medical tourism breast reduction

Breast Augmentation/Reduction

Stem cell orthopedics, stem cell anti-aging, stem cell fertility, steps involved in ivf:, procedure description.

Breast augmentation and reduction surgeries are increasingly popular options for those looking to alter the size and shape of their breasts. Breast augmentation typically involves inserting implants to enhance the size, shape, or symmetry of the breasts. It's popular among women who might be dissatisfied with their breast size or who have experienced changes due to pregnancy, weight loss, or aging. On the other side, breast reduction surgery aims to remove excess tissue, fat, and skin to reduce the size of overly large breasts. This procedure can help relieve physical symptoms like back and neck pain, posture issues, or skin irritations beneath the breast area.

Both of these procedures go beyond cosmetic concerns. For example, breast augmentation can be part of breast reconstruction after a mastectomy, helping to restore physical appearance and emotional well-being. Breast reduction can dramatically improve the quality of life by alleviating physical discomfort and enhancing mobility. However, like any other surgery, it's crucial to thoroughly consult with a qualified healthcare professional to assess your needs, discuss the different techniques available, and weigh the risks and benefits of the surgery.

Medical tourism opens up a broader range of options for these procedures, giving you access to experienced surgeons, advanced techniques, and potentially more affordable care. Before taking the step to undergo a breast augmentation or reduction abroad, understanding the full scope of the procedure and associated logistics is imperative.

Procedure Duration

The length of time needed for breast augmentation or reduction will depend on various factors such as the complexity of the surgery, the techniques involved, and the patient's specific needs. Generally, breast augmentation can take anywhere from one to three hours to complete. Patients typically spend an additional few hours in the hospital for monitoring before being discharged. Breast reduction surgery usually takes longer, averaging between three to five hours, with some cases requiring an overnight hospital stay for optimal monitoring and recovery.

As for the recovery time, it's essential to factor in both the immediate recovery phase and the long-term healing process. For breast augmentation, most patients can expect to return to light activities within a week and fully resume normal activities within six weeks. Breast reduction patients may require a more extended initial recovery period of two to three weeks and may need up to two months before returning to full physical activities. In both cases, multiple follow-up appointments will be necessary to monitor the healing process, remove sutures, and ensure that the breasts are healing as expected.

Medical tourists should plan to stay in the destination country for at least a few weeks to allow for proper recovery and follow-up care, thereby minimizing risks and optimizing results.

• Cost-Effectiveness : Lower labor and operational costs in some countries make the procedures more affordable.
• High-Quality Care : Some international healthcare providers specialize in cosmetic procedures, offering highly skilled surgeons and state-of-the-art technology.
• Minimal Wait Times : Many countries have shorter waiting lists for elective procedures, allowing faster access to medical care.
• Cultural Experience : Combining medical treatment with a stay in a foreign country offers a unique cultural experience.

Potential Destinations

• Thailand : Especially Bangkok, which is known for its top-notch healthcare system and advanced medical technology.
• South Korea : Seoul is globally recognized for its high standards in cosmetic surgery.
• Brazil : São Paulo and Rio de Janeiro offer some of the best cosmetic surgeons in the world.
• India : Cities like Delhi and Mumbai provide cost-effective options without compromising quality.
• Turkey : Renowned for offering good value for high-quality treatments, particularly in cities like Istanbul and Ankara.

Risks & Considerations

• Quality and Standards : Varying healthcare regulations across countries may affect the quality of care.
• Communication Issues : Language barriers can result in misunderstandings between patient and healthcare provider.
• Travel-Related Risks : Long-distance travel post-surgery may increase the risk of complications.
• Legal Recourse : Different countries have varied malpractice laws that might offer limited protection to foreign patients.

How to Choose the Right Doctor and Hospital

• International Accreditations : Look for healthcare facilities that have international healthcare accreditation.
• Check Surgeon Credentials : Ensure the surgeon is qualified and board-certified in their specialty.
• Read Reviews : Patient testimonials and reviews can offer invaluable insights into the quality of care you can expect.
• Personal Consultation : Utilize telemedicine options for initial consultations to assess comfort and trust levels with prospective healthcare providers.

To receive a free quote for this procedure please click on thelink: https://www.medicaltourism.com/get-a-quote

Patients are advised to seek hospitals that are accredited by Global Healthcare and onlywork with medical tourism facilitators who are certified by Global Healthcare Accreditation or who have undergone certification from the Certified Medical Travel Professionals (CMTP). This ensures that the highest standards in the industry are met. GHA accredits the top hospitals in the world. These are the best hospitals in the world for quality and providing the best patient experience. Click the link to check out hospitals accredited by the Global Healthcare Accreditation: https://www.globalhealthcareaccreditation.com

Frequently Asked Questions

What actually happens during hyperstimulation of the ovaries.

The patient will take injectable FSH (follicle stimulating hormone) for eight to eleven days, depending on how long the follicles take to mature. This hormone is produced naturally in a woman’s body causing one egg to develop per cycle. Taking the injectable FSH causes several follicles to develop at once, at approximately the same rate. The development is monitored with vaginal ultrasounds and following the patient’s levels of estradiol and progesterone. FSH brand names include Repronex, Follistim, Menopur, Gonal-F and Bravelle. The patient injects herself daily.

What happens during egg retrieval?

When the follicles have developed enough to be harvested, the patient attends an appointment  where she is anesthetized and prepared for the procedure. Next, the doctor uses an ultrasound probe to guide a needle through the vaginal wall and into the follicle of the ovary. The thin needle draws the follicle fluid, which is then examined by an embryologist to find the eggs. The whole process takes about 20 minutes.

What happens to the eggs?

In the next step, the harvested eggs are then fertilized. If the sperm from the potential father, or in some cases, anonymous donor, has normal functionality, the eggs and sperm are placed together in a dish with a nutrient fluid, then incubated overnight to fertilize normally. If the sperm functionality is suboptimal, an embryologist uses Intracytoplasmic Sperm Injection to inject a single sperm into a single egg with an extremely precise glass needle.  Once fertilization is complete, the embryos are assessed and prepared to be transferred to the patient’s uterus.

How are the embryos transferred back to the uterus?

The doctor and the patient will discuss the number of embryos to be transferred. The number of successfully fertilized eggs usually determines the number of eggs to be placed in the uterus. Embryos are transferred to the uterus with transabdominal ultrasound guidance. This process does not require anesthesia, but it can cause minor cervical or uterine discomfort. Following transfer, the patient is advised to take at least one days bed rest and two or three additional days of rest, then 10 to 12 days later, two pregnancy tests are scheduled to confirm success. Once two positive tests are completed, an obstetrical ultrasound is ordered to show the sac, fetal pole, yolk sac and fetal heart rate.

Embryoscope ©

Built into this technology there is a microscope with a powerful camera that allows the uninterrupted monitoring of the embryo during its first hours of life. In this way, we can keep a close eye on the embryo, from the moment when the oocyte is inseminated and begins to divide into smaller and smaller cells, until it can be transferred to the uterus.

Orthopedics Stem Cell

Research on mesenchymal stem cells regenerative properties in knee osteoarthritis. In these studies, researchers suggest that Stem Cell Therapy has the potential to regenerate lost cartilage, stop and reverse cartilage degeneration, provide pain relief, and improve patient mobility.

Stem Cell Therapy as an Alternative to Rotator Cuff & Shoulder Replacement Surgery. Stem cell therapy may offer an excellent alternative for patients looking to avoid shoulder joint replacement surgery, as well as many other surgical treatments for shoulder pain.

If you suffer from chronic or acute ankle pain or instability due to arthritis, cartilage loss, ligament strain or tear, or tendon damage, then you may benefit from non-surgical stem cell treatments or stem cell-enhanced surgery.

Patients now have a minimally invasive option. Stem cell therapy for back pain and disc herniations can potentially repair the damaged disc or facet joint, restore function, rehydrate the disc, and ultimately alleviate chronic pain.

Anti-Aging Stem Cell

Stem cell therapy and PRP therapy have been shown to be most effective for: Those in the early stages of hair loss, patients who are not viable candidates for surgery and women who prefer to avoid hair surgery.

Facial Anti-Aging

Aesthetic Anti-Aging. The Aesthetic Stem Cell Localized Treatment is a non-surgical minimally invasive procedure to enhance the appearance of aging skin and hair restoration. This all-natural technique combines dermal injections of bone marrow or adipose tissue derived stem cells and growth factors.

Fertility Stem Cell

Endometrial prp.

The stem cells used for treatment of a thin endometrium include mesenchymal stem cells. In addition, successful repair of the endometrium in pregnancy with stem cells has been reported previously.

Low Ovarian Reserve (PRP)

The treatment uses PRP (Platelet-Rich-Plasma), which with stem cell therapy is the novel therapeutic approach for restoring the quality of the ovarian reserve.Your PRP will contain a physiologic balance of platelets, growth factors and white blood cells tailored specifically for you.

Punta Mita Hospital

Punta Mita Hospital - Genesis Cell

Almater Hospital SA de CV

Mexicali, Mexico

Apollo Delhi

New Delhi, India

Baskent University Hospitals

Antalya, Turkey

Doctors Hospital Health System

Nassau, Bahamas

Fortis Healthcare

Haryana, India

Hospital Galenia

Quintana, Mexico

Memorial Health Group

Istanbul, Turkey

Nairi Medical Center

Yerevan, Armenia

Near East University Hospital

North Cyprus, Turkey

Schneider Regional Medical Center

St. Thomas, United States

MEDICOVER Hospital Poland

Warszawa, Poland

Sinaiclinic Hospital

Sharm El Sheikh, Egypt

Seoul, Korea

MedTourClub Ukraine

130/40, Momota str., Boryspil, Kyiv reg., 08300

MedicalTourism.com

MedicalTourism.com is a free, confidential, independent resource for patients and industry providers. Our mission is to provide a central portal where patients, medical tourism providers, hospitals, clinics, employers, and insurance companies can all find the information they need. Our site focuses on patients looking for specific knowledge in the fields of medical tourism, dental tourism, and health tourism.

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The Ultimate Guide to Breast Reduction

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. Table of content

Introduction.

Last fact-checked: 6 September 2020

Many women (and men) are choosing to have their surgery for breast reduction abroad not only to save on costs but also because it allows them the time to relax on holiday before having to get back into their normal routines at home.

Medical Departures has partnered with the best clinics in dozens of countries around the world that deliver a wide range of cosmetic procedures, including those offering breast reduction and augmentations  for thousands less than back home.

If you are unhappy because your breasts are disproportionately too large for your body—or they are a source of physical discomfort, then you may certainly be a candidate for breast reduction .

If you are self-conscious about the size, if one breast is much larger than the other or if your nipples and areolas (the dark skin surrounding the nipples) point downward you may also want to consider a breast reduction.

What Should Do Before and After Breast Reduction Surgery in Preparation?

Before your breast reduction surgery, you may:

• Have a mammogram (if you’re over 40), a chest x-ray or an ECG.
• Achieve weight goals and lifestyle changes to minimize complications
• Stop smoking at least six weeks before surgery to promote healing

After breast reduction surgery, you should:

• Arrange for someone to pick you up and to stay with you on the first night after your operation
• Eat healthily to encourage healing
• Take it easy for at least a week and wear loose-fitting clothes that you don’t need to lift your arms over your head to get into.

How Long Does a Breast Reduction Procedure Take?

The time taken to complete the procedure depends on how much breast tissue needs removing. There may also be two surgeons working on each breast, which may speed up the process. Typically, the surgery takes 90 minutes to three hours.

What's About the Recovery Time After Breast Reduction Surgery?

Your surgeon will give you detailed instructions on what to do during the recovery process, and what to expect with regard to symptoms and potential signs to look out for. It is important to remember that as we are all individuals, the time it takes to recover varies, so you will want to take your own recovery at its own pace.

Immediately after surgery you will be bandaged and may wear wound drains. These will usually be removed within a week. You will also feel stiff, sore and tender and probably not want to move very much for the first few days, but this will gradually ease as time goes by.

Stitches will be removed around 10 days after your procedure and your swelling and bruising should be subsiding at that time. Movement should be improved although it will take several more weeks before your mobility returns to normal and before you can do anything strenuous such as heavy lifting.

It could be up to six months before you are completely healed, inside and out.

Why Should I Book with Medical Departures?

Medical Departures has over a decade of experience working with the best clinics and hospitals in dozens of locations around the world. We only partner with reliable clinics so you are assured of receiving quality care and impressive results.  

While no medical procedure can ever be guaranteed, you can mitigate any problems by booking with a reliable facility that you can trust. This is why Medical Departures makes it our business to work with the best, carrying out our own pre-screening checks before we partner with any medical facilities. 

Our checks include:

• Searching criminal/legal records
• Collating and publishing real patient reviews
• Verifying doctor and surgeon qualifications
• Confirming professional memberships

How Much Can I Save on Breast Reduction Surgery Overseas?

In popular, reliable medical travel destinations such as Mexico, Costa Rica or Thailand, patients discover cost savings of 50-80%. This is compared to the United States where a breast reduction costs around $12,500. 

Check out the prices below in some of the world's top medical tourism destinations and click through to see our list of partner clinics: 

• In Mexico, prices for breast reductions are around $3,900
• In Thailand, breast reduction costs around $3,800
• In the Philippines, breast reduction costs on average $3,700

Getting Started with Medical Departures

Browse our clinics above or head straight to our global listings page to see all of our clinics and hospitals that offer breast reduction surgery. 

Book directly with us online or connect with our Customer Care Team  to lock in the best prices online and enjoy 24-hour assistance before, during and after your trip. 

Breast Reduction Surgery. WebMD. 3 February 2019. https://www.webmd.com/beauty/cosmetic-procedures-breast-reduction-surgery

Craven, Cameron MD, The five factors of breast augmentation. The American Society of Plastic Surgeons. 29 July 2016.  https://www.plasticsurgery.org/news/blog/the-five-factors-of-breast-augmentation

International Society of Aesthetic Plastic Surgery. Website accessed: 19 March 2020.  https://www.isaps.org/

Smokers who quit one month before surgery reap benefits: UN health agency. UN News. 20 January 2020.  https://news.un.org/en/story/2020/01/1055591

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Medical Tourism

Breast reduction surgery: tailoring techniques for individual needs.

Breast reduction surgery, also known as reduction mammaplasty, is a medical procedure that has gained popularity not only for its aesthetic benefits but also for its potential to alleviate various physical and emotional concerns. This comprehensive article explores breast reduction surgery, its tailored techniques, and how it addresses the individual needs of patients. It provides insights into the surgery's benefits, considerations, and recovery, making it a valuable resource for industry professionals and anyone interested in understanding this transformative procedure.

Understanding Breast Reduction Surgery

The importance of breast health.

Breast health is a vital aspect of overall well-being, and disproportionately large breasts can lead to a range of physical discomforts and emotional challenges. It's essential to recognize when breast size becomes a concern and affects a person's quality of life.

What Is Breast Reduction Surgery?

Breast reduction surgery is a medical procedure aimed at reducing the size of the breasts while reshaping and lifting them. This surgery is performed to achieve a more proportionate and comfortable breast size.

Candidates for Breast Reduction

Not everyone is a suitable candidate for breast reduction surgery. This section discusses the criteria that determine whether a person is a good candidate and highlights the importance of a thorough consultation with a qualified surgeon.

Tailoring Techniques for Individual Needs

Personalized surgical plans.

One of the key aspects of breast reduction surgery is its individualized approach. Surgeons tailor the procedure to each patient's unique needs, taking into account factors such as breast size, shape, and the patient's goals.

Surgical Techniques

There are different surgical techniques for breast reduction, each with its advantages and considerations. This section provides an overview of the commonly used techniques, including the vertical incision, anchor incision, and liposuction-assisted methods.

