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Background Cosmetic surgery tourism continues to grow, but the evidence on postoperative complications and healthcare costs remains fragmented. This systematic review synthesized the published literature on complications after cosmetic procedures performed abroad, with focus on clinical outcomes and financial repercussions, comparing European and non-European settings. Methods The review was conducted according to PRISMA guidelines and was pre-registered in PROSPERO, including PubMed, Embase, Scopus and the Cochrane Library. Eligible studies included adults who underwent cosmetic procedures abroad and later required treatment in their home countries. Risk of bias was assessed and for commonly reported binary outcomes a random-effects meta-analysis was performed. Results Fifty-eight studies were included, comprising 1249 patients. Thirty-six articles originated from Europe and 22 from elsewhere. Infection was the most frequently reported complication, followed by wound dehiscence, implant-related complications and systemic complications. Turkey was the most commonly reported destination in European studies, whereas the Dominican Republic dominated in non-European studies. Quantitative synthesis was feasible for infection, wound dehiscence, hospital admission, implant-related complications and systemic complications. Heterogeneity was present across all pooled outcomes and continuous outcome meta-analysis for cost and length of stay was not feasible. Conclusion Complications after cosmetic surgery abroad represent a substantial treatment burden for healthcare systems. The available evidence supports recurring patterns in reported procedures, complications, microbiology and destinations. Quantitative synthesis supported infection as the dominant reported complication, but regional comparisons remain observational and hypothesis-generating rather than epidemiological estimates.
Holm et al. (Wed,) studied this question.