The largest recent series on cosmetic surgery for international patients is cited as evidence about safety. Its headline sample and its complication denominator are different cohorts, and it contains no limitations section.
Information provided is for general reference only and does not constitute medical advice. Consult a qualified healthcare professional before making medical decisions.
The study most cited on cosmetic surgery abroad is a 2025 paper from one practice in Cartagena, Colombia, subtitled "A Review of 2324 Patients and 7141 Procedures". Its complication rate, 6.3 percent of patients and 2.2 percent of procedures, comes from a later sub-cohort of 1,363 patients, and the paper has no limitations section.
Sylk Health. Current as of October 2026.
A study published in 2025 reporting on thousands of international patients at one surgical practice has become the reference people reach for when asked whether operations abroad are safe. It is a real study and a useful one. It is also narrower than its citation, and the difference is worth setting out carefully, because we have cited it loosely ourselves.
The table below sets the Cartagena series beside the two other kinds of study in this literature.
Study | Design | Who was counted | Headline figure | What it cannot show |
|---|---|---|---|---|
Campbell and colleagues, 2025 | One practice reporting its own outcomes, retrospective | Complications counted in a sub-cohort of 1,363 | 6.3% of patients, 2.2% of procedures | No control group; no limitations section |
Mafi and colleagues | One receiving hospital, retrospective | 29 patients, 58 presentations, from 749 screened | Nearly half were repeat attendances | No denominator of people who travelled |
England and colleagues, rapid review | Review of published studies | 19 bariatric, 17 cosmetic and 1 ophthalmic study | Cost £1,058 to £19,549 per patient, 2024 prices | Very low certainty on its own grading |
Each design is strong where the others are weak. None answers the question it is usually cited for.
The Cartagena series is a retrospective, single-practice case series. The paper's (opens in new tab) design is stated plainly: "A retrospective observational study was conducted on 2324 international patients (7141 procedures) who underwent cosmetic surgery at a private practice in Cartagena, Colombia, from 2013 to 2024."
Three properties follow from that sentence and all three limit what the study can answer:
The patients are mostly American. The text gives "the majority being from the United States (76.1%) and Canada (12.7%)", while a figure caption in the same paper gives the combined North American share as 89 percent. Those are two different statements and should not be interchanged.
The complication figures come from a later sub-cohort, which is the part most citations miss. "Postoperative outcomes were analyzed retrospectively for all patients treated between 2020 and 2024, comprising 1363 patients and 4244 procedures." The result is reported against that smaller group: "Among 1363 patients undergoing 4244 procedures, 86 patients had a total of 99 complications, affecting 6.3% of patients and 2.2% of procedures".
A complication rate attributed to "a study of 2,324 patients" is in fact a rate observed in roughly 1,363 of them, treated from 2020 to 2024, inside a twelve-year series. Anyone quoting the rate should quote the denominator that produced it.
The paper contains two internal inconsistencies, both of which we report as printed rather than resolving. Its results table is headed with a patient count of 1,361 while the adjoining prose says 1,363. The abstract also reports "The overall complication rate was 6.2% per patient (2.2% per procedure)" where the body text reports 6.3 percent for the same measure.
Neither discrepancy is large and neither is hidden. They matter because a figure repeated across a dozen articles usually arrives without anyone having opened the source, and the source here does not speak with one voice about its own numbers.
We looked for the limitations section, because our argument when we planned this post was going to be that the authors are more careful than the people citing them. That turned out to be wrong in an instructive way. The paper has no limitations section, and the word does not appear in it.
A retrospective, single-practice, self-reported case series without a control group is a legitimate contribution to a literature. Its constraints are ordinarily stated by its authors; here a reader has to supply them. The comparisons the paper does draw are against a national outcomes database (TOPS) and published single-centre series, which are different populations collected by different methods. That is reasonable, and it is not a controlled comparison.
It shows independent reporting with no denominator. One series from a major trauma centre in Birmingham (opens in new tab), 2020 to 2025, screened 749 patients to reach a final cohort of "29 unique patients, accounting for 58 presentations to the hospital". Nearly half of the presentations were repeat attendances following an earlier complication. The authors note that "the true scale of cosmetic surgery tourism remains difficult to quantify because routine datasets do not systematically capture surgery performed abroad."
A recent review (opens in new tab) pulling this literature together reaches the same place. It graded its own cost findings as very low certainty and recommended data rather than a conclusion: "A systematic approach is needed to collecting information on the number of people who travel abroad for elective surgery and the frequency and impact on the UK NHS of treating complications."
Our own notes have carried an adjusted odds ratio of about 4.6 for complications among patients travelling for aesthetic procedures, attributed to a Colombian study. Two readers made ten separate searches for it and neither could find the study, the authors or the figure. We are therefore dropping it rather than repeating it, and recording that here rather than quietly removing it.
About one in twenty of those with outcomes recorded. The paper reports that "The majority (93%) were local complications, and 5% of patients required surgical reintervention," figures drawn from the 1,363 patients treated between 2020 and 2024. Its results table lists 68 reinterventions against that cohort.
Some were. The discussion records that six patients with systemic complications required hospitalisation at a partner facility. The figure comes from the same 2020 to 2024 cohort of 1,363 patients, and the paper reports it from the practice's own records rather than from the receiving hospital.
It does not, and it was not designed to. It reports one practice's own outcomes from 2020 to 2024, compared with other data collected differently, with no control group and no stated limitations. A UK review of the wider literature graded its evidence as very low certainty. The honest reading is that the published evidence supports no confident claim in either direction.
Neither literature on cosmetic surgery abroad supports a confident claim in either direction, and the honest position is less satisfying than either of the ones usually offered. A single practice reporting its own results from 2020 to 2024 found complications in about one patient in sixteen. A receiving hospital in another country saw 29 patients over five years and cannot say out of how many.
We publish prices. We hold no outcomes data, we do not rank providers by clinical quality, and we are not in a position to tell anyone that a procedure anywhere is safe. What we can do is read the studies that get cited at us and report what they measured, as our post on the bariatric returning-patient literature also does.
This article is general information about published research. It is not medical, legal or financial advice; decisions about surgery belong with a treating clinician.
Disclosure: Sylk Health supplies procedure-price data and earns a commission from providers on bookings completed through its platform. It would benefit from broader use of externally benchmarked prices for medical procedures, and from any gap between those prices and prices in the United States.
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