Achieving Symmetry and Aesthetics

Breast reduction surgery is not just about reducing size but also about achieving symmetrical and aesthetically pleasing results. Surgeons carefully plan incisions and tissue removal to create balanced and attractive breasts.

Benefits of Breast Reduction Surgery

Physical relief.

Many individuals with large breasts experience physical discomfort, including back and neck pain, shoulder grooving, and skin irritation. Breast reduction surgery can provide significant relief from these symptoms.

Improved Posture

The weight of large breasts can lead to poor posture. After surgery, patients often find it easier to maintain proper posture and experience relief from associated musculoskeletal issues.

Enhanced Self-Confidence

Breast size can have a profound impact on self-esteem and body image. Breast reduction surgery can boost self-confidence and improve overall mental well-being.

Considerations and Risks

Preoperative evaluation.

A thorough preoperative evaluation is essential to assess a patient's overall health and determine their suitability for surgery. This includes discussions about expectations, potential risks, and recovery.

Risks and Complications

Like any surgical procedure, breast reduction surgery carries certain risks and possible complications. It's crucial for patients to be informed about these and discuss them with their surgeon.

Recovery and Aftercare

Recovery from breast reduction surgery is a crucial phase. Patients need to understand what to expect during this period and follow postoperative instructions diligently to achieve the best results.

Breast reduction surgery is a transformative procedure that goes beyond aesthetics. It addresses the physical discomfort and emotional challenges associated with disproportionately large breasts. Surgeons tailor their techniques to meet the individual needs of each patient, ensuring both physical relief and enhanced self-confidence.

To receive a free quote for this procedure please click on the link: https://www.medicaltourism.com/get-a-quote .

For those seeking medical care abroad, we highly recommend hospitals and clinics who have been accredited by Global Healthcare Accreditation (GHA). With a strong emphasis on exceptional patient experience, GHA accredited facilities are attuned to your cultural, linguistic, and individual needs, ensuring you feel understood and cared for. They adhere to the highest standards, putting patient safety and satisfaction at the forefront. Explore the world's top GHA-accredited facilities here . Trust us, your health journey deserves the best.

Exploring the Surge of Cosmetic Tourism: Trends and Considerations in Aesthetic Procedures Abroad

Holistic healing: exploring integrative medicine and wellness retreats, meeting the surge: the growing demand for knee replacement surgeries and advances in the field, innovations in medical technology: how cutting-edge technology drives medical tourism, stem cells have powerful anti-aging properties, breakthrough stem cell treatment for autism, new shift for thailand’s medical travel landscape as mta launches new moves, continue reading, best countries for stomach cancer treatment: a global perspective, ponderas academic hospital: elevating medical tourism with jci accreditation and personalized care, brno and south moravia - a hidden treasure of central europe, featured reading, dominican republic’s giant strides to becoming a global leader in medical tourism, exploring niche markets in medical tourism, medical tourism magazine.

The Medical Tourism Magazine (MTM), known as the “voice” of the medical tourism industry, provides members and key industry experts with the opportunity to share important developments, initiatives, themes, topics and trends that make the medical tourism industry the booming market it is today.

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Medical Tourism in Aesthetic Breast Surgery: A Systematic Review

Susan mccrossan.

1 Pinderfields General Hospital, Wakefield, West Yorkshire England

Serena Martin

2 Ulster Hospital, Dundonald, Northern Ireland

Christopher Hill

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.

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.

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 .

Medical tourism is defined as a patient seeking medical treatment out with their local practitioner. Medical tourism can be classified within the plastic surgery field as “macrotourism”, where patients go abroad for plastic surgery, “microtourism”, which involves going to a distant surgeon for plastic surgery or “speciality tourism”, which involves going to a surgeon from a different specialty for a cosmetic surgery procedure. All of these definitions include the need for follow-up or fixation of complications by the local plastic surgery team. Although some patients may seek surgery elsewhere by a surgeon with a particular area of expertise, more commonly, patients travel for cosmetic procedures to seek out lower cost surgery [ 1 , 3 ].

Cosmetic tourism is increasing in popularity for numerous reasons including: lower perceived cost, confidentiality, availability of procedures in a timely fashion, including multiple procedures for a lower price, personal recommendations and social media influencers and advertisements [ 2 , 3 ]. Within the UK, there are strict guidelines for access to breast surgery within the National Health Service, with funding decisions made by local clinical commissioning groups [ 4 ]. Aesthetic breast procedures are not funded on the NHS.

To date, the literature has indicated higher complication rates amongst patients undergoing cosmetic procedures abroad. The majority of publications are retrospective in nature with low numbers of patients. Due to the nature of these reports, there is no comparison group to determine the equivalent surgical outcomes and complications in the native country for the same procedures. The home healthcare systems are left to deal with the resultant complications, which are usually costly. Thacoor et al have reported an average treatment cost of over $16,000 per patient following cosmetic tourism complications. They also conclude this is likely an underestimate as cosmetic tourists’ complications are under reported [ 5 ].

We have performed a systematic review to amalgamate the published data on cosmetic tourism, particularly, aesthetic breast surgery, to ascertain the specific risks involved and the outcomes on a global basis. Complications are graded I–V according to the Clavien–Dindo classification of surgical complications.

A systematic review of PubMed, Google Scholar, EMBASE, the Cochrane library and OVID Medline was conducted, using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines, in November 2020. The question we aimed to answer was “What are the outcomes for patients who seek aesthetic breast surgery abroad?”. Keywords used for the search included “ medical tourism”, “cosmetic tourism”, “surgery”, “surgical”, “tourism”, “tourist”, “travel”, “abroad”, “global”, “breast”, “outcomes”, “complications”, “postoperative” and “postsurgical”.

Two separate authors (SMc and SM) screened titles and abstracts independently using the “Covidence” application for systematic reviews. Duplicates were removed from the search process.

Inclusion criteria included: those studies relating to aesthetic breast surgery performed abroad. All study types encompassing case reports, case series, retrospective and prospective studies were included. Studies reporting on aesthetic breast surgery involving any type of breast implant, silicone injections, fat grafting, reduction, augmentation, mastopexy to either unilateral or bilateral breasts with or without any additional procedures, performed abroad were included.

Data extracted included home country, country where surgery was undertaken, demographics of patient, type of surgery undertaken, post-operative outcome, return trips to theatre, complications, and management plan in local institution.

Exclusion criteria included: conference abstracts, patients <18 years of age, cosmetic surgery other than aesthetic breast surgery. Papers were also excluded if there was insufficient information provided to give adequate outcomes specifically related to aesthetic breast surgery.

Once independently selected, the corresponding full texts were reviewed and those papers which contained salient information relating to risk factors and outcomes in aesthetic breast surgery performed abroad were analysed. Using the ‘COVIDENCE’ application for systematic reviews allowed for any disagreements to be resolved between the two authors with senior author making the final decision (see Fig. ​ Fig.1) 1) .

Flowchart showing methodology as per PRISMA guidelines

Seven hundred and seventy-one article titles were identified, 30 duplicates were removed, 86 titles were included, and their abstracts were screened. Thirty-five full texts met criteria and were reviewed by two authors. Nine full texts were subsequently excluded (see above flow chart for reasons), and 24 papers were deemed appropriate for inclusion and data extraction.

One hundred and seventy-one patients underwent aesthetic breast surgery abroad which included 167 females, 1 male and 3 male-to-female transgender patients. The average age (those whose age was recorded explicitly) was 38.7 years old (range 24–66 years).

The most common countries where aesthetic breast complications were specifically recorded following the primary procedures included: the Dominican Republic ( n =14), Thailand ( n =10) and Mexico ( n =6). However, Eastern Europe, India, other South American and Middle Eastern countries also had documented cases of aesthetic breast surgery tourism with complications within the texts.

The most frequent aesthetic breast procedure performed was breast augmentation in 83 patients (49%). There were 61 cases of bilateral breast augmentation alone, 7 cases of bilateral breast augmentation in conjunction with other multiple procedures (including abdominoplasty, liposuction, labiaplasty, etc.), 8 cases of augmentation mastopexy, 5 cases of augmentation mastopexy in conjunction with multiple other body site cosmetic procedures, one case of implant exchange and one case of bilateral breast augmentation utilising both implants and silicone injections. Out of the 103 patients that had specific procedures documented, 18 patients (17%) had multiple procedures, with at least one other cosmetic procedure being performed at the same time as their breast procedure (see Table ​ Table1) 1) .

Number of patients per procedure described

BBA bilateral breast augmentation, BBR bilateral breast reduction, “Breast surgery”—paper did not describe specifically what initial aesthetic breast procedure was performed

Bilateral breast reduction was performed in 11 cases, two of which had other body site cosmetic procedures at the same time. Four mastopexies in conjunction with other body site procedures were performed; there were no cases of mastopexy as a single procedure. Other procedures recorded included: one oncoplastic scar contracture revision and fat grafting, one case of fat grafting as a single procedure, one case of gynaecomastia excision, two cases of silicone breast injections.

Sixty-eight cases were documented only as aesthetic “breast surgery” without specific procedures being listed; however, the authors felt sufficient information was available in these articles to include their complications and information in the analysis.

Overall, there were 222 complications recorded in relation to aesthetic breast surgery. The most common complications included: wound infection in 39% ( n =67), breast abscess/collection in 12% ( n =21), wound dehiscence in 12% ( n = 20) and implant rupture in 8% ( n =13) of patients (see Table ​ Table2) 2) .

Infection was the commonest occurring complication, unusual but serious bacterial and fungal species were also recorded. There were 23 cases of Mycobacterium abscesses recorded (13%), including: one case each of Mycobacterium chelonae , Mycobacterium fortuitum and Saksenaea erythrospora infections.

Complications were classified using the Clavien–Dindo classification of surgical complications. This was chosen as a method of standardising complications across the included studies for more accurate comparison. (Table ​ (Table3 3 )

Types of complications found in aesthetic breast surgery tourism patients

NAC nipple–areolar complex

Grade V: one patient died due to hypoxic brain injury immediately post-operatively, grade IVa and IVb; two patients required ICU admission with either single or multiple organ failure secondary to sepsis from wound infections.

Grade IIIb: complications that required a return to theatre under general anaesthetic occurred 106 times in 88 patients (51%), with 15 patients requiring multiple general anaesthetics amongst that group (9% of overall patients, 17% of return to theatre group) [ 6 ], (see Table ​ Table3 3 and Graph 1).

Three patients required emergency mastectomies, three patients had split-thickness skin graft reconstruction, and one patient needed bilateral latissimus dorsi and implant-based delayed reconstruction post-débridement. In total, 39% ( n =32) of implant-based augmentation procedures ( n =83) required either a unilateral or bilateral explantation procedure on return to their local provider (Table ​ (Table4 4 ).

Results table of all papers reviewed

Clavien–Dindo classification of aesthetic breast surgery tourist complications

Two patients suffered from a deep vein thrombosis (DVT) and one from a pulmonary embolism (PE) requiring anticoagulation (see Fig. ​ Fig.2) 2) .

Operative procedures recorded by local surgeons to treat aesthetic breast surgery tourist complications (not including 24 “re-operations” that did not specifically explain the operative procedure) (SSG=split-thickness skin graft)

With the increasing popularity of cosmetic tourism for aesthetic breast surgery, it is surprising that governments that fund healthcare systems within their country have not developed a database to record all cosmetic tourism complications given the significant financial cost it incurs. Our systematic review amalgamates the published evidence to date, describing the risks and outcomes of aesthetic breast surgery abroad in 171 patients. The majority of these patients suffered life altering consequences, and in some cases, unfortunately, patients required lifesaving treatment for these complications, with one death reported.

The difficulty with interpreting outcome data for cosmetic tourism involves the lack of a comparison cohort of patients undergoing surgery at home. All papers published to date are retrospective case series. In addition, it is impossible to determine the “denominator”, i.e. the true number of patients that travel abroad for cosmetic surgery. The patients that come to the attention of clinicians are unfortunately only those that suffer complications necessitating treatment at home; therefore, the true complication rate is difficult to determine. Despite this, complication rates for aesthetic breast surgery are well published in the literature and despite minor inter-surgeon differences, the overall complication rates of aesthetic surgery remain low.

Despite the limitations discussed, this systematic review has found that patients suffer from higher rates of infective complications and wound dehiscence, as well as skin, nipple and/or fat necrosis, when undergoing aesthetic breast surgery abroad.

These procedures are commonly undertaken in countries with less regulated healthcare systems, which lure patients with the promise of lower costs and special rates for multiple procedures, further increasing the associated risks. Complications were reported from several countries across the globe within this systematic review, including: the Dominican Republic, Thailand and Mexico. Additionally, India and countries in the Middle East, South America and Eastern Europe were also included.

These countries are less likely to have a rigorously regulated healthcare systems. Indeed, some of these nations will not have any regulatory body, with some surgeons performing aesthetic breast procedures without any training in plastic surgery. Kantak describes the case of a retained sponge found in a patient who presented with a firm swelling months after a bilateral breast augmentation abroad. This demonstrates the consequences of a lack of standard operating procedures and safety regulations, such as the WHO checklist [ 11 ].

In the UK, patients undergoing breast surgery for a breast malignancy receive prophylactic antibiotics at induction due to higher rates of surgical site infection [ 29 , 30 ]. Aesthetic breast surgery is classified as a clean procedure with wound infection rates expected to be less than <5%. A systematic review by Harwicke et al concluded that aesthetic breast surgery should be classed as “clean–contaminated” due to bacteria harboured in the lactiferous ducts. All patients should be given prophylactic antibiotics at induction to lower the risk of surgical site infection [ 30 , 31 ].

The high rate of infective complications across all types of aesthetic breast surgery performed abroad (39%) in this systematic review suggests a lack of antibiotic prophylaxis or a lack of sterile aseptic surgical techniques, further supported by the high explantation rate (39%) in patients undergoing augmentation procedures due to purulent peri-prosthetic infections.

In addition, travelling to foreign countries exposes patients to a wider variety of pathogenic microorganisms, particularly rarer pathogens which are harder to culture, diagnose and treat. An important example of this was the identification of various Mycobacterium species following aesthetic surgery in the Dominican Republic [ 10 , 12 , 14 , 17 , 21 , 22 , 27 ]. Mycobacterium infection led to abscess formation, skin necrosis and the need for complex debridement and reconstruction in these patients after difficulty with diagnosis. These rarer pathogens are not commonly seen, and delayed culture techniques required for diagnosis are not performed routinely. An awareness of such infections is needed to ensure appropriate cultures are performed to enable targeted treatment of the offending organism [ 32 ].

Wound infection rates reported across the studies in this systematic review were significantly higher than the expected rate of less than 5%, with 39% of patients requiring treatment with antibiotics, 12% developing a breast abscess and at least 13% of the total group of patients culturing rare Mycobacterium infections (26% of all infections) [ 29 , 31 ] It is important to note that infective complications included in this review are only patients that required admission to hospital for intravenous antibiotics. The true wound infection rate is likely to be significantly higher, with patients requiring oral antibiotics for minor wound infections not included in these studies.

Class II complications that required treatment with simple measures such as pharmacological intervention, radiological aspiration or prolonged dressings were found in in over half the patients ( n =87, 51%). More serious complications, as per Clavien-Dindo classification, led to a return to theatre in 88 patients (51%) and multiple returns to theatre in 15 patients (9%), with two patients requiring ICU and one death following a cardiac arrest in the post-operative period.

