Complications Associated with Medical Tourism for Facial Rejuvenation: A Systematic Review

Aesthetic Plast Surg. 2020 Jun;44(3):1058-1065. doi: 10.1007/s00266-020-01638-w. Epub 2020 Feb 10.


Background: Medical tourism for cosmetic surgery has become increasingly popular in recent years. The existing literature has identified poor outcomes associated with general cosmetic tourism; however, the complications associated with cosmetic tourism for facial rejuvenation remain poorly understood. The aims of this study are to delineate the risk profile associated with medical tourism for facial rejuvenation.

Methods: A systematic review of PubMed, MEDLINE, and Embase was performed through January 2019 using the PRISMA guidelines. Search terms included combinations of keywords including medical tourism and plastic surgery and other related nomenclature. Articles published in English relevant to medical tourism for facial rejuvenation and its associated complications were examined.

Results: We identified six retrospective studies including 31 patients who had obtained facial rejuvenation procedures abroad and experienced treatment-associated complications. Twenty-five of 26 listed patients (96%) were female (age range 33-62 years). Departure nations included the USA, Switzerland, England, Ireland, Australia, and Thailand. Destination nations included the Dominican Republic, Cyprus, the USA, Colombia, Thailand, India, and China. Procedures included blepharoplasty, facelift, rhinoplasty, chin lift, and injections with botulinum toxin and dermal fillers. Complications included abscess, poor cosmesis, facial nerve palsy, and death.

Conclusions: We present the first study to systematically review the complications associated with medical tourism for facial rejuvenation. No definitive conclusions can be made given the paucity of relevant data, its clinical and statistical heterogeneity, and small sample size. Additional research is warranted to help inform patients who seek facial rejuvenation procedures abroad and to better understand the health system implications associated with cosmetic tourism for facial rejuvenation.

Level of evidence v: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors

Keywords: Complications; Medical tourism; Outcomes; Plastic surgery.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Australia
  • China
  • Cosmetic Techniques* / adverse effects
  • Dominican Republic
  • Female
  • Humans
  • Ireland
  • Middle Aged
  • Patient Satisfaction
  • Rejuvenation
  • Retrospective Studies
  • Skin Aging*
  • Switzerland
  • Tourism
  • Treatment Outcome