusive vacation packages and reduced wait times. Complication rates as high as 56% include infection, poor aesthetic and functional outcome and adverse cardiovascular events. Cross-border reproductive care has steadily increased due to less restrictive policies in select countries; however, the depth of research on outcomes and quality of care is abysmal. Stem cell therapy promise treatments that are often not well researched and offer minimal evidence of efficacy, yet patients are drawn to treatment through anecdotal advertisements and a last sense of hope. Transplant surgery sought to decrease wait times carries many of the similar aforementioned risks and may contribute to the practice of organ trafficking in countries with high rates of poverty. Patients and countries alike are motivated by a plethora of factors to engage in the MT industry but may be doing so without accurate knowledge of the quality, safety or potential for economic gain. Safety is of utmost importance to prevent surgical complications and the spread of treatment-resistant bacteria. CONCLUSIONS MT is growing in popularity and complexity. The lack of standardization in its definition and regulation leads to difficulty in epidemiologic and economic analysis and ethical issues of informed consent and health equity. The findings of this review may be used by the stakeholders of MT, including patients and providers, to enhance informed decision-making and quality of care.
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Affiliation(s)
- Brittany M Foley
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ 85054, Kingston, RI 02881, USA
| | - Jack M Haglin
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ 85054, Kingston, RI 02881, USA
| | | | - Adam E M Eltorai
- Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
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16
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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; 39:786-791. [PMID: 30590431 DOI: 10.1093/asj/sjy338] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cosmetic surgery tourism is thriving. Lower costs and all-inclusive cosmetic surgery holiday packages have led to more patients seeking cheaper aesthetic surgery abroad. However, limited postoperative care results in patients frequently presenting to UK National Health Service hospitals with postoperative complications requiring surgery. OBJECTIVES The authors sought to identify current trends and the financial impact of surgically managed complications from cosmetic surgery tourism. METHODS A retrospective review of consecutive surgically managed patients attending a London Teaching Hospital between 2006 and 2018 with complications following cosmetic surgery abroad was performed. Patient demographics, procedure characteristics, and length of stay were determined and a comprehensive cost analysis was performed. RESULTS Twenty-four patients presented with complications. Twenty-two were females aged a mean of 36 years (range, 25-58 years). Gluteal enhancement was the most common procedure (38%) and infection (92%) was the primary complication. Most procedures were undertaken in Turkey (29%) and performed in the last 5 years (63%). Twenty-one patients were inpatients and mean length of stay was 8 days (range, 1-49 days); abdominoplasty patients stayed the longest. The total cost to the hospital was $406,233, leading to an average cost per patient of $16,296 (range, $817-$41,778). Complications from abdominoplasty resulted in the highest cost per patient of $20,404. CONCLUSIONS Cosmetic surgery tourism is on the rise as patients travel for cheaper aesthetic surgery. There is urgent need to better address this issue to help reduce the growing financial strain on the National Health Service, safeguard patients, and optimize the use of valuable resources.
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Affiliation(s)
- Amitabh Thacoor
- Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK
| | - Peter van den Bosch
- Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK
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17
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Lee RA, Wigmore R. A Case of Lipotourism-associated Multidrug-resistant Mycobacterium abscessus Infection. J Glob Infect Dis 2019; 11:83-85. [PMID: 31198313 PMCID: PMC6555235 DOI: 10.4103/jgid.jgid_148_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rapidly growing mycobacteria have become increasingly recognized as pathogens implicated in surgical site infections that can be both difficult to diagnose and treat with an evolving understanding of both intrinsic and acquired resistance patterns. As common environmental commensal organisms that can colonize water supplies, they are of particular concern in the setting of a growing medical tourism industry. We present a case of a 49-year-old woman who acquired a highly multidrug-resistant Mycobacterium abscessus skin and soft-tissue infection after cosmetic abdominoplasty that required radical surgical debridement and 6 months of intravenous therapy to eradicate. This case highlights the challenges in the management of M. abscessus infections including delay to diagnosis and resistance patterns that are likely to become more common despite antibiotic stewardship efforts.
