Surgery in Spain or a trip to Colombia to have your biopolymers removed?

It is a legitimate and very frequent question, and it deserves an answer that is not advertising in disguise. So let us start with what we are not going to say.

We are not going to say that having surgery abroad is dangerous by definition, or that having surgery in Colombia is a bad idea. That would be easy, it would be profitable and it would be false.

What the data do say is something else, and it is far more useful: the variable that best predicts ending up admitted with a complication is not the country you have surgery in. It is how many days you stay afterwards.

The process is in the guide to biopolymer removal and, by area, in buttocks.

What the data do NOT say

It is worth dismantling first, because otherwise nothing that follows is credible.

Having surgery abroad is not the same as having bad surgery. The largest published work on safety in surgical tourism analysed 2,324 international patients and 7,141 procedures carried out at a private practice in Cartagena between 2013 and 2024. The overall complication rate was 6.2% per patient — 2.2% per procedure — and the authors compare it favourably with the standards published by board-certified plastic surgeons in the United States. Their conclusion is explicit: carried out in high-volume, well-regulated centres, surgical tourism can achieve results equivalent to best practice.

And with biopolymers specifically, the experience is there. The largest series cited across this whole cluster — 199 patients with a three-flap technique in Medellín, 20 with autologous reconstruction in Bogotá, 35 with a paramedian approach — come from Colombian teams. It makes sense: it is where the problem has been most widespread, and where most of the surgery has been done.

So the question “do they know how to do it there?” is the wrong question. They do, and pretty well.

The variable that does decide

Here is the finding that changes the conversation.

A 2026 study compared patients who came to a hospital with complications after having surgery far from home, separating those who had travelled abroad from those who had travelled within their own country. The hypothesis was that domestic tourism would be safer. It was not.

There were no significant differences between domestic and international patients in the type of complication or in the need for surgical treatment. What did make a difference was something else:

The authors sum it up like this: the length of the post-operative stay correlates with complications requiring admission to a greater extent than the destination itself. And they add that domestic tourism, which is assumed to be safer, can carry similar risks if adequate follow-up is missing.

Put another way: the problem was never the map. It was the calendar.

And this surgery’s calendar is the worst possible

This is where the above becomes concrete for biopolymers, using the same figures that appear across these pages.

• The most frequent complication of gluteal removal is a seroma, which appeared in 40% of a series of 35 patients.
• Its mean time to appearance was 31 days.
• In addition, in the series of 199 patients, 29.1% needed drains and there was wound dehiscence in 21.1%.

Now lay that over a trip. You come out of theatre, spend a few days, fly home. And the likeliest complication arrives three or four weeks after you have landed, thousands of kilometres from whoever operated on you and from whoever knows what they found inside.

That is not a commercial argument: it is arithmetic with the figures published by the very teams that do most of this surgery.

The flight home

There is one detail almost nobody takes into account and which, tellingly, has been studied by the same Colombian group that publishes the series of 199 removals.

They measured physiological variables in patients who had had cosmetic surgery during flights of more than four hours, comparing them with travellers who had not had surgery. What they found:

• Every patient who had had surgery experienced oxygen desaturation, with a mean fall of 4-7% in the first four hours of the flight.
• They also started from lower haemoglobin levels than before surgery.
• Heart rate rose by 15-20 beats per minute.
• The diameter of the popliteal vein progressively dilated over the course of the flight, from hypoxia-induced vasodilation and from remaining seated.

The authors conclude that those changes coincide with risk factors for thrombosis, flap necrosis, infection and post-operative bleeding, and that care protocols and pre-flight advice are needed.

And now the detail that makes it especially relevant here: in gluteal biopolymer removal, the mean fall in haemoglobin after surgery was 3.3 g/dl. That is, it is precisely this operation that leaves you in the state that study describes as risky for flying.

If something goes wrong, who sorts it out?

This is the part worth looking at beforehand rather than afterwards.

In Ireland, two university hospitals recorded 33 patients over two years who came back with complications after surgery abroad. The complications were above all wound dehiscence (22 cases), infections (9) and seromas (9). Twenty-seven operations were needed, with a mean stay of four days and a cost of €5,486 per patient, borne by the public system.

In the United States, one centre counted 44 patients over four years with complications after travelling for surgery: infection (52.3%), seroma or fluid collection (52.3%), dehiscence (20.5%), abscess (18.2%) and pulmonary embolism (6.8%). An average of 1.75 emergency department visits, five days of admission and a mean hospital bill of around $34,750 per patient.

