SO1. Cosmetic Tourism: A Cost-Utility Analysis of Abdominoplasty Performed in the United States Versus Abroad

PURPOSE: Rising U.S. abdominoplasty costs have driven patients to seek affordable options abroad despite risks. This study compares the cost-effectiveness of abdominoplasty performed in the U.S. versus abroad. METHODS: Patients presenting to an academic hospital’s emergency department with complications from out-of-state/country abdominoplasties (2018-2022) were surveyed electronically. Utility scores were obtained from the survey and used to calculate quality adjusted life years (QALYs) for each health state. A literature review was performed to obtain the probabilities and outcomes for abdominoplasty performed in the U.S. versus abroad. A decision analysis tree was constructed with rollback analysis to determine the more cost-effective strategy. An Incremental Cost-Utility Ratio (ICUR) was calculated with willingness-to-pay of $100,000/QALY. Deterministic and probabilistic sensitivity analyses were performed. RESULTS: Cosmetic tourism abdominoplasty was associated with a lower clinical effectiveness (39.08) compared to abdominoplasty in the U.S. (39.09), and a relative cost decrease of $2,066.26. The ICUR of $811,471.83/QALY did not result in cosmetic tourism abdominoplasty being cost-effective. In the case that the cost of the cosmetic tourism abdominoplasty was below $7,061.63, one-way sensitivity analyses showed this option was more cost-effective than abdominoplasty in the U.S., with 68.03% Monte-Carlo confidence. CONCLUSION: Cosmetic tourism abdominoplasty is cost-effective only when priced below $7,061.63. This analysis may inform patients’ reservation prices, considering postoperative complications, follow-up, and long-term relationships with healthcare providers.