Thrombotic complications, both DVT and PE, were reported in this review ( n =2 and n =1, respectively) [ 7 , 19 ]. VTE is a well-known complication associated with surgery and in particular, prolonged procedures under general anaesthesia. Prophylaxis in the form of subcutaneous heparin and thromboembolic deterrent stockings (TEDs) are routine practice in many countries for all patients undergoing surgery, and these are also included on the WHO checklist in many operating departments. VTE risk is increased further for patients undergoing multiple procedures which is common amongst cosmetic tourists, availing of package deals with extra savings. Across this systematic review, one-fifth of patients (20%) had multiple procedures documented, with at least one other cosmetic procedure performed at the same time as their breast procedure. In addition, travelling and long-haul flights are an independent risk factor for VTE; thus, these risk factors become cumulative in patients travelling abroad for aesthetic procedures. This complication is potentially life-threatening but also preventable in patients undergoing surgery in a regulated practice with appropriate prophylaxis [ 33 ].

The peri-operative care received by patients travelling abroad is commonly sub-optimal and likely to factor in the high rate of post-operative complications. A range of reasons for this have been reported. Patients commonly pay for procedures in advance before travelling, and in many cases before they have a consultation with the operating surgeon. A language barrier may further compromise the patients care, with patients felling obligated to proceed with surgery on arrival, without valid informed consent. Standard practice in the UK involves a minimum two-week “cooling off” period following the initial consultation and discussion of the potential risks before proceeding with surgery [ 1 , 34 – 36 ].

The follow-up included with these package deals tends to be minimal and when the patient travels home, any complications that develop become a problem for the home healthcare system. The cost of managing these complications ranges from £4000 per patient to $250,000 in one American paper [ 22 , 26 ]. The high price is due to emergency theatre, multiple outpatient visits, dressings, unexpected hospital admissions, long-term antibiotics and for a few patients, the prolonged inpatient treatment or ICU admission [ 20 , 22 , 26 , 37 ].

Within the UK, there is an obligation to treat patients presenting to an NHS hospital with acute complications. The need for revision procedures for cosmetic reasons, however, is not routinely covered, and patients should be directed to either their operating surgeon or a private cosmetic provider. It is important to note that the majority of patients requiring surgery for complications will be left with a sub-optimal cosmetic outcome, and in some patients, significant disfigurement. There are only scant reports in the literature reporting good outcomes following cosmetic tourism. Campbell et al. report a survey-based study of 460 cosmetic tourists who attended their Colombian clinic for a range of cosmetic procedures. They state 98% of patients said they passed the “friends and family test” and had an overall high rate of satisfaction with their surgical outcome [ 38 ].

The longer-term outcomes have not been discussed individually, but implant rupture, capsular contracture, recurrent ptosis, asymmetry and poor cosmesis were all documented within this systematic review. Further costs will be incurred by patients in a quest to correct both these short- and long-term complications which will negate the cost benefit of travelling abroad for the initial surgery.

The management of complications varies between countries, which is evident from this systematic review. Some of the papers included document reconstructive procedures including chest wall reconstruction with bilateral latissimus dorsi flaps and implants to treat the complications of silicone breast injections and implants carried out abroad. These were performed in the USA, where the healthcare system is significantly different to the UK. Trying to reconstruct or revise these cases is further complicated by the lack of access to operative notes. This is particularly relevant for BBR, with no documentation of the vascular pedicle used to preserve the NAC, further exacerbating the risks involved with any revision procedure. The need for explantation in 39% of implant cases as well as the need for emergency mastectomies in 3 patients is concerning. This is compounded with the aforementioned risk to life due to anaesthetic and thrombotic complications.

Aesthetic associations across the world, including the International Society of Aesthetic Plastic Surgery (ISAPS), the British Association of Plastic and Reconstructive Aesthetic Surgery (BAPRAS) and the American Society of Plastic Surgeons (ASPS), have produced information on their websites for people considering travelling abroad for cosmetic surgery. This includes questions to ask providers to ensure they choose a qualified plastic surgeon in a regulated hospital, educating and empowering the public to make informed choices and hopefully reduce the risks of complications and the burden on home healthcare systems. This is currently of particular importance within the constraints of a global pandemic that is pushing the health care we can offer to the limit, and we must therefore lower any potential chance of risk as a matter of necessity [ 39 ].

We highlight the COVID-19 pandemic as a final point as to why the cosmetic tourism industry should be an increasing concern. International travel increases the risk of transmission, and the resultant global travel restrictions in place will make it increasingly difficult for patients to return to the operating surgeon if required. In addition, healthcare systems are under extreme pressure and cosmetic tourists seeking treatment for complications from abroad adds increased pressure to an already stretched system. The knock-on effects of Covid-19, including the increased waiting list times, will potentially increase the demand for cosmetic tourism further in the future.

This systematic review highlights the high complication rates associated with travelling abroad for aesthetic breast surgery, including life-threatening complications. We describe the commonest complications encountered, including wound infection and peri-prosthetic infection requiring explantation in 38% of patients undergoing augmentation procedures. Poor long-term outcomes including implant rupture, capsular contracture, recurrent ptosis, asymmetry and poor cosmesis have been described. All of these will have a negative psychological impact and financial burden for the patients involved.

It is evident from this review that cosmetic tourism is a global phenomenon, with patients continuing to travel for these purposes even amidst a global pandemic. The regulatory bodies must highlight these risks, educate and empower the public to seek out regulated healthcare providers to reduce the associated morbidity and mortality and to reduce the burden on global healthcare systems already stretched beyond capacity.

Declaration

The authors declare that they have no conflicts of interest to disclose

This article does not contain any studies with human participants or animals performed by any of the authors

For this type of study informed consent is not required

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Breast Reduction in Mexico, Mammoplasty

A  breast reduction in Mexico is exactly what it implies; it’s a surgical procedure to reduce the breast size. Also known as reduction mammoplasty, this surgery is used to remove excess skin, tissue, and fat from the breasts.

Women who have really large breasts usually opt for this procedure to achieve a more proportionate breast size. It can also ease the discomfort and physical strain (on your neck and back) that comes with large sized breasts.

Contact Jet Medical Tourism ® today for more information on breast reduction surgery in Mexico.

Why choose breast reduction surgery in Mexico?

Sustainable relief from physical discomfort Unless you have heavy, large breasts, you simply cannot understand the serious strain it causes on your body. A breast reduction surgery not only removes this strain on your neck, back, and shoulders but it can also improve your posture.

Have you ever found yourself wishing for smaller breasts just so you could participate in sports or other strenuous activities without pain? A reduction mammoplasty in Mexico can help you move much more freely and get rid of those painful neck aches forever.

Proportionate breast appearance A breast reduction surgery in Mexico corrects the asymmetry and creates more proportional breast contours. By making your breasts smaller and firmer, this plastic surgery procedure offers similar results as a breast lift.

Imagine being able to wear all those dresses designed specifically for women with perkier breasts! You won’t have to hunt far and wide for clothes that fit your form correctly.

Higher personal confidence Have you ever felt like a subject of unwanted attention due to your large breasts? Even though we are living in the 21st century, the truth is stereotyping still exists.

Women with heavier breasts constantly question their true abilities and talents, (no) thanks to all the creepy attention. A breast reduction surgery in Mexico can help you regain your self-esteem and confidence.

Mexico breast reduction surgery – procedure steps

First of all, our board certified cosmetic surgeons in Mexico will discuss your medical history and goals during your initial consultation.

Contrary to what you may believe, not every big-chested woman is a good candidate for a reduction mammoplasty. The initial consultation will help the surgeon determine whether you’ll be a good candidate for the procedure.

Depending on your specific case and overall health, your breast reduction surgery can take up to 2 hours. The procedure includes the following steps:

Anesthesia Just like any other surgical procedure, your reduction mammoplasty will begin with a general anesthesia. An anesthesiologist will put you under general sedation so you’re completely asleep during the surgery.

Incision placement The surgeon will begin by making an incision using any of the three techniques. First, a scarless incision (where small incisions are made at the armpit or at the crease of the breast). Second, a vertical incision (an incision is made vertical down the breast and around the areola for minimum scarring). Third, an anchor incision (an incision is made vertical down the breast, around the areola, and horizontally beside the crease).

Reduction of tissue and fat Next, any excess tissue, fat, and skin are removed from the lower half of the breasts. If there’s only fat tissue, the plastic surgeon will administer liposuction to make the breasts smaller. This will also lead to minimum breast tissue trauma and scarring, which means there are fewer health complications.

Nipple  re-positioning Then the nipples will be placed higher up on the breasts. In some cases, the plastic surgeon may need to remove the nipple first and then re-place it in the correct place.

Sealing the incisions Finally, the sutures will be placed to close the incisions. This can be done in a variety of ways. Your surgeon will discuss the best suture technique for you beforehand (during the consultation.)

Post-surgical recovery breast reduction in Mexico

Once the breast reduction surgery is complete, the surgeon will wrap your chest in clean, sterile dressings. Your doctor will need to change these dressings after 1-2 days post-surgery. After that, you’ll have to wear a surgical bra for several weeks.

Most women find it easy to return to normal routine activities, including work, within 7 to 10 days. You may return to work after one week of your breast reduction surgery in Mexico. However, you must refrain from engaging in any physically strenuous activities for a few weeks.

Schedule a breast surgery consultation

If you are seeking a breast reduction in Mexico (mammoplasty) or another  plastic surgery procedure , Jet Medical Tourism ® can help you make your dream a reality.

Contact us today for more information on surgery prices or call (855) 506-6188 to schedule a virtual consultation with one of our board-certified plastic surgeons in Mexico .

Related breast surgeries

• Male breast reduction in Mexico
• Breast augmentation in Mexico
• Breast lift in Mexico
• Breast implant revision in Mexico
• Breast implant removal in Mexico
• Breast reconstruction in Mexico

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Breast Reduction

Reduction Mammoplasty | Breast Reduction

Description.

Reduction Mammoplasty or Breast Reduction is a surgical procedure to remove or eliminate the excess skin and fat located in the Breast. The Breast will be resized and reshaped with this procedure. Sometimes the areolas can be reduced in size for better appearance. The surgeon will determine what technique is best for your individual case upon your physical characteristics and desired results. The incisions depend on the technique the surgeon used in your case but most of them are concealed in natural breast contours. However, some of them may be visible on the surface of your breast. Even though incision lines are permanent, they fade and will be barely visible over time.

LENGTH OF SURGERY

The average length of this procedure is from 3 to 5 hours.

TYPE OF ANESTHESIA

General anesthesia is the most commonly used for this procedure, although in some cases it can be performed with a regional nerve block.

• General anesthesia related risks.
• Excess Bleeding.
• Changes in skin sensation.
• Hematoma or Seroma.

We strongly advise you ask your surgeon all the doubts and questions you have about risks and possible complications in detail.

RECOVERY TIME

• Initial recovery time in the destination: 10 days
• Full recovery process: 4 to 6 weeks
• It is important to follow the surgeon’s recommendations and instructions to the letter to ensure a positive recovery and the best results possible.

Why Do It In Cancún ?

Cancun is rapidly becoming one of the most popular medical tourism and medical travel destinations in the world. This is mostly due to the quality in hospitals, surgical centers, dental clinics using modern medical technology. Moreover, Cancun is close from home and offers extraordinary all-inclusive beachfront hotels designed for every budget.

Why Do It With My Medical Vacations?

Our programs were specifically designed to address the international patient. We know what is needed to have a positive experience and to sum it up, we present our 7 most important features.

MY MEDICAL VACATIONS’S BIG 7   (reasons to choose our services)

The Most Experienced Team

From the moment you make first contact, your case will be managed by one of our experienced and qualified MTC´s (Medical Tourism Consultant), who have more than 15 years of combined experience.

We have successfully assisted over 1500 foreign patients to complete their dreams and goals of health and aesthetic ! You will be communicating with reliable professionals who will guide you through

the entire process, always looking for your best interest and safety.

Immediate Response guaranteed

From your first inquiry to all of your subsequent doubts or questions, our highly experienced team of MTC’s (Medical Tourism Consultants) will provide you with the answers you need on an immediate basis.

Accurate / Useful Information Provided

Our MTC team has managed more than 1500 cases of international patients in the area of Cosmetic Surgery alone! Their perspective along with all of our surgeon´s recommendations will make you feel at ease. We promise!

Worry Free Organization Of Your Medical Trip

Our team will assist you with booking and organizing every little detail to ensure the perfect  Medical Vacation.

We remind you that all of our packages include:

• Private airport transfers.
• All ground transfers (Hospital, Hotel, Appointments)
• Personal Bilingual Assistance
• Translation services
• City Guidance
• Medical Appointments

We Choose To Promote Only The Best

Our concept is simple: Only work with the best.

All of the surgeons and specialized physicians MUST meet our criteria to be part of our network.

It is not ONLY about experience, training and credentials; we promote surgeons that KNOW how to treat the international patient with impeccable records and fully bilingual of course.

We have no obligation to promote any specific surgeon whatsoever. We CHOOSE the best.. for you!

Comprehensive Post Op Care Program

All of our packages also include the most complete follow up program available. Our multidiscipline staff includes: Specialized Registered Nurses (You will absolutely love them), certified Patient concierge (They will make everything easier for you) and more.

After being released from the hospital, our team will take over, providing and assisting you every step of the way.

You will never feel alone… if anything you will feel like part of the family!

Long Distance Follow Up

Our service doesn’t stop after our airport farewell! Our medical tourism consultant team will keep close communication, informing your surgeon about your progress and of course answering any doubt or question you may have at this stage and until you are completely recuperated and back to your normal life.

Am I a candidate for Plastic Surgery? US & Canada Toll Free: +1 888-587-9341 mail: [email protected]

Awards and Certifications

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Healing Starts Here

Breast Reduction

What is breast reduction surgery.

Breast reduction surgery, also known as reduction mammoplasty, is a surgical procedure designed to reduce the size and reshape the breasts. It is typically performed for medical reasons, although some individuals may opt for it for cosmetic purposes. The primary goals of breast reduction surgery are to alleviate physical discomfort and improve the overall appearance of the breasts.

Here are some key aspects of breast reduction surgery:

• Medical Reasons: Breast reduction is often recommended for individuals who experience physical discomfort and health issues due to overly large breasts. These issues can include chronic back, neck, and shoulder pain, skin irritation or rashes beneath the breasts, and difficulty engaging in physical activities. Large breasts can also cause posture problems and affect a person’s quality of life.
• Surgical Procedure: During the surgery, the surgeon removes excess breast tissue, fat, and skin. The areola may also be resized and repositioned to match the new breast shape. The remaining breast tissue is reshaped to create a smaller, more proportionate breast.
• Incision Types: The surgeon typically makes incisions in various patterns, such as the anchor (most common), lollipop, or periareolar incision, depending on the amount of tissue to be removed and the desired breast shape. The choice of incision type will be discussed with the surgeon before the procedure.
• Anesthesia: Breast reduction surgery is performed under general anesthesia, which means the patient is asleep and does not feel any pain during the surgery.
• Recovery: After the surgery, patients usually need to wear a surgical bra for support and follow the surgeon’s post-operative care instructions. Recovery time can vary, but most people can return to work and light activities within a couple of weeks, with full recovery taking several weeks to a few months.
• Scarring: Scarring is a common concern with breast reduction surgery. The extent of scarring depends on the type of incision used and individual healing. Over time, scars typically fade, and there are methods to minimize their appearance, such as scar creams or laser treatments.
• Benefits: Breast reduction surgery can offer numerous benefits, including relief from physical discomfort, improved posture, increased self-esteem and self-confidence, and the ability to wear a wider range of clothing styles.
• Risks: As with any surgical procedure, there are risks associated with breast reduction, including infection, scarring, changes in nipple sensation, and the possibility of not achieving the desired breast size or shape.

Before considering breast reduction surgery, it’s essential to consult with a board-certified plastic surgeon. They can assess your individual needs and discuss the potential risks and benefits of the procedure. Additionally, insurance may cover the cost of breast reduction if it is deemed medically necessary.

