Hundreds of emergency room visits a year for cosmetic surgeries abroad: "They almost killed me"

BarcelonaFlights, a stay in a five-star hotel, and surgery for €2,500. Deals low cost These kinds of posts flood TikTok and Instagram, accompanied by photos of seemingly satisfied patients who have achieved a flat stomach or firm, voluminous buttocks and breasts in private clinics in Turkey, Brazil, and Colombia. Low-cost cosmetic tourism is booming, primarily targeting women between 18 and 40 who want cosmetic surgery but don't want to or can't afford it in Catalonia—where prices are two to six times higher—or who are lured by aggressive marketing campaigns from doctors in what appear to be circus-like settings. But this business often comes at too high a price: the cost to one's health.

Sources from the Catalan Society of Plastic, Reconstructive and Aesthetic Surgery (SCCPRE) estimate that hundreds of people—some say nearly a thousand—end up in the emergency rooms of the Catalan healthcare system each year with health complications stemming from cosmetic surgeries abroad. These complications arise from hospital stays of 24 to 48 hours, for example, due to the removal of a contaminated implant or the treatment of an infection aggravated by a lack of medical follow-up or by air travel. In fact, some patients are brought directly from the airport tarmac, one or two days after the operation, with abdominal bruising and at risk of death if they are not treated immediately. "Bellvitge Hospital is probably the one that receives the most of these patients due to its proximity to El Prat Airport, around one per month," says Jordi Mir, president of the SCCPRE.

It is estimated that 25 million people worldwide travel abroad for surgery, and a third of these are for cosmetic procedures. Mir is emphatic: cosmetic tourism increases between 15% and 25% each year, and Christmas is a peak season. But what most clients don't know, she says, is that undergoing surgery abroad triples the risk of serious complications—some potentially fatal—and up to 50% of women who have surgery require treatment within the healthcare system to save their lives or minimize the aftereffects of a botched operation. The SCCPRE (Spanish Society of Plastic, Reconstructive and Aesthetic Surgery) has also found that patients return from foreign clinics without prophylactic thrombosis medication and that they take flights immediately after their surgeries.

This is the case of Mariami Mezvrishvili. She arrived at the emergency room of Barcelona's Hospital de Sant Pau in February 2024 by ambulance with a very serious abdominal infection. She was 22 years old at the time and had been in Istanbul for less than a week for a lipotransfer to her buttocks—a procedure that involves extracting fat from the abdomen and injecting it into the buttocks—and a breast augmentation and lift. "I hadn't even been in Barcelona 24 hours when they took me straight to the intermediate care unit. That same night I had emergency surgery, they had to intubate me, and I was in a coma for a week. That Turkish clinic almost killed me," she recalls.

"Cuts" in security

According to the results of a survey of cosmetic surgeons in Catalonia, Turkey has become the most popular destination for low-cost cosmetic tourism, but the experience of the 150 professionals practicing in the country indicates that up to 56% of procedures are risky. "In Europe, the accepted risk is 5%, 10% at most," explains Mir. Mariami says that her intention in choosing Turkey was not to cut costs. Months earlier, she had compared several options and found a surgeon who convinced her, so she contacted a consultant at the clinic to learn the details of the procedure. The flights, hotel, and both surgeries came to a total of 6,000 euros, the price of liposuction in Catalonia. Ultimately, the young woman decided to have the surgery there.

Mir warns that cost-cutting should be a red flag, as "the reduction" will come at the expense of facility safety, surgical technique, and technology. "Turkey and Colombia often have endemic multidrug-resistant bacteria," he adds. Oriol Bermejo, head of the plastic surgery department at Bellvitge Hospital, admits that the trickle of these patients in the public system has intensified over the last five years and that they have to transfer one to the ICU at least once a month. They are mostly women, and approximately 85% will suffer aesthetic consequences. "With low-cost surgeries, which engage in almost fraudulent client recruitment, the experience of going under the knife has been completely trivialized," he laments, and warns that what the clinics advertise is "completely different" from what they ultimately perform.

Mariami's plan was to take the flight on January 31st, have surgery on February 1st, and land in Barcelona on February 4th. In total, she would spend two nights in the hospital and two in the hotel in Istanbul. "They took me to the hospital around seven in the morning, did some blood tests, and in 30 or 45 minutes the doctor saw me, drew a diagram, and sent me to the operating room," she summarizes. Before that, there was no interaction with the surgeon, and she was very surprised. But that was only the beginning of a nightmare. Once in the operating room, when they started sedating her, she thought she saw "people in street clothes without masks." "That scared me, and I considered escaping," she recalls. Furthermore, the consultant assured her that the operation would last about four hours, but it dragged on for eight and a half. And when she woke up, the doctor didn't visit her. In fact, she never saw her again. All the security and confidence the clinic had offered her months earlier had suddenly vanished.

