Traveling for cosmetic procedures may promise lower costs and convenience, but a decade-long CDC review found that serious infections, multistate outbreaks, and infection-control lapses can leave patients facing far more than a cosmetic concern.
Study: Adverse Outcomes of Travel-Related Cosmetic Procedures among US Residents, 2014–2024. Image credit: New Africa/Shutterstock.com
A recent study published in Emerging Infectious Diseases reviewed Centers for Disease Control and Prevention (CDC) consultations with state and local jurisdictions to describe the risks US residents face when traveling outside their state of residence for cosmetic procedures.
Growing cosmetic tourism raises safety concerns
Cosmetic procedures are medical interventions designed to enhance or alter a person’s appearance. Many individuals from the United States travel abroad for these interventions, especially to Mexico, Brazil, Thailand, and Turkey. Reports of adverse outcomes related to medical travel, both domestically and internationally, are common worldwide.
Although the exact number of people traveling for cosmetic procedures is unknown, the practice is expected to increase as more affordable options and destination-based medical services become available. Key motivators for seeking cosmetic procedures abroad include lower costs, shorter wait times, access to culturally similar providers, perceived higher-quality care, specific aesthetic preferences, and the ability to combine treatment with leisure travel.
Despite the increasing prevalence of cosmetic tourism, research examining the risks and outcomes of undergoing cosmetic procedures outside the United States remains limited. This lack of comprehensive evidence highlights a significant gap in the literature and emphasizes the need for new studies to better understand the health and safety implications for those pursuing cosmetic procedures abroad.
CDC records reveal travel-related cosmetic complications
The Division of Healthcare Quality Promotion (DHQP) of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases provides technical support to health departments investigating patient harm associated with breaches in healthcare infection prevention and control (IPC). For this study, a consultation was defined as any verbal or written request from health departments to the CDC for investigative or technical assistance.
DHQP consultation records from January 1, 2014, to December 31, 2024, were systematically reviewed using targeted search terms to identify incidents involving US residents who traveled for cosmetic procedures and subsequently experienced adverse outcomes. Consultations were included if the procedures occurred within or outside the United States and resulted in patient harm. Cases involving nonmedical travel, incidental or noncosmetic medical care, or reconstructive or bariatric procedures were excluded.
Key data extracted included patient counts, procedure location, procedure type, reporting jurisdiction, infection category, pathogen identified, healthcare setting, postsurgical interventions, management of complications, clinical outcomes, and available IPC assessment findings. Two investigators independently reviewed all included consultations and a random 10% of excluded consultations to ensure reliability and consistency in data abstraction.
Most reported complications involved serious infections
Among 2,162 consultations reviewed, 34 involved patients who traveled to receive medical care. Of these, 21 consultations comprising approximately 145 patients met the inclusion criteria for cosmetic procedures.
US residents underwent cosmetic interventions both internationally and domestically, with 17 consultations involving international travel and 4 involving domestic travel. Liposuction and abdominoplasty were the most frequently documented procedures, reported in 12 and 9 consultations, respectively.
A total of 16 consultations described patients undergoing multiple cosmetic procedures. Patient counts per consultation ranged from 1 to 38, with single-patient cases occurring in 12 consultations. A total of 7 consultations, each involving between 2 and 20 patients, described clusters of individuals from multiple states who received procedures from the same provider or at the same location within a defined time frame.
Postsurgical infections were documented in 20 consultations. Of these, 12 consultations involved confirmed nontuberculous mycobacteria (NTM), and 1 involved suspected NTM infection. Notably, suspected cases were defined as acid-fast bacillus cultures that were positive without species-level identification. The healthcare settings most frequently implicated were surgery centers or clinics. Four consultations reported patient fatalities, although not all fatalities were necessarily linked to infection-related complications.
Infection prevention and control (IPC) assessments, available for one domestic and one international consultation, identified deficiencies in environmental cleaning, use of personal protective equipment, hand hygiene practices, and reprocessing of surgical equipment.
Better surveillance could improve outbreak detection
Cosmetic medical tourism exposes patients to significant infection risks, often due to inconsistent infection prevention and control standards across locations. NTMs are a common cause of infections, underscoring the need for stringent practices, especially regarding the use of water and ice. Outbreaks are difficult to detect and investigate due to fragmented reporting and patients crossing jurisdictional boundaries. Regulatory differences and inconsistent oversight further hinder effective prevention and response.
To address these challenges, improved surveillance, communication, and collaboration among healthcare professionals, regulatory agencies, and patients are essential. Patients should carefully consider infection risks before undergoing cosmetic procedures abroad, and clinicians should remain vigilant and promptly report any complications to local or state health authorities. The CDC also encourages reporting of complications associated with medical tourism. Strengthening surveillance, infection prevention efforts, and data collection will be critical to reducing adverse outcomes in this growing field.
Importantly, the findings are based on CDC consultations requested by health departments and do not represent all adverse outcomes associated with cosmetic medical tourism. The authors note that outbreaks are likely underdetected and underreported because reporting standards vary across jurisdictions, and facilities may not consistently track patient outcomes.
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