Health
Plastic surgery deaths have spiked among US patients who traveled to Dominican Republic: CDC report
For a growing number of people, “medical tourism” can be dangerous — even fatal.
Twenty-nine U.S. citizens have died after they had cosmetic surgery in the Dominican Republic between 2009 and 2018, according to a Jan. 25 report from the Centers for Disease Control and Prevention (CDC).
More alarming is that the deaths have spiked in recent years. Between 2009 and 2018, there were an average of 4.1 deaths per year. Between 2019 and 2022, that average rose to 13 per year — peaking at 17 deaths in 2020.
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The deaths were linked to “fat or venous thromboembolism,” which is when a blood clot forms in a vein, the CDC reported.
Most of the patients had risk factors for the condition, such as obesity, diabetes, tobacco use and multiple surgical procedures being performed at once.
To ensure a safe procedure, the surgeon — as well as the entire surgical team, including the anesthesiologists, nurses and surgical techs — should be adequately trained in the specific procedures, a doctor noted. (iStock)
The Consular Section of the U.S. Embassy in the Dominican Republic has recorded cosmetic surgery-associated deaths among U.S. citizens since 2009.
The embassy contacted the CDC upon noticing the uptick in deaths — which sparked an investigation.
All but one of the deaths involved women, the report stated. The average age of the patients at the time of death was 40.
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For the 24 deaths that occurred between 2019 and 2020, liposuction was performed on all of the patients, usually along with other procedures, including gluteal fat transfer, abdominoplasty and breast augmentation.
Fat embolism was the cause of death in 55% of the cases and pulmonary venous thromboembolism was the determining cause in 35% of the cases, the report said.
Plastic surgeons’ reactions
Josef Hadeed, M.D., chair of the Patient Safety Committee for the American Society of Plastic Surgeons (ASPS), who was not involved in the CDC investigation, noted that the CDC’s report highlights the dangers associated with destination procedures.
For the 24 deaths that occurred between 2019 and 2020, liposuction was performed in all of the patients, usually along with other procedures. (Fox News Digital)
“Too often, patients will travel to other countries as the procedures are cheaper there,” Hadeed, who is also a plastic surgeon with practices in Beverly Hills, California, and Miami, Florida, told Fox News Digital in an interview.
“However, there are a lot of risks associated with traveling to other countries for cosmetic procedures.”
He added, “All surgery carries risk, but there are excessive deaths outlined in the report, most of which were presumably avoidable.”
“Just because something is cheaper doesn’t mean it is better for you.”
When it comes to the price of surgery, Hadeed advised patients that “you get what you pay for. Just because something is cheaper doesn’t mean it is better for you.”
He also said, “The most important issue in plastic surgery is patient safety.”
It is critical to find a plastic surgeon who is board-certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons, experts agreed. (iStock)
Jonathan Kaplan, M.D., a board-certified plastic surgeon who practices at Pacific Heights Plastic Surgery in San Francisco, who was also not involved in the report, said the CDC’s latest findings are “sad but true.”
“There are risks with any surgery, but in the U.S., you have a better sense of whether doctors are board-certified in the specialty they’re practicing in,” he told Fox News Digital in an email.
“There is also the added risk of going to a facility in a foreign country that has no quality assurance or safety protocols as required by law in the U.S.,” Kaplan added.
Heightened risks
International travel automatically puts patients at a higher risk for thromboembolic events, where they can develop potentially fatal blood clots, Hadeed said.
Another consideration is that those having surgery outside the U.S. won’t be able to get any assistance from the doctor if any complications arise, Kaplan warned.
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“Then you’ll have to find a doctor locally who will charge you an exorbitant amount to fix the problem and you’ll end up spending more than what you saved initially,” he said.
While all surgeries carry some element of risk, the “Brazilian Butt Lift” (BBL) has been associated with the highest risk of death in plastic surgery, which is corroborated by the report, noted Hadeed.
Twenty-nine U.S. citizens have died after having cosmetic surgery in the Dominican Republic between 2009 and 2018, according to a Jan. 25 report from the Centers for Disease Control and Prevention (CDC). (REUTERS/Tami Chappell/File Photo)
“While I cannot specifically comment on what led to the deaths in the Dominican Republic, I can say that using an ultrasound is essential while performing a Brazilian Butt Lift,” he told Fox News Digital.
