Passport Not Required: A Comparison of Plastic Surgery Complications From Domestic and International Medical Tourism

Medical tourism, commonly defined as the practice of traveling to another country for medical care, has increased in popularity over the past decade, particularly in aesthetic surgery where high costs lead patients to seek cheaper options abroad. Although patients may save money, inherent risks to medical tourism include truncated postoperative care and limited ability to evaluate providers. When complications arise, patients present to local institutions rather than to their original surgeons. Although literature describes complications from international tourism, less is known about domestic tourism. Although domestic centers may seem safer, medical tourists still face limitations that may affect the quality of their care. We hypothesize that similar limitations are present in both international and domestic medical tourism.

We performed a retrospective review of patients presenting to our institution for treatment from May 2015 to November 2025 with complications after elective aesthetic surgery. Patients were classified as international tourists if the surgery occurred outside the borders of the United States and domestic if travel was ≥200 miles away but within the United States. Data evaluated included demographics, procedure details, duration of stay, time to presentation, complications, and treatment.

Forty-one patients met the inclusion criteria: 22 (56%) had surgeries domestically and 19 (46%) internationally. Miami and the Dominican Republic were the most common destinations. Domestic patients returned home sooner (5.9 vs 13.9 days, P  < 0.05) and presented with complications earlier (18 vs 44 days, P  < 0.05). No significant differences were found in procedures, complication type, or need for surgical treatment. Patients who stayed at their operative location ≤5 days postoperative were more likely to require inpatient admission (88.9% vs 36.4%, P  < 0.05) and IV antibiotics (88.9% vs 27.3%, P  < 0.05), regardless of if they traveled to domestic or international destinations.

Length of postoperative stay after medical tourism is correlated to a greater degree with complications requiring inpatient admission than surgical destination itself. Domestic tourism, often assumed to be safer than international, may carry similar risks, particularly if proper follow-up is lacking.