When is Breast Reduction Surgery a Good Option?

Breast reduction surgery can be a good option for individuals who are experiencing physical discomfort, health issues, or emotional distress due to overly large breasts. Here are some situations in which breast reduction surgery may be a recommended or suitable option:

• Chronic Pain: Women with large breasts may suffer from chronic back, neck, and shoulder pain due to the excessive weight of their breasts. Breast reduction surgery can help alleviate this pain and improve overall comfort.
• Skin Irritation: The skin underneath the breasts may become irritated, leading to rashes, chafing, or even fungal infections. Reducing breast size can reduce the friction and irritation on the skin.
• Posture Problems: Overly large breasts can contribute to poor posture, as individuals may hunch forward to compensate for the weight. This can lead to long-term musculoskeletal issues, and breast reduction can help correct posture.
• Difficulty in Physical Activities: Engaging in physical activities, especially high-impact sports, can be challenging for women with large breasts. Breast reduction can enhance mobility and comfort during exercise.
• Psychological and Emotional Distress: Some individuals with disproportionately large breasts may experience emotional distress and self-esteem issues. Breast reduction surgery can improve body image, self-confidence, and overall well-being.
• Clothing Fit: Finding properly fitting clothing can be challenging for those with large breasts. Reducing breast size can expand clothing options and make shopping for clothes more enjoyable.
• Breast Asymmetry: In some cases, one breast may be significantly larger than the other, causing asymmetry. Breast reduction can help create a more balanced appearance.
• Proportionality: Aesthetic concerns, including a lack of proportionality between the upper and lower body, can also be a valid reason for breast reduction surgery, though this is often considered cosmetic rather than medically necessary.

It’s important to note that breast reduction surgery is a personal choice, and the decision should be made in consultation with a board-certified plastic surgeon. The surgeon will evaluate the individual’s specific circumstances, discuss their goals, and assess their overall health. Additionally, the surgeon will help determine whether the procedure is medically necessary or if it is primarily for cosmetic reasons.

In some cases, health insurance may cover the cost of breast reduction if it is deemed medically necessary. It’s essential to check with the insurance provider and the surgeon’s office to understand the requirements for coverage.

Consultation and Preparation

Consultation and preparation for breast reduction surgery are essential steps to ensure a safe and successful outcome. Here is an overview of what to expect during this process:

• Begin by scheduling a consultation with a board-certified plastic surgeon who specializes in breast reduction. Research and choose a surgeon with a good reputation and experience in this type of surgery.
• During the consultation, discuss your reasons for wanting breast reduction, your goals, and any concerns you may have. Be open and honest with your surgeon about your expectations.
• The surgeon will conduct a thorough physical examination, assess your overall health, and evaluate the size and shape of your breasts. They may take measurements and photographs for reference.
• Provide your complete medical history, including any preexisting medical conditions, allergies, medications, and previous surgeries. Be sure to mention any family history of breast cancer.
• The surgeon will discuss different surgical techniques, incision options, and the expected outcomes. You’ll also talk about breast size reduction goals and any additional procedures, such as liposuction, that may be necessary.
• Use this consultation as an opportunity to ask questions and express any concerns you have about the surgery, including recovery, potential complications, and scarring.
• You’ll be given consent forms to review and sign. The surgeon’s office will provide detailed information about the total cost of the procedure, including surgeon’s fees, anesthesia, facility fees, and any post-operative follow-up appointments.
• Your surgeon will provide specific preoperative instructions, which may include:
• Stopping certain medications or supplements that can increase the risk of bleeding.
• Quitting smoking, as it can interfere with the healing process.
• Avoiding food and drink for a specified time before surgery (typically after midnight the night before).
• Arranging for transportation to and from the surgical facility on the day of the procedure.
• Depending on your age and health status, your surgeon may recommend a preoperative medical evaluation to ensure you are fit for surgery. This may include blood tests, an electrocardiogram (ECG), or other tests.
• Plan for your post-operative recovery, including arranging for someone to assist you at home during the initial days after surgery. Stock up on groceries, over-the-counter pain relief medications, and any prescribed medications.
• Schedule any necessary follow-up appointments with your surgeon for post-operative care and monitoring.
• Consider joining a support group or talking to others who have undergone breast reduction surgery to better prepare yourself mentally for the procedure.

Remember that breast reduction surgery is a significant decision, and you should feel comfortable and confident in your surgeon’s abilities. It’s important to have realistic expectations and understand both the benefits and potential risks associated with the procedure. By following your surgeon’s recommendations and preparing adequately, you can increase the chances of a successful outcome and a smooth recovery.

Surgery Process

The breast reduction surgery process typically involves several steps, from the initial consultation to post-operative recovery. Here’s an overview of what to expect during the breast reduction surgery process:

• As mentioned in the previous response, the process begins with an initial consultation with a board-certified plastic surgeon who specializes in breast reduction. During this consultation, you discuss your goals, concerns, and reasons for wanting the surgery.
• After deciding to proceed with the surgery, you will undergo a preoperative evaluation, which may include blood tests, an electrocardiogram (ECG), and a review of your medical history to ensure you are a suitable candidate for the procedure.
• Your surgeon will work with you to develop a surgical plan that considers the size and shape you desire for your breasts. You’ll also discuss the surgical technique and incision type to be used.
• On the day of the surgery, you will be administered general anesthesia, which means you’ll be unconscious and feel no pain during the procedure.
• The surgeon will make incisions based on the predetermined surgical plan. The most common incision patterns are the anchor (or inverted-T), lollipop, and periareolar incisions. Through these incisions, excess breast tissue, fat, and skin are removed.
• After the removal of tissue, the surgeon will reshape the remaining breast tissue to create a smaller and more aesthetically pleasing breast shape. The areola may also be resized and repositioned as needed.
• Once the reshaping is complete, the surgeon will carefully close the incisions with sutures, typically using layered closure techniques for improved healing and minimized scarring.
• You’ll be dressed in surgical dressings and a supportive bra or bandage to minimize swelling and provide support to the breasts.
• After the surgery, you will be monitored in the recovery room until you wake up from anesthesia.
• You will need to rest and recover in the hospital or surgical facility for a few hours or until you are deemed fit for discharge. It’s essential to have someone available to drive you home.
• Your surgeon will schedule post-operative follow-up appointments to monitor your healing progress and remove any sutures as needed.
• Once you are back at home, follow your surgeon’s post-operative care instructions, which may include taking prescribed medications, wearing a supportive bra, and avoiding strenuous activities.
• Scarring is an inevitable part of the surgery, and the appearance of scars can vary from person to person. Your surgeon may provide instructions on scar care, including the use of scar creams, silicone sheets, or laser treatments to help minimize scarring.
• Your surgeon will continue to monitor your progress and address any concerns during post-operative follow-up appointments over several months to a year.

It’s important to have realistic expectations about the results, as the final outcome may take several months to fully manifest as swelling subsides and the breasts settle into their new shape. Also, remember that individual recovery experiences can vary, so it’s essential to follow your surgeon’s guidance and communicate any concerns during your post-operative appointments.

Risks and Safety

Breast reduction surgery, like any surgical procedure, carries certain risks and considerations. It is essential to be aware of these potential risks and safety measures to make an informed decision about the surgery. Here are some of the risks and safety aspects associated with breast reduction surgery:

• Infection: There is a risk of post-operative infection, although it is relatively low when the surgery is performed in a sterile environment with proper surgical techniques.
• Scarring: Scarring is an inevitable part of breast reduction surgery. The extent and appearance of scars can vary from person to person, and while they tend to fade over time, they may not disappear entirely.
• Changes in Sensation: Some individuals may experience changes in nipple sensation, including numbness or increased sensitivity. These changes may be temporary or permanent.
• Difficulty Breastfeeding: Breast reduction surgery can potentially impact the ability to breastfeed. Discuss this concern with your surgeon before the procedure if it’s important to you.
• Wound Healing Issues: In some cases, there may be issues with wound healing, such as delayed healing, wound separation, or skin necrosis (death of skin tissue). Proper post-operative care can help minimize these risks.
• Asymmetry: While the goal is to create symmetrical breasts, there can be slight variations in breast size and shape. Further surgical procedures may be necessary to address significant asymmetry.
• Anesthesia Risks: General anesthesia carries its own set of risks, including reactions, breathing difficulties, and allergic reactions. However, these risks are generally low, and your anesthesiologist will carefully monitor you during the surgery.
• Blood Clots: There is a slight risk of developing blood clots (deep vein thrombosis) after surgery, which can be a concern, especially for those with a history of blood clotting disorders or long periods of immobility during recovery.

Safety Measures:

• Choosing a Qualified Surgeon: Ensure that your surgeon is board-certified in plastic surgery and has significant experience in performing breast reduction procedures.
• Preoperative Evaluation: A thorough preoperative evaluation, including a discussion of your medical history, is essential to assess your suitability for the surgery.
• Informed Consent: Understand and sign informed consent forms, which acknowledge that you are aware of the potential risks and have discussed them with your surgeon.
• Accredited Surgical Facility: Make sure the surgery is performed in an accredited surgical facility with appropriate safety measures in place.
• Follow Preoperative Instructions: Adhere to your surgeon’s preoperative instructions, which may include discontinuing certain medications and preparing your home for post-operative recovery.
• Postoperative Care: Follow your surgeon’s post-operative care instructions carefully to minimize risks and ensure a smooth recovery.
• Regular Follow-Up Appointments: Attend all post-operative follow-up appointments to monitor your healing progress and address any concerns.
• Healthy Lifestyle: Maintain a healthy lifestyle by following your surgeon’s recommendations, which may include quitting smoking, maintaining a healthy weight, and engaging in regular exercise.

It’s important to have a detailed discussion with your surgeon to understand the specific risks and safety measures related to your unique situation. Your surgeon will guide you through the process and help you make an informed decision about breast reduction surgery. If you have concerns about the risks or the procedure in general, do not hesitate to ask your surgeon for clarification and additional information.

Recovery and Results

Recovery and results are crucial aspects of breast reduction surgery. Understanding what to expect during the recovery process and the anticipated outcomes can help you prepare for the procedure. Here’s an overview of breast reduction surgery recovery and the expected results:

• Immediate Post-Operative Period: After breast reduction surgery, you will wake up in the recovery area, where medical staff will monitor your condition. Once you are alert and stable, you will be discharged to go home or to an overnight facility.
• Pain and Discomfort: You can expect some degree of pain, swelling, and discomfort in the days following the surgery. Your surgeon will prescribe pain medications or recommend over-the-counter pain relief as needed.
• Dressings and Bandages: Your surgeon will apply dressings and a supportive bra or bandage to minimize swelling and provide support to the breasts. You will be instructed on how to care for these dressings.
• Rest and Recovery at Home: Plan to take at least one to two weeks off from work and regular activities to rest and recover. During this time, avoid strenuous physical activities and lifting heavy objects.
• Physical Activity: While light walking is encouraged to promote circulation, it’s important to avoid activities that can strain the chest area. Your surgeon will provide guidance on when you can gradually resume normal activities and exercise.
• Scarring Care: Follow your surgeon’s recommendations for scar care, which may include the use of scar creams, silicone sheets, or laser treatments to minimize scarring.
• Follow-Up Appointments: Attend all scheduled post-operative follow-up appointments with your surgeon. These appointments are essential for monitoring your healing progress and addressing any concerns.
• Results Assessment: The full results of your breast reduction may not be immediately evident due to swelling. It may take several months for the swelling to subside, and the breasts to settle into their final shape and position.

Expected Results:

• Breast Size Reduction: The primary goal of breast reduction surgery is to reduce the size of the breasts and create a more proportionate, balanced, and aesthetically pleasing breast shape.
• Alleviation of Physical Discomfort: Most individuals experience relief from chronic back, neck, and shoulder pain as well as improvements in posture and comfort in everyday activities.
• Improved Body Confidence: Many people report increased self-esteem and self-confidence after breast reduction surgery.
• Better-Fitting Clothing: With smaller, more proportionate breasts, you may find it easier to fit into clothing and bras, enhancing your fashion choices.
• Long-Term Outcomes: The results of breast reduction are generally long-lasting, but they can be influenced by factors such as weight fluctuations, aging, and pregnancy.

It’s important to keep in mind that individual experiences with breast reduction surgery can vary. Some people may experience a quicker recovery, while others may take longer to see their final results. Be patient and follow your surgeon’s guidance to maximize the benefits of the procedure and minimize any potential complications. If you have specific concerns about your recovery or results, don’t hesitate to discuss them with your surgeon during follow-up appointments.

Recovery Period

The recovery period after breast reduction surgery can vary from person to person, but typically, there are general guidelines for what to expect during the healing process. It’s important to follow your surgeon’s specific post-operative instructions, as they may tailor them to your unique situation. Here is a general overview of the breast reduction surgery recovery period:

• You’ll spend the first few hours after surgery in the recovery area, where medical staff will monitor your condition.
• Once you are alert and stable, you may be discharged to go home or to an overnight facility, depending on the surgeon’s recommendations.
• You can expect some degree of pain, swelling, and discomfort in the days following the surgery.
• Your surgeon will prescribe pain medications to manage the pain, and you should take them as directed.
• Your surgeon will apply dressings and a supportive surgical bra or bandage to minimize swelling and provide support to the breasts.
• You will be instructed on how to care for these dressings and when to remove them, which is typically within a few days after the surgery.
• Plan to take at least one to two weeks off from work and regular activities to rest and recover.
• During this time, it’s important to avoid strenuous physical activities, lifting heavy objects, and any activities that could strain the chest area.
• During the early recovery period, you may experience limited arm mobility, especially if your incisions are in the anchor pattern (the most common incision type). This is normal and should improve over time.
• Light walking is encouraged to promote circulation and prevent blood clots, but avoid activities that strain the chest area.
• Your surgeon will provide guidance on when you can gradually resume normal activities and exercise, which is usually around 4-6 weeks post-surgery.
• Follow your surgeon’s recommendations for scar care to minimize scarring. This may include the use of scar creams, silicone sheets, or laser treatments.
• Attend all scheduled post-operative follow-up appointments with your surgeon. These appointments are essential for monitoring your healing progress, removing sutures, and addressing any concerns.
• Swelling and bruising are common in the early stages of recovery, but they should gradually subside over the following weeks.
• The full results of your breast reduction may not be immediately evident due to swelling. It may take several months for the swelling to subside, and the breasts to settle into their final shape and position.

It’s important to be patient during the recovery period and to communicate any concerns or questions with your surgeon. Follow your surgeon’s recommendations closely to ensure a smooth recovery and achieve the best possible results from your breast reduction surgery.