What those numbers describe is not a moral judgement. It is a logistical reality: when the complication appears, the person who operated on you is far away and whoever is treating you does not know what was done. And with biopolymers, “what was done” includes information only the surgeon who opened you up has: how much material there was, in which planes, what could be removed and what was left.

The questions that do discriminate

They work in Valencia, in Medellín and anywhere else. If a centre answers them well, the postal address matters far less:

1. Who is operating on me and with what qualification? A specialist in plastic, aesthetic and reconstructive surgery, registered and verifiable. In Spain the rules have spelled it out since 2024 and it can be checked free: it is in who can operate on you for cosmetic surgery in Spain.
2. How many biopolymer removals do you do a year? It is volume surgery: specific experience matters more than general experience.
3. Where is the surgery done? Premises with an accredited theatre and the capacity to admit you, not a consulting room.
4. Is an MRI requested beforehand? It is what makes it possible to plan instead of improvise. It is in the diagnosis page.
5. How many days do I have to stay afterwards? The answer to this question is, on the data, the one that weighs most.
6. Who sees me if a seroma appears at 31 days? And at what cost.
7. What happens if I need reoperating? What is included and what is not.
8. Will I be given the surgical report with what was found and what was removed? It is the document any doctor who sees you afterwards will need, here or there.

And if you decide to go anyway

It is a legitimate decision, and there are reasons beyond price: the team’s experience, family there, or the fact that you were injected in that same country. If you go, these are the measures the literature itself suggests:

• Stay more than five days after the surgery. It is the threshold that appears in the data.
• Pre-flight advice and anti-thrombotic measures: it is the explicit recommendation of the in-flight study.
• Come home with the full surgical report, with what was found and what was removed.
• Have it settled in advance who reviews you here during the first and second month, which is when a seroma arrives.
• Ask for a real line of contact with the team that operated on you, for when whoever sees you here needs to ask something.

Frequently asked questions

Is it more dangerous to have surgery in Colombia?

The available data do not say that. In a review of 2,324 international patients operated on in Cartagena, the complication rate was 6.2% per patient, comparable to the standards of board-certified surgeons in the United States, when the surgery is done in high-volume, well-regulated centres.

So where is the problem?

In the follow-up. A 2026 study found that those who stayed five days or fewer after surgery needed admission in 88.9% of cases, against 36.4% of those who stayed longer, regardless of destination.

Why does it matter so much in this particular operation?

Because its most frequent complication, a seroma, appears on average at 31 days. By then, anyone who travelled is already back.

Is flying after surgery risky?

A study measured, on flights of more than four hours, falls in oxygen saturation of 4-7%, a rise of 15-20 beats per minute and progressive dilation of the popliteal vein in patients who had recently had surgery — changes that coincide with risk factors for thrombosis, infection and bleeding.

I was injected there. Does it make sense to go back there to have it removed?

It is an understandable reason and it is not unreasonable: it is where most of this surgery is done. What has to be sorted out, if you do, is the follow-up: how many days you stay and who sees you here during the following weeks.

If I have a complication on getting back, will I be treated here?

Yes, and in fact that is what happens. Two Irish hospitals recorded 33 patients over two years, with 27 operations and a mean cost of €5,486 per patient borne by the public system. What does not travel with you is the information about what was done to you.

Is it cheaper?

In the short term yes, and that is why people do it. The works cited analyse precisely the other side: the costs of the complication, which do not appear in the initial quote. On the price of the surgery here, there is the price page.

What do I take with me if I do have surgery abroad?

The surgical report with what was found and what was removed, the earlier imaging and a line of contact with the team. And stay more than five days.

