Let’s address the elephant in the room: you’ve heard the horror stories. Headlines about Americans dying after cosmetic surgery in the Dominican Republic. CDC warnings. Social media posts from grieving families. These stories are real, and they deserve to be taken seriously.

But here’s what those headlines don’t tell you: the problem isn’t the Dominican Republic. The problem is choosing the wrong surgeon.

As a board-certified plastic surgeon who has practiced in Santo Domingo for over 15 years, I’ve watched my country become one of the world’s most popular destinations for cosmetic surgery. I’ve also watched unqualified practitioners exploit that popularity, putting patients at risk for profit. The result is a market where exceptional, world-class care exists alongside dangerous, corner-cutting operations — sometimes on the same street.

This article is my honest assessment of plastic surgery safety in the Dominican Republic. I’ll explain the real risks, show you how to identify red flags, and give you the tools to make an informed decision. Whether you ultimately choose to have surgery with me, with another qualified surgeon, or decide against traveling for surgery altogether, my goal is to help you understand what safe surgery actually looks like.

Understanding the Data: What the Numbers Actually Show

In January 2024, the CDC published a report documenting 93 deaths among US citizens who traveled to the Dominican Republic for cosmetic surgery between 2009 and 2022. That’s approximately 7 deaths per year over 13 years.

Is that number acceptable? Absolutely not — every preventable death is a tragedy. But context matters. During that same period, hundreds of thousands of cosmetic procedures were performed in the Dominican Republic. The mortality rate for cosmetic surgery here is not dramatically different from rates in other countries, including the United States.

What IS different is the concentration of procedures. The Dominican Republic performs an enormous volume of cosmetic surgeries relative to its size, which means both the successes and the tragedies are more visible. When something goes wrong, it makes international headlines in a way that a complication in Miami or Los Angeles might not.

The CDC report also identified specific risk factors present in many of the deaths: procedures performed in unaccredited facilities, surgeons without proper plastic surgery training, no pre-operative medical evaluations, multiple extensive procedures combined in single sessions, and operations on high-risk patients who should have been declined.

Notice what’s NOT on that list: the country itself. The risk factors are all related to surgeon choice and surgical practices — things that are entirely within your control when choosing where and with whom to have surgery.

Why Some Surgeries Go Wrong

To understand safety, you need to understand what causes complications. In my experience, dangerous outcomes in Dominican plastic surgery almost always trace back to one or more of these factors.

Unqualified Practitioners

This is the biggest issue. In the Dominican Republic, as in many countries, the term ‘cosmetic surgeon’ is not legally protected. This means a general surgeon, an OB-GYN, or even a physician with no surgical training at all can market themselves as a cosmetic surgeon and legally perform procedures.

Board-certified plastic surgeons complete years of specialized training in reconstructive and aesthetic surgery. We learn not just how to perform procedures, but how to handle complications, how to assess surgical risk, and when to say no. A general surgeon performing a BBL is like a family doctor performing brain surgery — technically a doctor, but catastrophically unqualified for that specific procedure.

Unaccredited Facilities

Safe surgery requires more than a skilled surgeon. It requires an accredited facility with proper equipment, trained support staff, anesthesiologists (not nurse anesthetists), emergency protocols, and backup systems. Some practitioners in the DR operate in converted apartments, hotel rooms, or clinics that lack basic safety infrastructure.

When complications occur — and they can occur even in perfect conditions — the difference between an accredited surgical center and a makeshift clinic is often the difference between a manageable problem and a fatal one.

Skipping Pre-Operative Evaluations

Every body contouring patient should undergo cardiac and pulmonary evaluation before surgery. These tests identify patients whose hearts or lungs may not tolerate the stress of surgery and anesthesia. They’re not optional — they’re essential safety screening.

But pre-operative evaluations cost money and take time. They also sometimes reveal that a patient isn’t a safe surgical candidate, which means turning away a paying customer. Unethical practitioners skip these evaluations to maximize volume and minimize barriers to booking.

Excessive Procedures in Single Sessions

Longer surgeries mean longer anesthesia time, more blood loss, more stress on the body, and higher complication rates. There’s a reason responsible surgeons limit operating time — typically to 6 hours maximum.

But patients often want multiple procedures, and saying ‘we should do this in two separate surgeries’ means less revenue per patient. So some surgeons perform marathon 8, 10, even 12-hour operations that dramatically increase risk.

Operating on High-Risk Patients

BMI matters. Medical conditions matter. A patient with a BMI of 38 and uncontrolled diabetes is at significantly higher risk for complications than a healthy patient with a BMI of 28. Responsible surgeons decline or postpone surgery for high-risk patients. Irresponsible ones take anyone who can pay.

The BBL-Specific Risk: Fat Embolism

Brazilian Butt Lifts deserve special mention because they carry a unique risk: fat embolism. If fat is injected into or below the gluteal muscle (rather than above it, in the subcutaneous tissue), it can enter large blood vessels and travel to the lungs, causing sudden death.

This risk is almost entirely technique-dependent. Surgeons who inject fat superficially, into the subcutaneous layer above the muscle, have dramatically lower complication rates than those who inject deeply. Unfortunately, deep injection creates more dramatic immediate results, so some surgeons use dangerous techniques to produce impressive ‘before and after’ photos.