Terminology Patient Should Be Aware of

If you’re considering breast reduction surgery, it’s helpful to be familiar with certain terminology related to the procedure. Understanding these terms can assist you in your discussions with your surgeon and ensure that you have a clear grasp of the process. Here are some key terms and concepts you should be aware of:

• Breast Reduction (Reduction Mammoplasty): The surgical procedure designed to reduce the size and reshape the breasts.
• Breast Asymmetry: A condition where one breast is significantly larger or shaped differently than the other. Breast reduction surgery can help correct asymmetry.
• Inverted-T Incision (Anchor Incision): This is a common incision pattern used in breast reduction surgery. It includes an incision around the areola, a vertical incision from the areola to the breast crease, and a horizontal incision along the breast crease, forming an anchor shape.
• Lollipop Incision: This incision pattern includes an incision around the areola and a vertical incision down the front of the breast, creating a shape resembling a lollipop.
• Periareolar Incision: This incision is made around the edge of the areola, resulting in less visible scarring. It is suitable for patients with smaller reductions.
• Liposuction: Sometimes used in breast reduction, liposuction is a technique that involves removing excess fat from the breasts through small incisions.
• Mammary Gland: The glandular tissue in the breast responsible for milk production. During breast reduction surgery, excess mammary gland tissue is often removed.
• Areola: The darker pigmented area around the nipple.
• Nipple: The raised projection at the center of the areola.
• Anesthesia: Medications administered before surgery to induce sleep (general anesthesia) or numb the surgical area (local anesthesia).
• Informed Consent: A legal document you sign, acknowledging that you have been informed about the risks and benefits of the procedure.
• Postoperative Care: The care and instructions provided by your surgeon for your recovery, which includes activities to avoid, medications to take, and when to return for follow-up appointments.
• Scarring: The marks or lines left on the skin after incisions have healed. Scarring is a normal part of surgery and can vary in appearance.
• Compression Garment: A supportive bra or bandage used after surgery to minimize swelling, provide support, and promote healing.
• Sutures (Stitches): The threads used to close incisions and promote wound healing. Sutures may be dissolvable or require removal during a follow-up appointment.
• Wound Healing: The process by which your body repairs incisions and damaged tissue.
• Hematoma: A collection of blood outside of blood vessels, which can occur after surgery and may require drainage.
• Seroma: A collection of clear fluid within a surgical site, which can occur after surgery and may also require drainage.
• Deep Vein Thrombosis (DVT): A blood clot that forms in a deep vein, which is a potential risk following surgery. Staying mobile and following post-operative guidelines can help reduce this risk.
• Anesthesiologist: The medical professional responsible for administering and monitoring anesthesia during surgery.

Understanding these terms can help you communicate effectively with your surgeon and medical team and ensure that you have a clear understanding of the breast reduction surgery process.

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Breast Reduction

What is Breast Reduction Surgery?

Breast reduction, also known as reduction mammoplasty, is a surgical procedure aimed at reducing the size and weight of large breasts.

This procedure is quite sought after in Antalya, Turkey, a city renowned for its advanced medical facilities and cosmetic surgery services, often facilitated by agencies like Medical Tourism Turkey.

Who is a good candidate for breast reduction surgery?

A good candidate for breast reduction surgery, particularly for those considering the procedure in Antalya, Turkey, under the guidance of agencies like Medical Tourism Turkey, includes individuals who meet certain medical and personal criteria. Here’s an overview of what makes someone a suitable candidate for this surgery:

Physical and Health Criteria

• Excessive Breast Size: Individuals with disproportionately large breasts causing physical discomfort like back pain, neck pain, or skin irritation.
• Shoulder Grooves: Marks or indentations on the shoulders from bra straps due to the weight of the breasts.
• Limited Physical Activity: Those whose breast size interferes with daily activities or exercise.

Psychological and Emotional Factors

• Psychological Discomfort: People experiencing psychological distress, self-consciousness, or emotional discomfort due to the size of their breasts.
• Realistic Expectations: It’s important for candidates to have a realistic understanding of the surgery’s outcomes and limitations.

Medical Considerations

• Overall Health: Good candidates are generally in good health, without underlying conditions that could complicate surgery or recovery.
• Non-Smokers: Smoking can significantly affect the healing process and increase the risk of complications.

Lifestyle and Age

• Mature Breast Development: Breasts should be fully developed before considering reduction surgery.
• Post-Childbearing: Women who have completed childbearing may be advised to pursue surgery as pregnancy and breastfeeding can affect breast size and shape.

Benefits Of Breast Reduction

Breast reduction surgery offers numerous benefits, addressing both physical and psychological concerns for individuals with disproportionately large breasts. Here are some of the key benefits.

Physical Relief

• Alleviates Back, Neck, and Shoulder Pain: Reduction in breast size can significantly relieve the chronic pain in the back, neck, and shoulders often associated with large, heavy breasts.
• Reduces Skin Irritation: It helps eliminate rashes or skin irritation under the breasts, a common issue for those with larger breasts.

Improved Physical Activity

• Enhanced Mobility and Comfort: Smaller, lighter breasts can make it easier and more comfortable to engage in physical activities and exercise.
• Increased Participation in Sports: Many women find that breast reduction facilitates a more active lifestyle, including participation in sports or fitness activities they might have avoided before due to discomfort or self-consciousness.

Psychological and Emotional Benefits

• Boosts Self-Esteem and Confidence: A breast reduction can lead to a significant improvement in self-confidence and body image.
• Positive Mental Health Impact: The alleviation of physical discomfort and enhancement of body image can have a profound positive impact on mental health and overall well-being.

Aesthetic Improvements

• More Proportional Body Contour: Breast reduction can result in a more balanced and proportionate figure.
• Broader Clothing Options: It can make it easier to find well-fitting and flattering clothing, expanding wardrobe options.

Lifestyle Enhancements

• Comfort in Daily Activities: Routine tasks and daily activities can become more comfortable without the extra weight and size of large breasts.
• Improved Posture: Reduced breast weight can lead to improved posture, reducing strain on the spine and potentially alleviating associated discomfort.

Long-Term Health Benefits

• Prevention of Long-Term Spinal Issues: By alleviating the strain on the back and shoulders, breast reduction can help prevent long-term spinal problems and postural issues.
• Easier Mammography and Breast Exams: Smaller breasts can make it easier to perform breast exams and mammograms, which are crucial for breast health.

In summary, breast reduction surgery is not just a cosmetic procedure; it offers substantial physical, psychological, and lifestyle benefits, significantly improving the quality of life for those who undergo it.

Breast Reduction Surgery Procedure

Consultation and Planning

• Initial Evaluation: A consultation with a plastic surgeon is essential to discuss goals, expectations, and any medical considerations. The surgeon will evaluate the breast size, shape, and skin quality.
• Planning the Surgery: The surgeon will outline the surgical plan, which includes the technique to be used and the amount of breast tissue to be removed.

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Best International Destinations for Plastic Surgery [2023]

The plastic surgery industry is booming at an unprecedented rate. Currently, the market size is valued at approx.  66 Billion(USD) . Realizing the potential revenue that can be earned from it, more countries are opening their doors to all sorts of affordable beauty procedures. Governments are investing in building excellent healthcare infrastructure, minimizing costs, and even subsiding to promote their country’s cosmetic tourism sector. So which country should you visit? To help you decide, we have prepared a list of the best medical tourism destinations for plastic surgery.

Table of Contents

The most popular procedures for cosmetic surgery abroad, why choose brazil, popular hospitals in mexico, price of common plastic surgery procedures in brazil, why choose mexico, price of common plastic surgery procedures in mexico, why choose costa rica, popular hospitals in costa rica, price of common plastic surgery procedures in costa rica, why choose panama, popular hospitals in panama, price of common plastic surgery procedures in panama, why choose india, popular hospitals in india, price of common plastic surgery procedures in india, why choose thailand, popular hospitals in thailand, price of common plastic surgery procedures in thailand, why choose south korea, price of common plastic surgery procedures in south korea, why choose turkey, popular hospitals in turkey, price of common plastic surgery procedures in turkey, why choose colombia, popular hospitals in colombia, price of common plastic surgery procedures in colombia, why choose spain, popular hospitals in spain, price of common plastic surgery procedures in spain.

• Cost saving 
• Luxury and personalized care 
• Specialized medical procedures 
• Vacationing at a foreign country 

Paying for Medical Procedures in Other Countries

Things to consider before you get plastic surgery abroad, frequently asked questions.

The popularity of cosmetic surgeries has grown exponentially over the last decade. It used to be the case that only women opted for such procedures. But circumstances have changed. Now, men in increasing numbers are looking for various cosmetic surgeries abroad. In fact,  men account for over 13% of the total cosmetic surgeries  performed worldwide.

For women, the popular surgeries are:

• Breast Augmentation
• Liposuction
• Hair Removal
• Eyelid Surgery
• Breast Lift
• Nose Surgery
• Breast Reduction

For men, the popular surgeries are:

• Gynecomastia
• Ear Surgery
• Face Fat Grafting

Best Medical Tourism Destination for Plastic Surgery

The countries listed below are a few of the most renowned destinations for reconstructive and cosmetic surgeries. We have also included a list of the popular hospital and the cost of common procedures available in the country.

Brazilians obsession with beauty has skyrocketed the popularity of Brazil’s plastic surgery industry. According to the  International Society of Aesthetic Plastic Surgery (ISAPS) , Brazil ranks 2nd in performing most plastic surgeries globally. Though Brazil offers all types of procedures, the most popular ones are Breast Augmentation and Liposuction. It is also home to the Brazilian Buttlift that is famous for its sculpted and natural-looking figure.

Brazil offers some of the best plastic surgeons found globally . You can find numerous board-certified surgeons with 15 to over 20 years of experience, each specializing in specific types of surgeries. Many private hospitals have modern equipment and facilities that adhere to JCI standards. And because of the favorable exchange rate, the cost of medical expenses is very cheap.

• Hospital Sao Rafael – Sao Paulo, Brazil
• Hospital Jayme da Fonte – Recife, Brazil
• Passy Clinic – Rio de Janeiro, Brazil
• Clinica Athena – Curitiba, Brazil
• Leger Clinic – Rio de Janeiro, Brazil
• Breast Augmentation – $3,500
• Liposuction – $3,000
• Face Lift – $5,500
• Breast Reduction – $4,000
• Nose Surgery – $3,00

Mexico is probably the obvious choice for most Americans looking for plastic surgeries. Hospitals are located just outside the southern border, and the prices are lower by at least 30% to 70%.

Although cosmetic surgeries are the most sought-after procedures, it isn’t uncommon to see patients flying across the border for simple dental checkups. Medical expenses in the US are notoriously high, due to which Americans consider Mexico as the go-to choice for all sorts of medical needs.

Certified hospitals dedicated to foreign patients are located close to the US borders, making it easy for Americans and Canadians to fly here in a very short time. Also, Mexico has many JCI accredited hospitals with board-certified surgeons trained in the US or other European countries. Regarding the price, surgeries like Liposuction will cost you around $3,000 in Mexico, in contrast to $5,000 being charged in the US. Complicated procedures like Heart Bypass will cost you over $100,000 in the US vs. around $27,000 in Mexico.

• Hospital CIMA Hermosillo – Sonora, Mexico
• Hospital Angeles – Tijuana, Mexico
• Hospital Star Medica – Chihuahua, Mexico
• Obesity Control Center – Tijuana, Mexico
• Face Lift – $4,250
• Breast Augmentation – $3,800
• Tummy Tuck – $6,500
• Liposuction – $3,00
• Rhinoplasty – $3,200

With an expat-friendly infrastructure and international standard medical system, Costa Rica is amongst the most beautiful biodiverse countries you can visit. The country is quickly gaining traction for its cosmetic treatments, specifically in Breast Augmentation and Liposuction.

Costa Rica may not be the cheapest destination in terms of medical expenses, but its healthcare system is one of the best in all Latin America. Here, you will find some of the best board-certified surgeons and excellent private hospitals for cosmetic procedures.

Costa Rica’s healthcare stands in 7th position in the  global healthcare index , and the quality is on par with the US medical system. Any surgeon operating in the country needs to be certified, which reduces the risk of medical malpractices. Hospitals also need to meet set criteria before they can offer their services. Also, the country is primarily an ecotourism destination, so you can easily combine your medical travel with beautiful eco-friendly vacations.

• Hospital CIMA – San José, Costa Rica
• Hospital Clínica Bíblica – San José, Costa Rica
• Facelift – $4,600
• Rhinoplasty – $3,500
• Breast Augmentation – $2,700
• Tummy Tuck – $3,900
• Male Breast Reduction – $2,00

If you prefer staying in city environments and don’t want any cultural shocks, Panama will be a great option for affordable plastic surgeries. The country is very well modernized, and you will find all the facilities and amenities you’d expect in a city environment.

Doctors in Panama are known to provide very personalized care. They will even give their personal contact and come to visit you in your hotel if needed. This level of personal care is not common in other destinations. Also, the prices for cosmetic surgeries are at least 50% less when compared to the US. For example, you can expect to pay $2,000 for a facelift, which, in the US, will cost you around $10,000.

The top hospitals in Panama usually have affiliations and are recognized by Internationally accredited organizations. The Panamanian government has also placed local accrediting organizations to certify hospitals for their services. If you prefer JCI accredited hospitals, then there are currently two available in the country. Panama is also a very safe country for tourists in terms of both personal safety and tourism.

• San Fernando Hospital – Vía España, Panamá, Panama
• Hospital Punta Pacifica – Panama City, Panama
• Face Lift – $2,000
• Breast Augmentation/Reduction – $3,100
• Liposuction – $2,500
• Buttocks Augmentation – $3,500
• Nose Surgery – $1,500
• Chemical Peel – $450

India was already a major player in the Asian medical tourism market. But with the government’s amendment on medical visa policies, it has become much easier to travel here for medical treatment. Now instead of 60 days, patients can stay up to 180days for medical treatment.

The costs of cosmetic surgeries are one of the cheapest in India. Popular surgeries like Breast Augmentation can go as low as $1,300, and Liposuction can cost you around $800.

Despite the medical costs being so cheap, healthcare quality is comparable to the US healthcare system. Doctors here are highly trained and uses advanced medical procedures to conduct their treatment. Local accrediting organizations are in place to certify surgeons and hospitals, but foreign patients can also choose from the 36 JCI accredited hospitals available in the country. India is also a safe tourism country with a large English-speaking population. And considering the cost of living and medical expenses, it is one of the cheapest countries in Asia.

• Fortis Memorial Research Institute(FMRI) – Delhi, India
• Global Hospital – Mumbai, India
• The Cosmetic Surgery Institute – Mumbai, India
• BLK Super Specialty Hospital – New Delhi, India
• Breast Augmentation – $1,300
• Liposuction – $770
• Thigh Lift – $1,300
• Strip Hair Transplant – 0.7 $ per Graft
• Tummy Tuck – $1,300
• Gynecomastia – $700
• Nose Surgery – $310

Thailand is not just a general tourism country. Its medical tourism industry has been booming rapidly over the past decade, especially in the cosmetic sector. Most plastic surgery institute in Thailand will offer a comprehensive range of procedures starting from simple to complex reshaping services. Gender resignment surgeries are the most notable ones in the country. The most commonly performed surgical procedures are Eyelid Surgery followed by nose surgery and Breast Augmentation.

Many of the best doctors in Thailand are certified by American and European medical boards. There are over 35 JCI accredited hospitals, all of which are private hospitals. Also, living in Thailand is very cheap compared to other tourism destinations. It is also common to find packages that include both sightseeing and medical treatment.

• Bumrungrad Hospital – Bangkok, Thailand
• Bangkok Hospital Pattaya – Bangkok, Thailand
• Yanhee Hospital – Bangkok, Thailand
• Breast augmentation – $2,600
• eyelid correction – $1,100
• Buttock implant – $4,000
• Cheek implant – $1,200
• Nose reshaping – $1,200
• Forehead lift – $1,400
• Hair transplant – $1,000
• Tummy Tuck – $3,000

South Korea

The K-pop culture in South Korea is a big influence on the country’s plastic surgery industry. With both men and women opting for various cosmetic surgeries, South Korea is quickly becoming the global plastic surgery capital. In fact, the country has the highest rate of plastic surgeries done per capita, with  13 cosmetic surgeries done per 1000 people . South Korea isn’t the cheapest destination for beauty and reconstructive procedures. Still, it is amongst the best in terms of offering medical facilities, state-of-the-art equipment, and international medical expertise. 

South Korea’s technological advancement is portrayed in their medical sector. The quality of their equipment and availability easily surpasses many Asian destinations. South Korea is also known to have dedicated facilities for international tourists. Getting bi-lingual staff and comprehensive services shouldn’t be an issue. Hotel accommodations, transportations, and recuperation packages are also widely available. You can possibly spend your post-operative care in a luxurious hotel, and the price will still be lower than in the US.