Sources

• Campbell A, Restrepo C, Luna-Pisciotti T, Hernandez M. Safety and Outcomes in Plastic Surgery Medical Tourism: A Review of 2324 Patients and 7141 Procedures. Plast Reconstr Surg Glob Open. 2025;13:e7113. A retrospective observational study of 2,324 international patients (7,141 procedures) treated at a private practice in Cartagena, Colombia, between 2013 and 2024, with analysis of post-operative outcomes in 1,363 patients treated between 2020 and 2024; 89% travelled from the United States or Canada; the overall complication rate was 6.2% per patient and 2.2% per procedure, which the authors compare favourably with the standards published by board-certified plastic surgeons in the United States; they conclude that, carried out in high-volume, well-regulated centres, surgical tourism can achieve results equivalent to benchmark practice. https://pubmed.ncbi.nlm.nih.gov/41018743/
• Deivasigamani S, Khaw KL, Bonawitz SC. Passport Not Required: A Comparison of Plastic Surgery Complications From Domestic and International Medical Tourism. Ann Plast Surg. 2026;96:S220-S224. A retrospective review of 41 patients treated for complications after elective cosmetic surgery between May 2015 and November 2025, classified as international or domestic tourism; there were no significant differences in procedures, type of complication or need for surgical treatment; patients who stayed 5 days or fewer at the place of surgery were more likely to require hospital admission (88.9% against 36.4%) and intravenous antibiotics (88.9% against 27.3%), regardless of destination; the authors conclude that the length of the post-operative stay correlates to a greater degree with complications requiring admission than the destination itself does, and that domestic tourism can carry similar risks where adequate follow-up is missing. https://pubmed.ncbi.nlm.nih.gov/41587442/
• Ramírez B, Aguilar H, Stanford N, Paez Z, Menendez JP, Pachon J, Osorio E, Varela A. Aesthetic Surgical Tourism: Physiological Changes During Flight That May Affect Patient Safety and Outcomes. Plast Reconstr Surg Glob Open. 2026;14:e7568. A prospective study of physiological variables in patients who had had cosmetic surgery during flights of more than 4 hours, compared with travellers who had not; every post-operative patient showed oxygen desaturation, with a mean fall of 4-7% in the first 4 hours of the flight, and they started from significantly lower haemoglobin levels than before surgery; heart rate rose by 15-20 bpm and the diameter of the popliteal vein expanded progressively from hypoxia-induced vasodilation and prolonged sitting; the authors conclude that these changes coincide with risk factors for thrombosis, flap necrosis, infection, haematoma and bleeding, and that post-operative care protocols and pre-flight advice are essential. https://pubmed.ncbi.nlm.nih.gov/42110381/
• Chee SY, Sheil F, Keane A, Feeley A, Martin-Smith JD, Cahill KC. Impact of aesthetic surgery performed abroad on the Irish healthcare system. J Plast Reconstr Aesthet Surg. 2024;98:339-341. A retrospective analysis of patients treated for complications of cosmetic surgical tourism at two Irish university hospitals between July 2021 and June 2023: 33 patients with a mean age of 41, operated on mostly in Turkey (67%) and Lithuania (24%); complications: wound dehiscence (22), infection (9), seroma (9), haematoma (2) and skin necrosis (1); 27 operations were carried out, with a mean hospital stay of four days and a cost per patient of €5,486; the authors conclude that these complications place a burden on the public health system. https://pubmed.ncbi.nlm.nih.gov/39332160/
• Maini RS, Hall J. Aesthetic Surgery Tourism: The Real Cost of Discount Plastic Surgery. Aesthetic Plast Surg. 2026;50:6485-6491. A single-centre retrospective study of 44 patients treated for complications after cosmetic surgical tourism between January 2021 and December 2024; complications: infection (52.3%), seroma or fluid collection (52.3%), dehiscence (20.5%), abscess (18.2%) and pulmonary embolism (6.8%); an average of 1.75 emergency department visits and a mean stay of 5 days; 25% required a return to theatre; the mean hospital cost was $34,752.91 per patient. Level of evidence V. https://pubmed.ncbi.nlm.nih.gov/42298159/
• Eusse Llanos JC, Posada López S. Paramedian open approach for gluteal biopolymers removal: a case series of 35 patients. JPRAS Open. 2025;45. A series of 35 patients; the most frequent complication was seroma (40%), with a mean time to formation of 31 days. https://pubmed.ncbi.nlm.nih.gov/40837208/
• Osorio E, Ramírez B, Herrera O, Suarez C, Ciro C, Varela A. Three-flap Technique: Comprehensive Approach for Biopolymer Removal in the Gluteal and Lumbar Regions. Plast Reconstr Surg Glob Open. 2026;14:e7870. A retrospective cohort of 199 patients operated on in Medellín; mean fall in haemoglobin of 3.3 g/dl; need for a drain in 29.1% and dehiscence in 21.1%. https://pubmed.ncbi.nlm.nih.gov/42495057/

Book your consultation

Whatever you decide, there is one thing worth settling before booking anything: who sees you here during the first and second month, which is when this surgery’s most frequent complication appears.

If you want to consider having surgery in Valencia, the conversation starts with the MRI and with finding out what can be removed in your case.

Clinical confirmation by the surgeon

Dr Enrique Salmerón González

Specialist in Plastic, Aesthetic and Reconstructive Surgery
Registration no. 46/4624077

Dr Elena García Vilariño

Specialist in Plastic, Aesthetic and Reconstructive Surgery
Registration no. 46/4624503

Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.