Complications of silicone cosmetic procedures among medical tourists from the Bronx, New York: A retrospective analysis

Hundreds of thousands of Americans travel abroad each year for medical care, such as cosmetic silicone procedures. However, medical tourists risk encountering unqualified providers and receiving injectable or implantable cosmetic materials of questionable purity. We performed a retrospective chart review of patients treated at a multisite academic center in the Bronx, New York, between the years 2008 and 2017, and identified 12 patients who developed complications following silicone procedures performed in a foreign country, Puerto Rico, or the United States by an unlicensed provider. Procedures included silicone injections or implants in the breasts, buttocks, and face. Destination countries included the Dominican Republic, Guatemala, Venezuela, and Mexico. The patients in our study suffered significant morbidity, with complications including infection, implant rupture, and silicone migration. Laboratory and radiographic findings demonstrated nonspecific markers of inflammation. The management of silicone complications can be difficult and prolonged, and can place a large financial burden on the healthcare system as well as have significant and long-term negative consequences for the patient. Clinicians should be aware of the risks for adverse events, such as the ones described here following silicone injection and/or implant procedures, in patients who, whether for financial, cultural, or other reasons, chose to undergo cosmetic procedures in another country or by an unlicensed practictioner in the US. It is important that clinicians recognize the considerable and diverse morbidity of such patients and treat them with sensitivity and empathy to ensure optimal outcomes.