When the fat is injected into one of the blood vessels within the gluteal muscle, it can enter the bloodstream and make its way to the blood vessels of the lungs, blocking off circulation and leading to immediate death — which constitutes a fat embolism, the doctor said.
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This can be prevented by using an ultrasound, he noted, which allows the plastic surgeon to visualize the gluteal muscle and ensure that the fat is placed above, and not within, the muscle.
“This has already become state law in Florida as of 2023,” said Hadeed.
Safety tips
While Hadeed said it’s “better” to look for plastic surgeons within the U.S., if patients do decide to travel outside the country, they should carefully research a provider.
It is critical to find a plastic surgeon who is board-certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons, Hadeed emphasized.
The surgeon — as well as the entire surgical team, including the anesthesiologists, nurses and surgical techs — should be adequately trained in the specific procedures, the doctor added.
The “Brazilian Butt Lift” (BBL) has been associated with the highest risk of death in plastic surgery, the report stated. (iStock)
“It is equally important to ensure that the facility in which the procedure is being performed is fully accredited to the same standards that are found in the United States and has the proper safety measures in place,” said Hadeed.
“The money you save is not worth it if you have a complication, which is a very real possibility.”
“Also remember that longer flights increase the risk of venous thromboembolism, and it is advised to wait several days after travel before undergoing a surgical procedure, which can add to the cost of the travel when you factor in additional days of staying in a hotel,” he pointed out.
When asked for his advice on international surgery, Kaplan said simply, “Don’t do it.”
Those having surgery outside the U.S. won’t be able to get any assistance from the doctor if any complications arise, an expert warned. (iStock)
“The money you save is not worth it if you have a complication, which is a very real possibility,” he said.
“And remember, complications don’t have to be major — they can be minor, but still a nuisance if you don’t have a doctor locally to take care of it,” he went on. “And even the smallest complication will be much more expensive to take care of in the U.S. if your original surgery was outside the country.”
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For those who are considering having an elective surgical procedure outside the U.S., the CDC recommends discussing the risks with a doctor here first.
The agency also emphasized the importance of surgeons conducting proper preoperative exams and only performing one procedure for each operation.
Potential limitations
The study did have some limitations, the CDC acknowledged.
All but one of the deaths involved women, the report stated. The average age of the patients at the time of death was 40. (iStock)
“No reliable statistics on the number of U.S. citizens who receive cosmetic surgery in the Dominican Republic each year are available, precluding calculation of the risk for perioperative death,” the report stated.
Also, the data only included deaths that were reported to the U.S. Embassy — which means the actual number could be higher.
The mortality count also does not include deaths resulting from post-surgical infections, the CDC noted.
Fox News Digital reached out to the CDC requesting comment on the report.
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Historically, parents were advised to avoid feeding peanuts to babies for the first few years of life, but emerging research has confirmed that introducing them sooner — as early as infancy — could help stave off food allergies.
A 2025 study led by the Children’s Hospital of Philadelphia analyzed medical records from dozens of pediatric practices across the U.S., finding that early introduction of peanuts resulted in a 27% decrease in peanut allergy diagnoses among children and a 38% decrease in overall food allergies.
The latest research also found that eggs had surpassed peanuts as the most common food allergen in the children studied. Beyond peanuts, other common food allergens include milk, egg and wheat.
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The new research — published in Pediatrics, the journal of the American Academy of Pediatrics, in October 2025 — focused on a two-year period after new guidance was issued by the National Institute of Allergy and Infectious Diseases, which first advised parents to introduce peanuts earlier.
Emerging research has confirmed that introducing peanuts as early as infancy could help stave off food allergies. (iStock)
That updated guidance was based on a landmark 2015 study — the Learning Early About Peanut Allergy (LEAP) trial — which found that for infants who had severe eczema or an egg allergy, exposing them to peanuts when they were between 4 and 11 months old could reduce peanut allergy risk by 81%.
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The guidelines were updated again in 2021, encouraging the introduction of peanut, egg and other major food allergens as early as 4 to 6 months for all children — including those without a history of prior reaction, according to health experts.