• Banobagi plastic surgery – Seoul, South Korea
• Sarang Plus Hospital – Seoul, South Korea
• Jk Plastic Surgery – Seoul, South Korea
• Eyelid Surgery – $2,000
• Breast augmentation – $7,000
• Facelift – $6,000
• Nose Surgery – $4,000
• Liposuction – $4,000
• Hair Transplant – $6,000
• Breast Surgeries – $8,000
• Laser Skin Therapy – $4,000

Turkey is considered a hub for affordable medical and cosmetic tourism in Europe. It is mostly sought-after by European and American nationalities. According to a 2019 report, Turkey’s medical tourism sector generated about $1.6billion in revenue.

In Turkey, procedures such as anti-aging treatments are very popular amongst patients over 40 years of age. Cosmetic procedures, in general, are around 50% to over 70% cheaper in most private hospitals. Also, the government has taken various initiatives to improve its medical tourism sector. Many medical facilities will offer packages that include shuttle services, hotel accommodation, and attractive travel packages. Also, you can easily find highly discounted airplane tickets.

The government is very strict in terms of its healthcare standards and who can offer medical services. To be eligible for service, a surgeon needs to undergo many years of extensive training and also need to become a member of the Turkish Society of Plastic, Reconstructive & Aesthetic Surgery. Medical centers are required to maintain strict quality implementation and medical standards set by the government. These strict regulations make Turkey a safer destination for plastic surgeries.

• Hisar Intercontinental Hospital – Istanbul, Turkey
• Derindere Hospital – Istanbul, Turkey
• Lokman Hekim Esnaf Hospital – Fethiye, Mugla, Turkey
• Face Lift – $3,000
• Breast Reduction – $3,200
• Nose Surgery – $2,500
• Mommy Makeover – $9,000

Medical tourism is not new to Colombia. The country has been promoting its cosmetic and other Healthcare services for several years. Being a South American country with solid security and great vacation spots, it continues to attract international patients from all over the world.

Colombia’s cosmetic surgeries are equally popular amongst locals as it is with foreigners. Surgical procedures most common in Colombia are Breast Augmentation, Liposuction, and Eyelid Surgery. For non-surgical procedures, the common ones are Botulinum Toxin, Hyaluronic Acid, and Hair Removal.

The healthcare system relating to plastic surgery is very well established. As of 2019, there are at least 1,100 plastic surgeons in the country. So finding surgeons for cosmetic procedures won’t be an issue. Plus, the prices are far less than the US and Canadian hospitals.

• Centro medico imbanaco – Cali, Colombia
• Hospital universitario de san vicente fundación – Medellín, Colombia
• Liposuction – $2,000
• Buttock Enlargement – $3,100
• Tummy Tuck – $4,200

Spain has a reputation for having one of the most efficient healthcare systems in Europe. Healthcare in Spain is continually improving, and as of 2021, the country is ranked 4th in the global medical tourism index. In Europe, Spain is particularly popular for its plastic surgeries. There are over 1,000 plastic surgeons available in various parts of the country. Prices are also very low from many other UK, European, and American countries. In addition, medical centers offer attractive discounts and packages combining surgery with holiday tours for medical tourists.

Being a mainstream tourism destination, Spain has all the necessary facilities in place to serve foreign tourists. To make tourism more accessible, the government allows US and Canadian citizens to travel to Spain without any visa and stay up to 3 months. Regarding the cost of cosmetic surgeries, you can save around 20% to 50% of the total cost.

• Vithas Xanit International Hospital – Malaga, Spain
• Grupo Hospitalario Quirónsalud – Madrid, Spain
• Centro médico quironsalud teknon – Barcelona, Spain
• Breast Augmentation – $3,600
• Face Lift – $5,400
• Liposuction – $1,800
• Nose Lift – $2,900

Benefits of getting plastic surgery abroad

Getting plastic surgeries through medical tourism can be considered a gateway for people willing to receive affordable and quality treatment that aren’t feasible in their home country. Depending on which country you are from, the benefits you receive will vary. Below, we have mentioned some of the benefits you would receive by choosing plastic surgery abroad. 

Cost saving

Cost-saving is the biggest reason why people travel abroad to get plastic surgeries. Patients can easily save from 20% to 80% of what they would normally pay back home. Also, insurance generally doesn’t cover plastic surgeries, and paying such high cash out-of-pocket isn’t financially viable. So, patients usually opt for foreign treatments. 

Luxury and personalized care

Foreign hospitals usually offer patients to be pampered during their stay at a fraction of the cost. Top medical centers offer hospital rooms that feel more like a hotel suite rather than a typical hospital cabin. By paying slightly extra, you can get one-on-one care with a private nurse, translator, higher staff ratio, and more. 

Specialized medical procedures

Certain countries specialize in specific areas of surgery. For instance, Brazilian surgeons are known for their Butt lifts and precise sculpting skills. Thailand is considered a primary destination for gender reassignment surgeries, and Mexico is known for providing a wide range of plastic surgeries at an affordable cost while complying with international standards. 

Vacationing at a foreign country

Patients take advantage of their stay in a foreign country by traveling to various local tourism destinations. Often patients will schedule a vacation before or after their procedure. Purchasing vacation plans from a tourism company will be ideal if you intend to stay for several days.  Note : although it seems logical to spend the recovery in an island resort, it is important that you do not risk your recovery. So, plan wisely. 

Payment procedures will vary between countries. Some may accept credit cards and bank checks, while others may require you to pay in cash. So before you make your travel plan, talk to the hospital about their payment procedures. Ask them what payment methods they accept and exactly what amount of money you have to pay for your treatment. Also, you may have to stay in the country for a month or longer, depending on your recovery. So consider the cost of travel and accommodation accordingly.

Millions of people are getting cosmetic surgeries done and have seen amazing results, but there are scenarios of medical misconduct in whichever country you visit. You need to make sure you are getting treated by professional surgeons and from a properly accredited hospital. So, before you start planning your vacation, here are some important things you need to consider.

• The surgeon needs to be board-certified. They can ensure that all the risk minimization steps are taken into consideration.
• Are you physically fit for the surgery? Cosmetic surgeries are not for everyone. For example, surgeries like tummy tuck require the patient to be in a healthy condition. If you have too much fat in your body, you cannot get the surgery.
• Know what you need to pay. Consult with the surgeon and talk in detail about the total cost of the procedure.
• Ask the surgeon about his previous work. See the before and after photos of patients that the surgeon has operated on.
• The surgeon needs to speak English fluently.

Can I trust a plastic surgeon abroad?

You can trust a board-certified surgeon. Go to the ISAPS website to find certified surgeons. Practitioners associated with them are put through rigorous training as per international standards.

How to know the cosmetic surgery clinic abroad is of the highest standards?

The clinic you choose needs to have accreditation from a reputed international organization. There are many accrediting bodies, but the ideal one would be Joint Commission International (JCI). JCI is considered a gold standard for accrediting medical centers globally. Clinics accredited by such organizations mean that they are capable of maintaining and serving international-level medical care.

Is cosmetic surgery abroad safe?

As long as the surgeon is board-certified and the hospital has international accreditation, cosmetic surgery abroad is safe. We’d recommend avoiding public hospitals regardless of which country you visit. That’s because public hospitals usually don’t offer the level of care you will receive in a private hospital.

Why go abroad for cosmetic surgery?

Cosmetic surgeries, in general, are very expensive, and insurance companies usually won’t cover these procedures. You will have to pay out-of-the-pocket for it. So by getting these procedures done abroad can save you a lot of money.

There is no right or wrong in deciding which is the best place to go for plastic surgery. All countries mentioned above have great hospitals and medical infrastructure to serve foreign patients. Which country to choose depends entirely on your preference and how you want to spend your medical vacation. In short, if you have taken all the safety precautions, you should have a pleasurable during your stay in the country.

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• Medical Tourism
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• Breast Reduction

Breast Reduction Abroad

Yanhee Hospital

• Private Hospital, 

The plastic surgery center at Yanhee Hospital has 15 full-time cosmetic surgeons, and offers a full range of cosmetic surgery procedures at reasonable prices.

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15 listed plastic surgeons:

Dr. Greechart Pornsinsirisak

Plastic Surgeon

Dr. Pitch Paiboonkasemsutthi

Anadolu Medical Center

Anadolu Medical Center is one of the most modern, comprehensive and respected hospitals in Turkey. Anadolu is affiliated with John Hopkins Hospital.

Listed plastic surgeon:

Prof. Haluk Duman, MD

Reconstructive and Plastic Surgeon

Turkeyana Clinic

• Multi Specialty Clinic, 

Turkeyana is right place for you to be as you are… We use our experience in the field to achieve the excellency for more than a decade while providing the best VIP service to make you feel comfortable.

5 listed plastic surgeons:

Assoc. Prof. Atacan Emre Kocman, MD

Aesthetic and Plastic Surgery Specialist

Prof. Ahmet Kalaycioglu, MD

Aesthetic and Cosmetic Plastic Surgery Specialist

Optimed Hospital

ISO accredited Private Hospital located near Istanbul and has a confined area of 17.000m2 with its heliport and 200 Bed capacity with General Intensive Care, Coronary, Cardiovascular and Newborn Intensive care units.

Dr. Muzaffer Kurt

ADATIP Hospital

Our hospital is a leading medical facility in Turkey, with highly specialized doctors, advanced technology, and 40+ procedures. Our facility has 200 beds, 81 doctors, and 50 ICU units. We prioritize patient well-being with VIP services, including hotel stays, checkups, and transportation. Our focus

Dr. Baykurt Ozbey

Plastic Reconstructive and Aesthetic Surgeon

Liv Duna Medical Center

Established in 2015, Liv Duna Medical Center is Hungary's premier private healthcare facility, offering outpatient, inpatient, and diagnostic services. With dedicated professionals, modern diagnostics, consultations in 45 specialties, advanced surgical infrastructure, obstetrics center, and patient-

Dr. Csaba Kunos

Guven Hospital

Founded in 1974, Ankara Güven Hospital provides health services at modern and international standards with its 1600 experienced staff, 254 beds, 12 operating rooms and an area of 40,000 square meters. Our priority is patient confidence. We strive for excellence.

Listed plastic surgeons:

Prof. Gokhan Adanalı

Dr. Hatice Gozde Muratoglu

Rambam Medical Center

• Public University Hospital, 

The Department of Plastic Surgery belongs to the Surgery Division and is affiliated with the Technion's Ruth & Bruce Rappaport Faculty of Medicine. The department also treats children hospitalized in the Pediatric Surgery Department, in the best possible environment for them.

Dr. Yehuda Ullmann MD, DSc

Director, Department of Plastic Reconstructive Surgery Director, Burn Unit Director, Aesthetic Medicine

Hospital Universitario de San Vicente Fundación

Our main objective in the care of patients is to provide comprehensive care for their problems, with a maximum of quality and efficiency, with the highest scientific, technological and academic concepts.

TWT Health Tourism

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Step into the realm of TWT Health, a sanctuary where your well-being takes center stage, and meet the extraordinary individuals who orchestrate a symphony of exceptional healthcare experiences. We are committed to working exclusively with distinguished doctors.

Dr. Alican Gunenc

Plastic, Reconstructive and Aesthetic Surgery

Dr. Murat Acar

Plastic Surgery, Microsurgery and Hand Surgery

Cosmetic surgery centers abroad (Page 1 of 3)

About breast reduction.

This information is intended for general information only and should not be considered as medical advice on the part of Health-Tourism.com. Any decision on medical treatments, after-care or recovery should be done solely upon proper consultation and advice of a qualified physician.

What is Breast Reduction? Breast reduction surgery is a procedure to remove unwanted skin, fat and tissue in order to reduce breast size. During breast reduction surgery the surgeon cuts around the nipple, from the nipple down to the underside of the breast and across beneath the breast. After the fat and skin are taken away the nipple is often moved upwards. Women with large breasts (macromastia) undertake breast reduction surgery to achieve pain reduction, improved self-image, improved confidence, or an increased ability to take part in physical activity. Men may also undertake a breast reduction to correct gynecomastia (abnormal enlargement of the male breast). Breast reduction is also known as reduction mammoplasty. What surgeon performs Breast Reduction? Your surgeon for a breast reduction procedure will usually be a cosmetic surgeon although general surgeons also perform this type of surgery. How popular is this type of surgery? Breast reduction is a reasonably common procedure and according to the American Society of Plastic Surgeons, approx. 90,000 American women had breast reduction surgery in 2008.

Duration of procedure/surgery : The breast reduction operation will usually last between 2 and 5 hours.

Days admitted : after a breast reduction you will stay overnight in the hospital or clinic where your procedure took place. some breast reduction surgeries require a hospital stay of between 2 and 4 days., anesthesia : a breast reduction procedure is usually carried out under general anesthesia. if your breast reduction surgery is carried out under local anesthesia you will also receive drugs to relax the body., recovery : - after your breast reduction surgery you will need at least one week of rest, away from work. some people need two weeks. - you can resume full physical activity after one month to six weeks. - swelling and bruising will ease after a few days. - you will have follow-up appointments for the removal of stitches and bandages around two weeks after breast reduction surgery., risks : common risks when having breast reduction surgery include: - decreased sensation in the nipple and surrounding area following the surgery. - difficulty with breastfeeding after the procedure. if you have a breast reduction which separates the nipple from the milk duct you will be unable to breast feed. if you are considering starting a family you may wish to schedule a breast reduction for after the pregnancy in order to avoid these problems. - scarring. breast reduction surgery creates scars and these scars are permanent. however, the scars will fade after the first year and most surgeons will place incisions so as to minimize the impact of the scars. - uneven nipple position or difference between the two breast sizes. - unwanted skin between and at the side of the breasts, which may require another surgery for removal. - adverse reaction to the medicine or anesthesia. - bleeding inside the breast (hematoma) which causes swelling. - rarely, loss of the nipple., after care : - your breasts will be protected by supportive dressings, a support bra or elastic bandages. - wear a soft bra after the first week, day and night for many weeks, and loose clothing. - you may have tubes attached to the breasts to drain fluids, which will be removed after three to five days. - take prescribed pain and nausea medications. your doctor may also prescribe antibiotics to cut the risk of infection. - don’t lift heavy objects as this can make scars worse., learn more about breast reduction.

• Breast Reduction on MedlinePlus
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• Breast Reduction on Mayo Clinic
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Medical Tourism in Aesthetic Breast Surgery: A Systematic Review

• Special Topic
• Published: 19 April 2021
• Volume 45 , pages 1895–1909, ( 2021 )

Cite this article

• Susan McCrossan   ORCID: orcid.org/0000-0002-0156-5703 1 ,
• Serena Martin 2 &
• Christopher Hill 2  

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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.

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.

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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Avoid common mistakes on your manuscript.

Medical tourism is defined as a patient seeking medical treatment out with their local practitioner. Medical tourism can be classified within the plastic surgery field as “macrotourism”, where patients go abroad for plastic surgery, “microtourism”, which involves going to a distant surgeon for plastic surgery or “speciality tourism”, which involves going to a surgeon from a different specialty for a cosmetic surgery procedure. All of these definitions include the need for follow-up or fixation of complications by the local plastic surgery team. Although some patients may seek surgery elsewhere by a surgeon with a particular area of expertise, more commonly, patients travel for cosmetic procedures to seek out lower cost surgery [ 1 , 3 ].

Cosmetic tourism is increasing in popularity for numerous reasons including: lower perceived cost, confidentiality, availability of procedures in a timely fashion, including multiple procedures for a lower price, personal recommendations and social media influencers and advertisements [ 2 , 3 ]. Within the UK, there are strict guidelines for access to breast surgery within the National Health Service, with funding decisions made by local clinical commissioning groups [ 4 ]. Aesthetic breast procedures are not funded on the NHS.