"When I got back to the hotel, I already felt terrible: very dizzy, I couldn't walk, I had a very high fever... They prescribed an antibiotic and I started taking it, but I kept vomiting. I couldn't eat anything," Mariami explains. The clinic promised her a nurse to take care of her, but the attention she received, she says, was minimal. "They didn't remove the drains and they didn't want to help me shower. I had a very high fever, my lips were pale, white, I couldn't move... And they kept saying, 'It's normal.' But I knew it wasn't true," she laments. The next day she had flights back to Catalonia, and she had to board the plane in a wheelchair. "I felt like I was going to faint the whole time, but luckily I was able to get home. If I had stayed one more day, I would have died," she says.

Without medical follow-up

The Catalan public healthcare system treats patients like Mariami in the emergency room, but it doesn't address the long-term consequences such as scarring, irregularities, or skin depressions. This must be done in the private sector. "It ends up costing the patient much more than if she had had the surgery here from the start," Mir warns. Surgeon Francesc Mora, who treated Mariami, explains that a crucial part of medical practice is palpating the patient. "You have to see how she is, whether there's fluid or not, how the wounds are, how she's progressing. However, most things can't be diagnosed or controlled, and that's where the problems arise," he states. For Andrea Arroyo, a dietitian and nutritionist and member of the Eating Disorders and Psychological Treatment of Obesity Working Group of the Official College of Psychologists of Catalonia (COPC), cosmetic procedures have gone from being the exception to the rule in today's society. "The message has taken hold that a natural look is no longer enough, and the aesthetic pressure we women, in particular, face has intensified. It's now normal to turn 40 and get plastic surgery to look 30," she explains. The psychologist points out that the female "ideal of beauty" is changing, and while before the pressure was to be thin, now it's to be thin but voluptuous. phytoBut behind it all, she indicates, lies a business "based on violence that makes no secret of exploiting people's dissatisfaction." "They sell you an operation as if it were a pastime, not as the procedure with a series of risks that it truly is," she warns. Mariami says she has fully recovered, but still has some scars. "What they did to me was a disaster, honestly. When I left the hospital and saw my body covered in cuts and scars, I wanted to die. I thank God for giving me another chance at life," she says. Dr. Mora has recommended that she not have another surgery, but that she can try some technologies to improve the appearance of the scars. "This is the only thing I'll do. I've done a lot of therapy and I accept myself as I am," she says, praising the public healthcare system. "I've traveled a lot, but nothing compares to the healthcare here," she asserts. Mariami didn't report the clinic because she has no contacts in Turkey, doesn't speak Turkish, and the whole process was expensive. "But people need to know what's going on," she says. The hospital administration offered to operate on her again for free if she paid for her flights or give her 1,000 euros "to remove the scars." "It would be crazy to have surgery again in a place where they almost killed me," she says.

In the last five years, the problem has been concentrated in Turkey, but a decade ago it was in Colombia, Brazil, and the Dominican Republic. Priscilla had breast and abdominal surgery in Brazil, where she is from, eight years ago. "Both procedures cost me 2,000 euros, and they told me the recovery would be very simple," she explains. Initially, the breast implants were a success, but a bulge and irregularities appeared in her abdomen that went undetected because the surgeon didn't provide any postoperative follow-up. "They only told me to wear a compression garment for three months and to take care of the scars," she recalls.

A few months ago, however, during a medical visit, they found that her breast implantsThey were also ruptured, and she will have surgery in December to have them removed. She will also undergo surgery to address the problems that arose in her abdomen. "At that time I was 28 years old, and it was cheaper to travel and have the surgery in Brazil than in Barcelona. But I'm embarrassed to show my stomach, and I'm worried about having problems with my breasts. I look in the mirror and I don't like what I see, and I went into surgery to look good," she says.

Priscilla wants to send a message to other women considering traveling for cosmetic surgery to save money: "Don't do it. It may seem very appealing, but what you save you end up paying for later, or even with your health; you could end up in the emergency room. There are very good surgeons in Catalonia: in another country."