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Affiliation(s)
- Rose Anne Lee
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, US
| | - Robin Wigmore
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, US
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18
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Complications of Cosmetic Surgery Abroad - Cost Analysis and Patient Perception. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2281. [PMID: 31624684 PMCID: PMC6635218 DOI: 10.1097/gox.0000000000002281] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 04/09/2019] [Indexed: 11/25/2022]
Abstract
Supplemental Digital Content is available in the text. 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.
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Campbell CA, Restrepo C, Navas G, Vergara I, Peluffo L. Plastic Surgery Medical Tourism in Colombia: A Review of 658 International Patients and 1,796 Cosmetic Surgery Procedures. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2233. [PMID: 31333960 PMCID: PMC6571311 DOI: 10.1097/gox.0000000000002233] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 03/01/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cosmetic surgery is at the forefront of a $60 billion medical tourism industry. Patients are now able to research options globally through the internet, and increasing numbers are seeking improved service, quality, and value through surgery overseas. This study examines 658 consecutive patients receiving 1,796 cosmetic surgery procedures at a private plastic surgery practice in Cartagena, Colombia. METHODS We retrospectively reviewed the medical records of 658 consecutive international patients receiving cosmetic surgery at a private plastic surgery practice in Cartagena, Colombia. RESULTS Patients traveled to Colombia from 34 different countries spread across 6 continents. Ninety percent of patients came from North America. Patients from the United States represented 38 states and the District of Columbia, and Canadian patients represented 7 provinces. Eighty-three percent of patients were women and 90% were between the age of 20 and 54. The 658 patients in this study had a total of 1,796 cosmetic surgery procedures, involving 5,456 surgical sites. Seventy-two percent of patients received combination procedures with an average of 2.7 procedures per patient. Ninety-nine percent of cases were performed under general anesthesia and 100% were performed in an accredited hospital. CONCLUSIONS Our data highlight trends defining plastic surgery medical tourism. Our data indicate that traveling for surgery is widely appealing, with women and men from diverse backgrounds traveling to Colombia from all over the world for a variety of procedures.
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Affiliation(s)
- Christopher Alexander Campbell
- From the Premium Care Plastic Surgery, Cartagena, Colombia
- Penn State Hershey Medical Center, Hershey, Pa
- Operation Smile, Virginia Beach, Va
| | - Carolina Restrepo
- From the Premium Care Plastic Surgery, Cartagena, Colombia
- Penn State Hershey Medical Center, Hershey, Pa
- Operation Smile, Virginia Beach, Va
| | - Genesis Navas
- From the Premium Care Plastic Surgery, Cartagena, Colombia
| | - Ileyna Vergara
- From the Premium Care Plastic Surgery, Cartagena, Colombia
| | - Laura Peluffo
- From the Premium Care Plastic Surgery, Cartagena, Colombia
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Sadr AH, Pau A, Griffin MF, Butler PE, Mosahebi A. The implications of cosmetic tourism on tertiary plastic surgery services; The need for a national reporting database. J Plast Reconstr Aesthet Surg 2019; 72:1219-1243. [PMID: 30885524 DOI: 10.1016/j.bjps.2019.02.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 01/09/2019] [Accepted: 02/12/2019] [Indexed: 11/16/2022]
Affiliation(s)
- A H Sadr
- Plastic and Reconstructive Surgery Department, Royal Free Hospital, London, United Kingdom.
