Beauty Abroad, Burden at Home: Complications and NHS Impact of Cosmetic Tourism-Insights From the BAAPS National Database.

Abstract

Cosmetic surgery tourism has increased rapidly, with growing numbers of UK patients returning with complications requiring NHS care. Limited regulation and inconsistent perioperative standards contribute to preventable harm. To characterise the nature, severity, and causes of complications from overseas cosmetic surgery and estimate the resulting burden on the NHS. A national retrospective study analysed all 198 cases reported to the British Association of Aesthetic Plastic Surgeons (BAAPS) Cosmetic Tourism Complications Database between September 2022 and September 2024. Demographic, procedural, and clinical data were examined, and complications were graded using the BAAPS five-stage classification. Patients were predominantly female (93%) with a mean age of 39 years; 76% had surgery in Turkey. Abdominoplasty (45%) was the most common procedure, followed by breast and liposuction surgeries. Frequent complications included wound dehiscence (37%), infection (28%), seroma (24%), and tissue necrosis (20%). Nearly half (48%) required operative management under general anaesthesia, 28% minor procedures, and 4% intensive care; one death occurred from pulmonary embolism. Thematic analysis identified inadequate aftercare (21%), poor preoperative optimisation (12%), and premature air travel (5%) as recurrent contributory factors. Estimated NHS treatment costs (£5,883-£9,328 per patient) equated to £1.2-1.8 million over two years. Cosmetic surgery tourism poses a substantial clinical and financial challenge for the NHS. A multi-level harm-reduction strategy-encompassing patient education, complication insurance, international accreditation, and data surveillance-is essential to improve safety and reduce preventable harm.