Dozens of U.S. citizens died after receiving cosmetic surgery in the Dominican Republic over a 14-year period, according to the Centers for Disease Control and Prevention. The agency found that 93 Americans died after undergoing such procedures in the Caribbean country between 2009 and 2022.

Autopsy reports were available for 20 of the cases, and in all of them, the patients suffered complications either during or after surgery, the CDC said in a report published Thursday.

A fat embolism, a condition when particles of fat in the bloodstream block blood vessels, was the cause of death for 11 of the cases, according to the CDC.

The agency said the patients whose deaths were caused by fat emboli had undergone liposuction and a “gluteal fat transfer,” also known as a Brazilian butt lift.

“Fat embolism is a recognized risk associated with fat injections, particularly as used in gluteal augmentation,” the CDC said.

For seven other cases, the cause of death was a condition known as pulmonary venous thromboembolism, which is a sudden blockage in a lung artery. Following major surgery is one of the times when people are most at risk of developing the condition, according to the National Heart, Lung, and Blood Institute.

The CDC said risk factors like obesity and multiple procedures being performed during the same operation could have been mitigated or prevented with improved surgical protocols and postoperative care.  

The agency noted that so-called medical tourism is becoming more common among Americans seeking cheaper procedures quickly.

“U.S. citizens interested in receiving elective cosmetic surgery outside the United States should consult with their health care professionals regarding their risk for adverse outcomes,” the CDC said.

Last year, four Americans were kidnapped in Mexico on a trip during which a member of the group wanted to get cosmetic surgery; two of the Americans died in the ordeal.