| | - A Pau
- Plastic and Reconstructive Surgery Department, Royal Free Hospital, London, United Kingdom
| | - M F Griffin
- Plastic and Reconstructive Surgery Department, Royal Free Hospital, London, United Kingdom; Division of Surgery and Interventional Science, University College London (UCL), London, United Kingdom; Charles Wolfson Centre for Reconstructive Surgery, Royal Free Hospital, London, United Kingdom
| | - P E Butler
- Plastic and Reconstructive Surgery Department, Royal Free Hospital, London, United Kingdom; Division of Surgery and Interventional Science, University College London (UCL), London, United Kingdom; Charles Wolfson Centre for Reconstructive Surgery, Royal Free Hospital, London, United Kingdom
| | - A Mosahebi
- Plastic and Reconstructive Surgery Department, Royal Free Hospital, London, United Kingdom; Division of Surgery and Interventional Science, University College London (UCL), London, United Kingdom
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21
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Medical Tourism and Postoperative Infections: A Systematic Literature Review of Causative Organisms and Empiric Treatment. Plast Reconstr Surg 2019; 142:1644-1651. [PMID: 30489537 DOI: 10.1097/prs.0000000000005014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Medical tourism has become increasingly globalized as individuals travel abroad to receive medical care. Cosmetic patients in particular are more likely to seek surgery abroad to defray costs. Unfortunately, not all procedures performed abroad adhere to strict hygienic regulations, and bacterial flora vary. As a result, it is not uncommon for consumers to return home with difficult-to-treat postoperative infections. METHODS A systematic literature review of PubMed, Ovid, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases was performed to assess the microbiology patterns and medical management of patients with postoperative infections after undergoing elective surgery abroad. RESULTS Forty-two cases of postoperative infections were reported among patients who underwent elective surgery abroad. Most cases were reported from the Dominican Republic, and the most common elective procedures were abdominoplasty, mastopexy, and liposuction. Rapidly growing mycobacteria such as Mycobacterium abscessus, Mycobacterium fortuitum, and Mycobacterium chelonae were among the most common causes of postoperative infection, with M. abscessus involving 74 percent of cases. Most cases were treated with surgical débridement and a combination of antibiotics. Clarithromycin, amikacin, and moxifloxacin were the most common drugs used for long-term treatment. CONCLUSIONS When encountering a patient with a history of medical tourism and treatment-refractory infection, rapidly growing mycobacteria must be considered. To increase the likelihood of yielding a diagnostic organism, multiple acid-fast bacilli cultures from fluid and débridement content should be performed. There has been reported success in treating rapidly growing mycobacterial infections with a combination of antibiotics including clarithromycin, amikacin, and moxifloxacin.
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Abstract
Medical tourism, or traveling abroad to obtain medical services, has evolved into a global health care phenomenon, with over 15 million U.S. patients each year seeking medical care internationally, representing a $50 billion dollar industry in 2017. Speculation and media fascination about the growing industry, diverse destinations, and rationale behind the medical tourists is rampant; however, the legal implications of tourism medicine, particularly when it goes wrong, are often unclear. On the international stage, accreditation agencies are limited in scope and practice, legal jurisdiction is difficult to establish, and the enforcement of rulings is nearly impossible. Patients seeking tourism medicine have little legal recourse and shoulder all the legal burden.
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Plastic Surgery Complications from Medical Tourism Treated in a U.S. Academic Medical Center. Plast Reconstr Surg 2018; 141:517e-523e. [PMID: 29595725 DOI: 10.1097/prs.0000000000004214] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Medical tourism is a growing, multi-billion dollar industry fueled by improvements in the global transportation infrastructure. The authors studied patients living in the United States who travel to other countries for plastic surgical procedures and returned to have their complications treated in the authors' center. METHODS A retrospective patient evaluation was performed. Patients who had presented to an urban tertiary academic hospital plastic surgery service with complications or complaints associated with plastic surgery performed in a developing country were studied. The authors collected demographic information, types of surgery performed, destinations, insurance coverage, and complications. RESULTS Seventy-eight patients were identified over 7 years. Most commonly, complications were seen following abdominoplasty (n = 35), breast augmentation (n = 25), and foreign body injections (n = 15). Eighteen patients underwent multiple procedures in one operative setting. The most common destination country was the Dominican Republic (n = 59). Complications included surgical-site infections (n = 14), pain (n = 14), and wound healing complications (n = 12). Eighty-six percent of patients (n = 67) relied on their medical insurance to pay for their follow-up care or manage their complications, with the most common type of health insurance coverage being Massachusetts Medicaid (n = 48). CONCLUSIONS Cosmetic surgery performed in developing countries can carry substantial risks of complications that can be challenging to patients, primary care providers, insurers, and plastic surgical teams not associated with the original surgery. These complications pose significant burdens on our public health systems.