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“Everyone has been wondering whether these landmark public health interventions have had an impact on reducing rates of IgE-mediated food allergies in the United States,” said first author Stanislaw Gabryszewski, M.D., Ph.D., an attending physician in the Division of Allergy and Immunology at the Children’s Hospital of Philadelphia, in a statement.
A 2025 study led by the Children’s Hospital of Philadelphia found that early introduction of peanuts resulted in a 27% decrease in peanut allergy diagnoses among children and a 38% decrease in overall food allergies. (iStock)
“We now have data that suggest the effect of this landmark public health intervention is occurring.”
The latest findings “are supportive of efforts to increase education and advocacy related to early food introduction practices,” the study authors wrote.
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“If confirmed, these findings would represent a meaningful public health advance — affirming that clinical research, when coupled with clear guidelines and committed dissemination, can indeed shift the trajectory of childhood food allergy.”
Study limitations
The study only included data through early 2019 and did not consider the guidance released in 2021, which recommended early introduction of multiple allergens regardless of risk, the researchers acknowledged.
It also relied on allergy diagnoses from electronic health records, which may miss some cases. Also, the researchers did not capture individual feeding patterns.
Parents are encouraged to discuss any concerns with their pediatrician before introducing potential food allergens. (iStock)
Because the study was observational, it cannot prove cause and effect, but only association, the researchers noted. Other factors may influence the outcome.
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In some children, peanut allergy can trigger severe, life-threatening reactions, including difficulty breathing, swelling of the throat and a dangerous drop in blood pressure, according to Mayo Clinic. These reactions require immediate treatment with epinephrine, a life-saving allergy medication.
Not all parents may be comfortable with these revised guidelines, health experts say.
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“Not everyone has followed those guidelines, but this is further evidence that this early introduction is effective at preventing food allergies,” Dr. Susan Schuval, chief of the Division of Pediatric Allergy and Immunology at Stony Brook Children’s Hospital in New York, previously told Fox News Digital.
Parents are encouraged to discuss any concerns with their pediatrician before introducing potential food allergens.
Amy McGorry contributed reporting.
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encampment in Berkeley, California.
Leptospirosis, which is caused by Leptospira bacteria, is a zoonotic infection that can be passed from animals to people.
The disease has been confirmed in multiple rats and dogs at the homeless encampments along Harrison Street near Eighth Street in West Berkeley, according to an alert from City of Berkeley Public Health.
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Rats and their urine are the primary vectors of the disease, officials warned. It can also be transmitted through contaminated soil or water exposed to infected animal urine.
“People or animals who touch or drink contaminated water or mud are potentially exposed to the bacteria,” the alert stated. “The disease is transmitted to humans and animals when the contaminated water touches mucous membranes, such as eyes, nose, mouth or skin cuts. This disease is not spread in the air or by coughing or sneezing.”
Health officials are warning of a dangerous bacterial infection that has been detected at a homeless encampment in Berkeley, Calif. (iStock)
There is a higher risk after heavy rainfall, flooding or hurricanes, as this increases contact with infected water or soil.
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Leptospirosis typically causes flu-like symptoms, including fever, chills, headache, body aches, vomiting or nausea, according to the CDC. Infected people may also experience yellowed eyes or skin, rash, stomach pain or diarrhea.
Rats and their urine are the primary vectors of the disease, officials warned. It can also be transmitted through contaminated soil or water exposed to infected animal urine. (iStock)
Without antibiotic treatment, the disease can lead to serious illness, including kidney damage, liver failure, meningitis and difficulty breathing. In rare cases, it can be fatal to humans and animals, health officials say.
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Illness usually begins between two and 30 days of exposure to the bacteria, according to the CDC. People generally start feeling better within a few days or weeks, but recovery without treatment could take several months.
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“The presence of rats that are transmitting leptospirosis has made the area unsafe for human encampment conditions in the vicinity of Harrison Street encampments in the area generally bounded by San Pablo Avenue, Gilman Street, Codornices Creek and the railroad tracks,” the alert stated.