How to Identify a Safe Surgeon

Now for the practical part: how do you find a safe surgeon in the Dominican Republic? Here’s what to look for.

SODOCIPRE Certification

SODOCIPRE — the Sociedad Dominicana de Cirugía Plástica, Reconstructiva y Estética — is the Dominican board that certifies plastic surgeons. This is the equivalent of board certification in the United States. A SODOCIPRE-certified surgeon has completed accredited plastic surgery training and passed rigorous examinations.

Crucially, you can verify SODOCIPRE membership yourself. Visit sodocipre.net, navigate to their member directory, and search for your surgeon’s name. If they’re not listed, they’re not board-certified in plastic surgery — regardless of what their website claims.

Accredited Surgical Facility

Ask where your surgery will be performed. Research that facility. Is it a recognized surgical center with a track record? Does it have proper accreditation? Is it equipped for emergencies? A qualified surgeon should be proud to tell you about their facility, not evasive.

Pre-Operative Evaluation Requirements

A safe surgeon will REQUIRE cardiac and pulmonary evaluations before body contouring procedures. If a surgeon is willing to operate without these clearances, that’s a major red flag. They’re prioritizing convenience over your safety.

Reasonable Procedure Limits

Ask about limits on combined procedures and total operating time. A surgeon who will perform unlimited procedures in a single session is not prioritizing your safety. Responsible surgeons have clear boundaries.

The ‘Will They Say No?’ Test

Perhaps the most telling sign of a safe surgeon is their willingness to decline patients. Ask directly: ‘Under what circumstances would you refuse to perform surgery?’ A surgeon who can’t clearly articulate patient selection criteria — BMI limits, medical condition restrictions, procedure limits — is likely taking everyone who pays, regardless of risk.

Red Flags to Avoid

Just as there are positive signs, there are warning signs that should make you reconsider a surgeon. Any of these should give you serious pause.

No pre-operative evaluations required. If they don’t require cardiac and pulmonary clearance, they’re not serious about safety.

Willing to combine unlimited procedures. ‘We can do everything you want in one surgery’ sounds appealing but often means dangerous operating times.

Operating in unaccredited facilities. Surgery in hotel rooms, private homes, or clinics without proper equipment is never acceptable.

Significantly lower prices than market rate. If a surgeon is charging half what others charge, ask yourself why. Often it’s because they’re cutting corners on safety.

Pressure to book quickly. ‘This price is only available if you book today’ is a sales tactic, not a medical recommendation. Legitimate surgeons give you time to make informed decisions.

Unverifiable credentials. If you can’t verify their SODOCIPRE membership, if their training history is vague, if they can’t provide references — walk away.

Defensive or dismissive about safety questions. A surgeon who gets irritated when you ask about safety protocols is telling you something important about their priorities.

What Safe Medical Tourism Actually Looks Like

If you decide to move forward with plastic surgery in the Dominican Republic, here’s what a safe experience should include.

Before you travel, you should have a comprehensive virtual evaluation where the surgeon reviews your photos and medical history. You should receive a clear surgical plan with transparent pricing. You should complete cardiac and pulmonary evaluations, either at home or arranged in the DR.

When you arrive, you should have an in-person consultation before surgery day. Your blood work should be repeated locally. The surgical facility should be obviously professional and well-equipped.

After surgery, you should have access to proper recovery facilities with nursing care. Your surgeon should check on you regularly — not just once before discharge. You should have clear instructions and direct access to your surgeon for questions.

Before you leave, you should not be cleared to fly until drains are removed and healing is confirmed. Your surgeon should provide ongoing support after you return home.

A Note on My Own Practice

I’ve written this article to educate, not to sell. But I also want to be transparent about how these principles apply to my own practice.

I am SODOCIPRE certified — you can verify my membership directly at sodocipre.net. I operate at CIPLA, an established surgical center in Santo Domingo with proper accreditation and emergency capabilities. I require cardiac and pulmonary evaluations for all body contouring patients. I limit surgical time and will stage procedures across multiple surgeries when necessary for safety. I decline patients whose health profiles pose unacceptable risks.

I turn away patients regularly. It’s not good for business in the short term, but it’s essential for the outcomes I want to achieve and the reputation I’ve built over 15 years. My patients call me ‘The Prince’ because they feel genuinely cared for — not because I tell them whatever they want to hear.

For detailed information about my specific safety protocols, I encourage you to visit our Safety page.

Conclusion: The Question Isn’t ‘Is DR Safe?’ — It’s ‘Is YOUR Surgeon Safe?’

Plastic surgery in the Dominican Republic can be completely safe — or it can be dangerous. The country itself doesn’t determine your outcome. Your surgeon does.

Do your research. Verify credentials. Ask hard questions. Trust your instincts. If something feels off — if a price seems too good to be true, if a surgeon seems evasive about safety protocols, if you’re being pressured to make quick decisions — listen to that feeling.

The patients who have safe, successful experiences in the DR are the ones who treat surgeon selection as the most important decision of their journey. Because it is.

Your safety is not negotiable. Any surgeon who treats it as such doesn’t deserve your trust.