Research: Aesthetic Surgery Risks, Equity Challenges

UC Davis

Researchers from UC Davis Medical Center have identified significant socioeconomic disparities among patients seeking treatment for complications after aesthetic surgery, according to a new study published in JPRAS Open.

The study, "Aesthetic Surgery Complications in Private Practice Settings: Insights to Optimize Patient Access and Outcomes," examined patients who visited UC Davis Medical Center between 2020 and 2023 with complications following cosmetic procedures performed at other facilities. Researchers evaluated patient demographics, complication patterns, healthcare utilization and the financial impact on patients, insurers and healthcare systems.

Among the study's key findings:

  • Patients with reported complications were disproportionately Black, Hispanic and Medicaid-insured compared with the overall emergency department population.
  • Nearly half of procedures had been performed outside traditional United States surgical settings, most commonly in Mexico and the Dominican Republic.
  • Tobacco and cannabis use were associated with significantly higher rates of infection and a greater likelihood of requiring additional intervention.
  • Complications generated substantial healthcare costs for government sponsored insurance programs. The median hospital charge for patients being treated for the complications exceeded $43,000 per person and surpassed $125,000 among those who ultimately required a new surgery.

These findings highlight the often-overlooked downstream costs associated with aesthetic surgery complications and the burden they place on patients, healthcare systems and public payors.

The study noted that patients with lower incomes may be more likely to seek low-cost procedures without adequate consideration of surgeon qualifications, facility accreditation, or complication risks.

"As demand for aesthetic surgery continues to grow, ensuring that patients have access to safe, high-quality care is increasingly important," said co-author Scott Levin, chief resident in Plastic and Reconstructive Surgery at UC Davis Health. "Our findings suggest that complications from cosmetic procedures disproportionately affect vulnerable patient populations, creating challenges not only for patients themselves but also for the healthcare systems that care for them. Improving access to safe aesthetic care is ultimately both a patient safety and health equity priority."

Lead author Nina Yu noted that the findings underscore the importance of understanding the social and economic factors that influence patient decision-making and postoperative outcomes.

"Our study highlights that complications from aesthetic surgery extend beyond the operating room," Yu said. "Improving patient education, optimizing preoperative risk assessment and expanding access to qualified providers may help reduce preventable complications and improve outcomes for patients."

The researchers conclude that interventions focused on patient education, risk stratification, access to qualified surgeons and health equity may help reduce complications while alleviating financial burdens on patients and healthcare systems alike.

Granger B. Wong, chief of the Division of Plastic and Reconstructive Surgery at UC Davis Health was also a co-author of the study.

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