The disease has been confirmed in multiple rats and dogs at the homeless encampments along Harrison Street near Eighth Street in West Berkeley, according to an alert from City of Berkeley Public Health. (iStock)
The city has designated public health risk zones, with the Red Zone marking the highest risk area inside the encampment. Surrounding areas have been defined as the Yellow Zone, with an elevated but lower risk.
“The City’s Health Officer strongly recommends that encampment residents move out of the defined encampment ‘RED ZONE’ area as soon as possible and at least ⅓ of a mile away due to the public health risk caused by the rat infestation transmitting leptospirosis in the area,” officials advised.
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Residents in the area are encouraged to avoid contact with standing water and mud, use protective clothing and monitor themselves and their pets for signs of illness.
Anyone who has been exposed or is experiencing symptoms should seek immediate medical attention.
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With a new year underway, it might seem like a good idea to embrace a stricter morning routine of waking up early and getting a jump-start on the day — but a 6 a.m. alarm isn’t for everyone, experts say.
“Morning birds” fall asleep and reach deep sleep earlier, often waking up more alert, while “night owls” naturally sleep later and rely more on late-night and early-morning REM. Waking too early can leave night owls groggy and less mentally restored.
“We need to move beyond the ‘early bird gets the worm’ sayings and consider the biological cost of fighting one’s internal clock,” Dr. Aaron Pinkhasov, chair of the Department of Psychiatry at NYU Grossman Long Island School of Medicine, told Fox News Digital.
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The science of sleep
People sleep in repeated 90- to 110-minute cycles that alternate between deep NREM sleep and REM sleep, according to Pinkhasov.
Early in the night, deep sleep dominates, supporting physical repair, immunity and memory. Later cycles include more REM sleep, which supports learning, emotional regulation and brain function. Brief awakenings between cycles are normal.
Woman stopping an alarm clock (iStock)
Whether someone naturally rises early or late depends on the body’s “chronotype,” that is, whether they’re a morning bird or a night owl, he said.
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The chronotype is a “genetic blueprint” that determines when the body is naturally more alert or ready to rest, according to Pinkhasov.
“About 40% to 50% of our sleep-wake preference is inherited, meaning our internal clock is hardwired,” he noted.
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Waking earlier than one’s body’s clock often means sacrificing REM sleep. Forcing this discrepancy between the internal clock and the alarm clock can lead to “wired but tired” fatigue, mood instability and long-term metabolic risks, Pinkhasov warned.
“About 40% to 50% of our sleep-wake preference is inherited, meaning our internal clock is hardwired,” one expert said. (iStock)
“Unfortunately, because a lot of people have early work, family or social commitments, night owls have a higher prevalence of anxiety, depression, eating disorders, obesity, obstructive sleep apnea and [type 2 diabetes],” Dr. Nissa Keyashian, a California board-certified psychiatrist and author of “Practicing Stillness,” told Fox News Digital.
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Ultimately, health and productivity are highest when prioritizing consistency and sleep quality over an early-morning goal, experts say.
“The main benefit of switching to an earlier schedule is social alignment. It makes it easier to navigate a world built around a 9-to-5 lifestyle. However, the drawbacks can be significant if the shift is forced,” Pinkhasov said.
While waking at set times may improve social alignments, it can harm those who don’t naturally fit the mold. (iStock)
Smart shifts
There are some ways to “rewire” internal clocks or at least lessen the negative effects. Experts agree that having a regular bedtime and wake-up time — even on the weekends — can help.
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Pinkhasov recommends a wind-down nighttime routine that includes minimizing electronics, meditating, using essential oils, taking a warm shower or bath or drinking warm, herbal tea.
Pushing up your wake-up time by just 15 minutes a day is the most helpful, according to Keyashian.
Briefly waking up between REM cycles is normal, and adjusting to those cycles may help people wake up easier. (iStock)
The expert also recommends exposure to bright light in the morning, which can be helpful for mood, energy and concentration. People who experience dips in mood during the winter months can also benefit from using a therapeutic light box.
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“If you believe this might be you, I recommend speaking with a psychiatrist,” she advised. “I also recommend minimizing caffeine. Some people also notice difficulty falling asleep with exercise late in the day, so be mindful of this as well.”
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