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Zavlin D, Chegireddy V, Echo A, Friedman JD, Heller L. Population Health Implications of Medical Tourism. Plast Reconstr Surg 2018; 141:464e-465e. [PMID: 29485603 DOI: 10.1097/prs.0000000000004159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Dmitry Zavlin
- Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Texas
| | - Vishwanath Chegireddy
- Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Texas
| | - Anthony Echo
- Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Texas
| | - Jeffrey D Friedman
- Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Texas
| | - Lior Heller
- Department of Plastic Surgery, Assaf Harofeh Medical Center, Tel Aviv, Israel, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
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25
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Ingargiola MJ, Molina Burbano F, Yao A, Motakef S, Sanati-Mehrizy P, Burish NM, David LR, Taub PJ. Plastic Surgery Resident-Run Cosmetic Clinics: A Survey of Current Practices. Aesthet Surg J 2018; 38:793-799. [PMID: 29548007 DOI: 10.1093/asj/sjy065] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The recently increased minimum aesthetic surgery requirements set by the Plastic Surgery Residency Review Committee of the Accreditation Council for Graduate Medical Education highlight the importance of aesthetic surgery training for plastic surgery residents. Participation in resident aesthetic surgery clinics has become an important tool to achieve this goal. Yet, there is little literature on the current structure of these clinics. OBJECTIVES The authors sought to evaluate current practices of aesthetic resident-run clinics in the United States. METHODS A survey examining specific aspects of chief resident clinics was distributed to 70 plastic surgery resident program directors in the United States. Thirty-five questions sought to delineate clinic structure, procedures and services offered, financial cost to the patient, and satisfaction and educational benefit derived from the experience. RESULTS Fifty-two questionnaires were returned, representing 74.2% of programs surveyed. Thirty-two (63%) reported having a dedicated resident aesthetic surgery clinic at their institution. The most common procedures performed were abdominoplasty (n = 20), breast augmentation (n = 19), and liposuction (n = 16). Most clinics offered neuromodulators (n = 29) and injectable fillers (n = 29). The most common billing method used was a 50% discount on surgeon fee, with the patient being responsible for the entirety of hospital and anesthesia fees. Twenty-six respondents reported feeling satisfied or very satisfied with their resident aesthetic clinic. CONCLUSIONS The authors found aesthetic chief resident clinics to differ greatly in their structure. Yet the variety of procedures and services offered makes participation in these clinics an effective training method for the development of both aesthetic surgical technique and resident autonomy.
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Affiliation(s)
- Michael J Ingargiola
- Division of Plastic and Reconstructive Surgery, Mount Sinai Hospital, New York, NY
| | | | - Amy Yao
- Icahn School of Medicine, Mount Sinai Hospital, New York, NY
| | - Saba Motakef
- Department of Plastic Surgery, Loma Linda University, Loma Linda, CA
| | | | - Nikki M Burish
- Division of Plastic and Reconstructive Surgery, Mount Sinai Hospital, New York, NY
| | | | - Peter J Taub
- Division of Plastic and Reconstructive Surgery, Mount Sinai Hospital, New York, NY
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Discussion: Plastic Surgery Complications from Medical Tourism Treated in a U.S. Academic Medical Center. Plast Reconstr Surg 2018; 141:524e-525e. [PMID: 29595726 DOI: 10.1097/prs.0000000000004215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Reply. Plast Reconstr Surg 2018; 141:465e-466e. [DOI: 10.1097/prs.0000000000004160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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