Breast implants in Dominican Republic
The district attorney's office for Santo Domingo says it has not yet begun an investigation because it has not received a formal complaint from Brignoni's relatives. Family members say they plan to make one.
Shortly after Brignoni's death, the Health Ministry inspected the Vista del Jardin Medical Center where she was treated and ordered the operating room temporarily closed, citing the presence of bacteria and violations of bio-sanitary regulations. The doctor who performed the procedure and the clinic have not responded to requests for comment.
Brignoni's death is unusual, but it is not isolated.
Concerns about the booming cosmetic surgery business in the Dominican Republic are enough of an issue that the State Department has posted a warning on its page for travel to that country, noting that in several cases U.S. citizens have suffered serious complications or died.
The U.S. Centers for Disease Control issued an alert March 7 after health authorities in the United States reported that at least 19 women in five states had developed serious mycobacterial wound infections over the previous 12 months following cosmetic procedures in the Dominican Republic such as liposuction, tummy tucks and breast implants.
There were no reported deaths in those cases, but treatment for these types of infections, which have been caused in the past by contaminated medical equipment, tend to involve long courses of antibiotics and can require new surgery to remove infected tissue and drain fluid, said Dr. Douglas Esposito, a CDC medical officer.
Excited: Brignoni's last Instagram picture showed her passport and boarding pass on her way to the Dominican Republic
'Some of these patients end up going through one or more surgeries and various travels through the medical system, ' Esposito said.
'They take a long time typically to get better.'
The Dominican Republic, like countries such as Mexico, Costa Rica and Thailand, has promoted itself as a destination for medical tourism, so-called because people will often tack on a few days at a resort after undergoing surgery.
The main allure is much lower costs along with the promise that conditions will be on par with what a patient would encounter at home.
In 2013, there were more than 1, 000 cosmetic procedures performed in the Dominican Republic, 60 percent of them on foreigners, according to the country's Plastic Surgery Society.
The Internet is flooded with advertisements and testimonials from people who say they have had successful procedures in the Dominican Republic, and an industry of 'recovery houses' has sprung up to serve clients, along with promoters who canvass for clients in the United States.
The price is often about a third of the cost in the United States.
Dr. Braun Graham, a plastic surgeon in Sarasota, Florida, says he done corrective surgery on people for what he says were inferior procedures abroad.
He warns that even if a foreign doctor is talented, nurses and support staff may lack adequate training.
'Clearly, the cost savings is certainly not worth the increased risk of a fatal complication, ' said Graham, past president for Florida Society of Plastic Surgeons.
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