To date, the literature has indicated higher complication rates amongst patients undergoing cosmetic procedures abroad. The majority of publications are retrospective in nature with low numbers of patients. Due to the nature of these reports, there is no comparison group to determine the equivalent surgical outcomes and complications in the native country for the same procedures. The home healthcare systems are left to deal with the resultant complications, which are usually costly. Thacoor et al have reported an average treatment cost of over $16,000 per patient following cosmetic tourism complications. They also conclude this is likely an underestimate as cosmetic tourists’ complications are under reported [ 5 ].

We have performed a systematic review to amalgamate the published data on cosmetic tourism, particularly, aesthetic breast surgery, to ascertain the specific risks involved and the outcomes on a global basis. Complications are graded I–V according to the Clavien–Dindo classification of surgical complications.

A systematic review of PubMed, Google Scholar, EMBASE, the Cochrane library and OVID Medline was conducted, using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines, in November 2020. The question we aimed to answer was “What are the outcomes for patients who seek aesthetic breast surgery abroad?”. Keywords used for the search included “ medical tourism”, “cosmetic tourism”, “surgery”, “surgical”, “tourism”, “tourist”, “travel”, “abroad”, “global”, “breast”, “outcomes”, “complications”, “postoperative” and “postsurgical”.

Two separate authors (SMc and SM) screened titles and abstracts independently using the “Covidence” application for systematic reviews. Duplicates were removed from the search process.

Inclusion criteria included: those studies relating to aesthetic breast surgery performed abroad. All study types encompassing case reports, case series, retrospective and prospective studies were included. Studies reporting on aesthetic breast surgery involving any type of breast implant, silicone injections, fat grafting, reduction, augmentation, mastopexy to either unilateral or bilateral breasts with or without any additional procedures, performed abroad were included.

Data extracted included home country, country where surgery was undertaken, demographics of patient, type of surgery undertaken, post-operative outcome, return trips to theatre, complications, and management plan in local institution.

Exclusion criteria included: conference abstracts, patients <18 years of age, cosmetic surgery other than aesthetic breast surgery. Papers were also excluded if there was insufficient information provided to give adequate outcomes specifically related to aesthetic breast surgery.

Once independently selected, the corresponding full texts were reviewed and those papers which contained salient information relating to risk factors and outcomes in aesthetic breast surgery performed abroad were analysed. Using the ‘COVIDENCE’ application for systematic reviews allowed for any disagreements to be resolved between the two authors with senior author making the final decision (see Fig. 1) .

Flowchart showing methodology as per PRISMA guidelines

Seven hundred and seventy-one article titles were identified, 30 duplicates were removed, 86 titles were included, and their abstracts were screened. Thirty-five full texts met criteria and were reviewed by two authors. Nine full texts were subsequently excluded (see above flow chart for reasons), and 24 papers were deemed appropriate for inclusion and data extraction.

One hundred and seventy-one patients underwent aesthetic breast surgery abroad which included 167 females, 1 male and 3 male-to-female transgender patients. The average age (those whose age was recorded explicitly) was 38.7 years old (range 24–66 years).

The most common countries where aesthetic breast complications were specifically recorded following the primary procedures included: the Dominican Republic ( n =14), Thailand ( n =10) and Mexico ( n =6). However, Eastern Europe, India, other South American and Middle Eastern countries also had documented cases of aesthetic breast surgery tourism with complications within the texts.

The most frequent aesthetic breast procedure performed was breast augmentation in 83 patients (49%). There were 61 cases of bilateral breast augmentation alone, 7 cases of bilateral breast augmentation in conjunction with other multiple procedures (including abdominoplasty, liposuction, labiaplasty, etc.), 8 cases of augmentation mastopexy, 5 cases of augmentation mastopexy in conjunction with multiple other body site cosmetic procedures, one case of implant exchange and one case of bilateral breast augmentation utilising both implants and silicone injections. Out of the 103 patients that had specific procedures documented, 18 patients (17%) had multiple procedures, with at least one other cosmetic procedure being performed at the same time as their breast procedure (see Table 1) .

Bilateral breast reduction was performed in 11 cases, two of which had other body site cosmetic procedures at the same time. Four mastopexies in conjunction with other body site procedures were performed; there were no cases of mastopexy as a single procedure. Other procedures recorded included: one oncoplastic scar contracture revision and fat grafting, one case of fat grafting as a single procedure, one case of gynaecomastia excision, two cases of silicone breast injections.

Sixty-eight cases were documented only as aesthetic “breast surgery” without specific procedures being listed; however, the authors felt sufficient information was available in these articles to include their complications and information in the analysis.

Overall, there were 222 complications recorded in relation to aesthetic breast surgery. The most common complications included: wound infection in 39% ( n =67), breast abscess/collection in 12% ( n =21), wound dehiscence in 12% ( n = 20) and implant rupture in 8% ( n =13) of patients (see Table 2) .

Infection was the commonest occurring complication, unusual but serious bacterial and fungal species were also recorded. There were 23 cases of Mycobacterium abscesses recorded (13%), including: one case each of Mycobacterium chelonae , Mycobacterium fortuitum and Saksenaea erythrospora infections.

Complications were classified using the Clavien–Dindo classification of surgical complications. This was chosen as a method of standardising complications across the included studies for more accurate comparison. (Table 3 )

Grade V: one patient died due to hypoxic brain injury immediately post-operatively, grade IVa and IVb; two patients required ICU admission with either single or multiple organ failure secondary to sepsis from wound infections.

Grade IIIb: complications that required a return to theatre under general anaesthetic occurred 106 times in 88 patients (51%), with 15 patients requiring multiple general anaesthetics amongst that group (9% of overall patients, 17% of return to theatre group) [ 6 ], (see Table 3 and Graph 1).

Three patients required emergency mastectomies, three patients had split-thickness skin graft reconstruction, and one patient needed bilateral latissimus dorsi and implant-based delayed reconstruction post-débridement. In total, 39% ( n =32) of implant-based augmentation procedures ( n =83) required either a unilateral or bilateral explantation procedure on return to their local provider (Table 4 ).

Two patients suffered from a deep vein thrombosis (DVT) and one from a pulmonary embolism (PE) requiring anticoagulation (see Fig. 2) .

Operative procedures recorded by local surgeons to treat aesthetic breast surgery tourist complications (not including 24 “re-operations” that did not specifically explain the operative procedure) (SSG=split-thickness skin graft)

With the increasing popularity of cosmetic tourism for aesthetic breast surgery, it is surprising that governments that fund healthcare systems within their country have not developed a database to record all cosmetic tourism complications given the significant financial cost it incurs. Our systematic review amalgamates the published evidence to date, describing the risks and outcomes of aesthetic breast surgery abroad in 171 patients. The majority of these patients suffered life altering consequences, and in some cases, unfortunately, patients required lifesaving treatment for these complications, with one death reported.

The difficulty with interpreting outcome data for cosmetic tourism involves the lack of a comparison cohort of patients undergoing surgery at home. All papers published to date are retrospective case series. In addition, it is impossible to determine the “denominator”, i.e. the true number of patients that travel abroad for cosmetic surgery. The patients that come to the attention of clinicians are unfortunately only those that suffer complications necessitating treatment at home; therefore, the true complication rate is difficult to determine. Despite this, complication rates for aesthetic breast surgery are well published in the literature and despite minor inter-surgeon differences, the overall complication rates of aesthetic surgery remain low.

Despite the limitations discussed, this systematic review has found that patients suffer from higher rates of infective complications and wound dehiscence, as well as skin, nipple and/or fat necrosis, when undergoing aesthetic breast surgery abroad.

These procedures are commonly undertaken in countries with less regulated healthcare systems, which lure patients with the promise of lower costs and special rates for multiple procedures, further increasing the associated risks. Complications were reported from several countries across the globe within this systematic review, including: the Dominican Republic, Thailand and Mexico. Additionally, India and countries in the Middle East, South America and Eastern Europe were also included.

These countries are less likely to have a rigorously regulated healthcare systems. Indeed, some of these nations will not have any regulatory body, with some surgeons performing aesthetic breast procedures without any training in plastic surgery. Kantak describes the case of a retained sponge found in a patient who presented with a firm swelling months after a bilateral breast augmentation abroad. This demonstrates the consequences of a lack of standard operating procedures and safety regulations, such as the WHO checklist [ 11 ].

In the UK, patients undergoing breast surgery for a breast malignancy receive prophylactic antibiotics at induction due to higher rates of surgical site infection [ 29 , 30 ]. Aesthetic breast surgery is classified as a clean procedure with wound infection rates expected to be less than <5%. A systematic review by Harwicke et al concluded that aesthetic breast surgery should be classed as “clean–contaminated” due to bacteria harboured in the lactiferous ducts. All patients should be given prophylactic antibiotics at induction to lower the risk of surgical site infection [ 30 , 31 ].

The high rate of infective complications across all types of aesthetic breast surgery performed abroad (39%) in this systematic review suggests a lack of antibiotic prophylaxis or a lack of sterile aseptic surgical techniques, further supported by the high explantation rate (39%) in patients undergoing augmentation procedures due to purulent peri-prosthetic infections.

In addition, travelling to foreign countries exposes patients to a wider variety of pathogenic microorganisms, particularly rarer pathogens which are harder to culture, diagnose and treat. An important example of this was the identification of various Mycobacterium species following aesthetic surgery in the Dominican Republic [ 10 , 12 , 14 , 17 , 21 , 22 , 27 ]. Mycobacterium infection led to abscess formation, skin necrosis and the need for complex debridement and reconstruction in these patients after difficulty with diagnosis. These rarer pathogens are not commonly seen, and delayed culture techniques required for diagnosis are not performed routinely. An awareness of such infections is needed to ensure appropriate cultures are performed to enable targeted treatment of the offending organism [ 32 ].

Wound infection rates reported across the studies in this systematic review were significantly higher than the expected rate of less than 5%, with 39% of patients requiring treatment with antibiotics, 12% developing a breast abscess and at least 13% of the total group of patients culturing rare Mycobacterium infections (26% of all infections) [ 29 , 31 ] It is important to note that infective complications included in this review are only patients that required admission to hospital for intravenous antibiotics. The true wound infection rate is likely to be significantly higher, with patients requiring oral antibiotics for minor wound infections not included in these studies.

Class II complications that required treatment with simple measures such as pharmacological intervention, radiological aspiration or prolonged dressings were found in in over half the patients ( n =87, 51%). More serious complications, as per Clavien-Dindo classification, led to a return to theatre in 88 patients (51%) and multiple returns to theatre in 15 patients (9%), with two patients requiring ICU and one death following a cardiac arrest in the post-operative period.

Thrombotic complications, both DVT and PE, were reported in this review ( n =2 and n =1, respectively) [ 7 , 19 ]. VTE is a well-known complication associated with surgery and in particular, prolonged procedures under general anaesthesia. Prophylaxis in the form of subcutaneous heparin and thromboembolic deterrent stockings (TEDs) are routine practice in many countries for all patients undergoing surgery, and these are also included on the WHO checklist in many operating departments. VTE risk is increased further for patients undergoing multiple procedures which is common amongst cosmetic tourists, availing of package deals with extra savings. Across this systematic review, one-fifth of patients (20%) had multiple procedures documented, with at least one other cosmetic procedure performed at the same time as their breast procedure. In addition, travelling and long-haul flights are an independent risk factor for VTE; thus, these risk factors become cumulative in patients travelling abroad for aesthetic procedures. This complication is potentially life-threatening but also preventable in patients undergoing surgery in a regulated practice with appropriate prophylaxis [ 33 ].

The peri-operative care received by patients travelling abroad is commonly sub-optimal and likely to factor in the high rate of post-operative complications. A range of reasons for this have been reported. Patients commonly pay for procedures in advance before travelling, and in many cases before they have a consultation with the operating surgeon. A language barrier may further compromise the patients care, with patients felling obligated to proceed with surgery on arrival, without valid informed consent. Standard practice in the UK involves a minimum two-week “cooling off” period following the initial consultation and discussion of the potential risks before proceeding with surgery [ 1 , 34 , 35 , 36 ].

The follow-up included with these package deals tends to be minimal and when the patient travels home, any complications that develop become a problem for the home healthcare system. The cost of managing these complications ranges from £4000 per patient to $250,000 in one American paper [ 22 , 26 ]. The high price is due to emergency theatre, multiple outpatient visits, dressings, unexpected hospital admissions, long-term antibiotics and for a few patients, the prolonged inpatient treatment or ICU admission [ 20 , 22 , 26 , 37 ].

Within the UK, there is an obligation to treat patients presenting to an NHS hospital with acute complications. The need for revision procedures for cosmetic reasons, however, is not routinely covered, and patients should be directed to either their operating surgeon or a private cosmetic provider. It is important to note that the majority of patients requiring surgery for complications will be left with a sub-optimal cosmetic outcome, and in some patients, significant disfigurement. There are only scant reports in the literature reporting good outcomes following cosmetic tourism. Campbell et al. report a survey-based study of 460 cosmetic tourists who attended their Colombian clinic for a range of cosmetic procedures. They state 98% of patients said they passed the “friends and family test” and had an overall high rate of satisfaction with their surgical outcome [ 38 ].

The longer-term outcomes have not been discussed individually, but implant rupture, capsular contracture, recurrent ptosis, asymmetry and poor cosmesis were all documented within this systematic review. Further costs will be incurred by patients in a quest to correct both these short- and long-term complications which will negate the cost benefit of travelling abroad for the initial surgery.

The management of complications varies between countries, which is evident from this systematic review. Some of the papers included document reconstructive procedures including chest wall reconstruction with bilateral latissimus dorsi flaps and implants to treat the complications of silicone breast injections and implants carried out abroad. These were performed in the USA, where the healthcare system is significantly different to the UK. Trying to reconstruct or revise these cases is further complicated by the lack of access to operative notes. This is particularly relevant for BBR, with no documentation of the vascular pedicle used to preserve the NAC, further exacerbating the risks involved with any revision procedure. The need for explantation in 39% of implant cases as well as the need for emergency mastectomies in 3 patients is concerning. This is compounded with the aforementioned risk to life due to anaesthetic and thrombotic complications.

Aesthetic associations across the world, including the International Society of Aesthetic Plastic Surgery (ISAPS), the British Association of Plastic and Reconstructive Aesthetic Surgery (BAPRAS) and the American Society of Plastic Surgeons (ASPS), have produced information on their websites for people considering travelling abroad for cosmetic surgery. This includes questions to ask providers to ensure they choose a qualified plastic surgeon in a regulated hospital, educating and empowering the public to make informed choices and hopefully reduce the risks of complications and the burden on home healthcare systems. This is currently of particular importance within the constraints of a global pandemic that is pushing the health care we can offer to the limit, and we must therefore lower any potential chance of risk as a matter of necessity [ 39 ].

We highlight the COVID-19 pandemic as a final point as to why the cosmetic tourism industry should be an increasing concern. International travel increases the risk of transmission, and the resultant global travel restrictions in place will make it increasingly difficult for patients to return to the operating surgeon if required. In addition, healthcare systems are under extreme pressure and cosmetic tourists seeking treatment for complications from abroad adds increased pressure to an already stretched system. The knock-on effects of Covid-19, including the increased waiting list times, will potentially increase the demand for cosmetic tourism further in the future.

This systematic review highlights the high complication rates associated with travelling abroad for aesthetic breast surgery, including life-threatening complications. We describe the commonest complications encountered, including wound infection and peri-prosthetic infection requiring explantation in 38% of patients undergoing augmentation procedures. Poor long-term outcomes including implant rupture, capsular contracture, recurrent ptosis, asymmetry and poor cosmesis have been described. All of these will have a negative psychological impact and financial burden for the patients involved.

It is evident from this review that cosmetic tourism is a global phenomenon, with patients continuing to travel for these purposes even amidst a global pandemic. The regulatory bodies must highlight these risks, educate and empower the public to seek out regulated healthcare providers to reduce the associated morbidity and mortality and to reduce the burden on global healthcare systems already stretched beyond capacity.

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McCrossan, S., Martin, S. & Hill, C. Medical Tourism in Aesthetic Breast Surgery: A Systematic Review. Aesth Plast Surg 45 , 1895–1909 (2021). https://doi.org/10.1007/s00266-021-02251-1

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Article Contents

Introduction.

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Aesthetic journeys: a review of cosmetic surgery tourism

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Ryan Terrence Pereira, Carmel M Malone, Gerard T Flaherty, Aesthetic journeys: a review of cosmetic surgery tourism, Journal of Travel Medicine , Volume 25, Issue 1, 2018, tay042, https://doi.org/10.1093/jtm/tay042

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Medical tourism has witnessed significant growth in recent years. The emerging trend towards international travel for cosmetic surgical interventions has not previously been reviewed. The current review aims to critically address the scale and impact of cosmetic surgical tourism and to delineate the complication profile of this form of medical tourism.

Articles published in the English language on the PubMed database that were relevant to surgical tourism and the complications of elective surgical procedures abroad were examined. Reference lists of articles identified were further scrutinized. The search terms used included combinations of ‘surgery abroad’, ‘cosmetic surgery abroad’, ‘cosmetic surgery tourism’, ‘cosmetic surgery complications’ and ‘aesthetic tourism’.

This article critically reviews the epidemiology of cosmetic surgical tourism and its associated economic factors. Surgical complications of selected procedures, including perioperative complications, are described. The implications for travel medicine practice are considered and recommendations for further research are proposed.

This narrative literature review focuses on the issues affecting travellers who obtain cosmetic surgical treatment overseas. There is a lack of focus in the travel medicine literature on the non-surgery-related morbidity of this special group of travellers. Original research exploring the motivation and pre-travel preparation, including the psychological counselling, of cosmetic surgical tourists is indicated.

A rise in globalization has provided a platform for medical providers from one country to source themselves to patients in another. 1 Concomitantly, a rise in the movement of healthcare workers for education has resulted in doctors providing care in low-income countries with the same qualification as those in high-income countries. This has sparked the increase in healthcare services, products and consumers globally and given rise to medical tourism. There is no clear definition of medical tourism, however, Neil and colleagues define medical tourists as patients who are mobile through their own volition to seek medical care abroad. 1 , 2 Johnson and colleagues define medical tourism with a greater emphasis on intent as ‘patients leaving their country of residence outside of established cross-border care arrangements made with the intent of accessing medical care, often surgery, abroad’. 2 , 3 The United Nations World Tourism Organization (UNWTO) estimate that there were 900 million international tourist arrivals between January and August 2017 with medical tourism being an increasingly popular reason for international travel. 4 A 2016 report by VISA and Oxford Economics predicts that the medical travel market will reach USD 3 trillion by 2025, with China poised to overtake the USA in healthcare travel spending due to the stronger demand for higher quality of care. 5

Currently, only a few studies have investigated push and pull factors for medical tourists seeking to travel for treatment. Affordability and greater patient savings were the primary motives to seek medical care abroad. 6 Glinos and colleagues added that availability (i.e. procedures unavailable in their home country due to cultural, legal or other reasons), perceived quality of care, familiarity and anonymity (which was important for patients in the Middle East seeking fertility treatment) were the precipitating factors in their cohort of patients. 7 The longer waiting times for procedures (UK and Canada), reduced language barrier, lower international transport cost and inappropriate health insurance coverage have led to patients seeking medical care abroad. 8 Concurrently, fear of the unfamiliar, lack of confidence in the healthcare system abroad, financial cost, discouragement by family physicians and feeling too ill to travel were some of the perceived barriers discouraging patients seeking treatment overseas.

As the majority of surgical tourism occurs in the private sector without formal referral and prior consultation from clinical gatekeepers or public health providers, this gap in the care network has impacted on the management of surgical tourists. 9 , 10 A myriad of factors has led to the growth in popularity of surgical tourism, with aesthetic procedures to the fore. However, there is a paucity of published literature regarding the complications arising from cosmetic surgery performed abroad. A recent review article stratified patient risk profiles against outcomes for cosmetic tourism involving breast augmentation surgery 11 . While there have been a limited number of studies on medical tourism in the travel medicine literature 12 , the focus of these has not been on individuals who travel for the purposes of undergoing cosmetic surgery. The current review aims to critically address the scale and impact of cosmetic surgical tourism and its specific complication profile.

All literature relevant to cosmetic surgery tourism and published through November 2017 was examined. The main focus of the review was surgical tourism and complications surrounding procedures. Articles published in the English language on the PubMed database that focused on surgical tourism and complications of elective surgical procedures abroad were interrogated. The following were excluded from this review: papers that were published in any language other than English, laws and directives, papers focusing on emergency surgical procedures abroad, articles involving paediatric surgical procedures abroad and articles involving non-surgical cosmetic procedures. Reference lists of articles identified were further examined. The initial yield of papers was reviewed based on the set criteria. Articles that were not accessible in full text were excluded. The search terms used were, ‘surgery abroad’, ‘cosmetic surgery abroad’, ‘cosmetic surgery tourism’, ‘cosmetic surgery complications’, ‘aesthetic tourism’.

Epidemiology

According to the global statistics released in 2016 by the International Society of Aesthetic Plastic Surgery (ISAPS), women continue to dominate the cosmetic surgical market with 86.2% or 20 362 655 cosmetic procedures worldwide, with silicone implant breast augmentation surgery being the most requested cosmetic surgical procedure followed by liposuction and eyelid surgery. 13 By comparison, men accounted for 13.8% or 3 264 254 cosmetic procedures worldwide with blepharoplasty being the most requested cosmetic surgical procedure followed by gynecomastia and rhinoplasty. 13 Overall at 15.8%, breast augmentation surgery remains the most popular cosmetic procedure followed by liposuction at 14% and eyelid surgery at 12.9% (Figure 1 ). 13 There was a 45% increase in the number of labiaplasties performed in 2016, with an increase in the number of gluteal lift procedures of 29%. 13

Global profile of cosmetic surgical procedure 13

The American Society of Plastic Surgeons reported a fall in the number of cosmetic surgical procedures performed in the USA of 6% from 2000 to 2016. 14 Concurrently, a rapid expansion of cosmetic surgical procedures occurred, with nearly a quarter of global cosmetic procedures being performed in Brazil, Japan, Italy and Mexico. 14 The decrease in cosmetic procedures conducted in the USA to a rise in procedural malpractice premiums, stagnation of economic growth and surgeons’ reluctance to perform high-risk surgery. 15 The National Health Service (NHS) in the UK, a free at point of use universal healthcare system, are finding it difficult to justify aesthetic procedures. This is due to an increasing ageing population, rise in pharmaceutical costs and demand in medical and surgical interventions which have threatened the availability of continued full service to all patients. Although case by case exceptions are made, this is the main reason cosmetic surgery is primarily undertaken in the private sector.

Economic factors

Relative costs of cosmetic surgical procedures worldwide 18

NR: data not reported.

Miyagi and colleagues undertook a prospective study on a cohort of 19 patients presenting to the NHS plastic surgery department from 2007 to 2009 due to complications from cosmetic surgery performed abroad. 19 The study revealed that the majority of patients sought their treatment in Europe ( n = 8), with breast surgery being the most popular surgical procedure ( n = 14). Complications from surgical procedures resulted in an additional mean cost of £6 360 and rising to £10 874 for patients who accepted treatment. 19 Tran and colleagues described a young patient seeking various cosmetic surgical procedures in Mexico, whose surgical procedures cost less than $5000; however, subsequent complications sustained from surgery resulted in an escalation in her overall cost of care to $77 693.50. 20 Livingston and colleagues reviewed 12 patients returning to an Australian public hospital with complications after receiving various cosmetic surgical procedures in Thailand. The average cost of treating these patients was $AUD12 597, with the overall financial burden on the hospital estimated at AUD$151 172. 21 Klein and colleagues reviewed a group of 109 patients between 2010 and 2014 presenting to a Swiss hospital for treatment of complications arising from cosmetic tourism. 22 The largest subset of these patients sought their treatment in South America ( n = 21), with cosmetic breast surgery being the most common surgical procedure. Conservative management was offered to only 44 patients; however, 24 patients from this study required inpatient care and surgery. The cost required to treat 109 patients amounted to AUD$696 338. 22

Surgical complications

Birch and colleagues observed a number of patients that presented with complications arising from cosmetic surgical procedures abroad that required inpatient care in the traveller’s home country. 23 They further investigated the deficiency in standards of postoperative care associated with cosmetic tourism by conducting a survey of 65 NHS consultants in the Thames region of the UK. A response rate of 53.8%, identified the most common areas operated on were the breast and abdomen and of the patients that presented, more than 80% of respondents reported these patients required emergency treatment. 23 A similar survey of members in the American Society of Plastic Surgeons revealed that 80.4% had reviewed patients following cosmetic procedures abroad. 17 The most common complications were infections followed by wound dehiscence and contour abnormalities. However, this survey failed to stratify data for procedure type and absolute number for rates of complication were not accounted. A survey of members of the British Association of Plastic, Reconstructive and Aesthetic Surgeons, identified 215 patients with complications resulting from cosmetic surgery abroad. 24 The authors found that 53 patients required emergency surgery and a further 56 patients were referred solely due to poor cosmetic outcome. 24

Summary of cosmetic surgical tourism procedures and complications

I&D, incision and drainage; IV, intravenous; NR, data not reported.

Perioperative infections

Non-tuberculous rapidly growing mycobacteria (NT-RGM) are an emerging pathogen group that has become increasingly more common in patients seeking surgical cosmetic procedures abroad. NT-RGM acquired through direct inoculation can affect cutaneous tissue; however pulmonary infections with the pathogen can occur with patients with pre-existing lung disease and disseminated infections have been identified in immunocompromised patients. The three clinically relevant species of NT-RGM associated with cosmetic surgery are Mycobacterium chelonae , Mycobacterium fortiutum and Mycobacterium abscessus. 38

A retrospective analysis that focused on cosmetic surgery-related mycobacterial infections presenting between 2010 and 201 5 35 identified three patients, two of whom had undergone breast augmentation surgery in the Dominican Republic and Mexico and presented with unilateral and bilateral breast abscesses that were positive for M. abscessus . Cusumano and colleagues identified 4 patients returning from elective cosmetic surgery in the Dominican Republic between August 2015 and June 2016, with laboratory-confirmed M. abscessus requiring aggressive surgical intervention and culture-directed antibiotic therapy. 38 Ruegg and colleagues, reported a case study of a 39-year-old patient with multisite infection with NT-RGM of breast implants and gluteal lipofillings, that required a multidrug treatment regime which precipitated a drug-induced hepatitis. 30 Rodriguez and colleagues were the first to report a rare case of mucormycosis infection from aesthetic breast augmentation surgery. 34 The pathogen isolated was Saksenaea erythrospora , causing a rare fungal infection which ultimately led to the patient undergoing a radical mastectomy and wound debridement.

Multivariate analysis of returned travellers hospitalized in Finland identified invasive surgical procedures abroad and travel to tropical rather than temperate zones as independent risk factors for colonization with multidrug-resistant bacteria. 39 Surgical tourists should be made aware of the differences in antimicrobial stewardship between hospitals in developed and developing countries and the risk of colonization which may lead to hospital-acquired infections during travel or to the spread of resistant bacteria to vulnerable individuals in returned tourists. The risks associated with receiving blood transfusions during international travel are well recognized among travel medicine practitioners and should serve as a reminder to intending surgical tourists about the need for careful consideration of the services offered by their host clinical facility abroad.

Implications for travel medicine practice and future research

It is likely that the field of cosmetic surgical tourism will increase in popularity in the future. There is considerable uncertainty with regard to the number of patients seeking cosmetic surgery abroad. This review aimed to identify the impact of patients seeking cosmetic surgery abroad and the complications associated with these procedures. It is difficult to determine the significance of these complication rates without valid comparisons to the equivalent domestic complication statistics. Furthermore, the available data collected are displayed in a non-standardized way, making them difficult to compare. 11 , 40

Websites which provide information regarding medical tourism may minimize the risks of clinical interventions in international jurisdictions 41 ; this was reported previously in relation to stem cell tourism. 42 This type of misinformation is compounded by the lack of reliable data on quality of care and patient flow in destination countries. Increasing travel for invasive aesthetic surgery necessarily leads to patients travelling to disease-endemic regions without the necessary pre-travel health preparation, adding to the risk of morbidity and illness in returning tourists. Prior to undertaking surgery abroad, patients may only be counselled by a company representative and not by a clinical gatekeeper or surgeon. This lack of information and holistic pre-travel evaluation compromises the patient’s capacity to make an informed decision prior to seeking cosmetic surgery overseas. Informed consent can only be truly obtained once the details of the surgical procedure, risk, outcomes and cost have been discussed. The American Society of Plastic Surgeons have included on their website information regarding, risk, follow-up care and aspects of travel prior to engaging in surgery abroad. 15 The Australian Medical Board advise patients to seek consultation with the performing surgeon prior to major operation with a minimum 7-day cooling-off period for all adults before major surgery and, a process that is unlikely to occur in the setting of surgical tourism abroad. 11

Over the last 10 years, multiple studies have identified post-cosmetic surgical tourism complications. 28 , 33 , 34 , 37 , 43 – 48 This rise in the number of cases could be due to the lack of continuity of care and patient follow-up on returning home. In the majority of cases, there was a lack of a medical care plan, accountability and legal protection framework should complications manifest. The medicolegal risks of travel medicine practice have been discussed previously in this journal. 49 Patients intending to undertake surgical cosmetic procedures abroad should be aware of their home country’s guidelines and understand that quality of care, adherence to protocols and provision of perioperative and postoperative care may differ greatly between medical tourism destinations.

Travel health recommendations for cosmetic surgical tourists

Limitations

A limitation encountered by this review is that the studies identified are of low methodological quality within the hierarchy of evidence, data collected in these studies were not uniform and varied in terms of information sources. 52 Certain studies were dependent on the subjective experiences of patients or anecdotal case studies only. The surveys in the study had a poor response rate and not all studies discussed cosmetic surgical outcomes as their principal focus. Although motivations for patients to seek cosmetic surgical procedures abroad are well documented, information regarding demographics and awareness of surgical tourism are few. This review focused on a narrow aspect of medical tourism, cosmetic surgery. Broadly speaking, the issues relating to complications, lack of continuity of care and informed consent may be common across many different medical and surgical specialties. The literature on psychological screening of cosmetic surgical tourists and the mental health sequelae of cosmetic surgery is sparse. This would be a fertile area of research among surgical tourists, whose dissatisfaction with their appearance or body shape may be exacerbated by limited follow-up care when they return to their home country. Alia and colleagues advocate the use of reverse innovation as a mechanism for developing global medical tourism partnerships. Further research may specifically explore this concept in relation to cosmetic surgery tourism. 53

This narrative literature review focused on the issues affecting travellers who obtain cosmetic surgical treatment in other countries. There is a lack of focus in the travel medicine literature on the non-surgery-related morbidity of this special group of travellers. Further original research which examines the motivation and pre-travel preparation of cosmetic surgical tourists is warranted.

Conflict of interest: None declared.

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• surgical complications
• surgical procedures, operative
• plastic surgery procedures
• medical tourism
• travel medicine

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