Medical tourism has often been berated for being unregulated, uncontrolled and dangerous. Any treatment has an element of risk. A rush of stories on the dangers of cosmetic surgery, the need to regulate medical spas, proposals for controlling ayurvedic hospitals, are all concerned with domestic treatment, not medical tourism. Any media scares or discussion of regulation also effects medical tourism, as does a new app for the Iphone that scarily turns cosmetic surgery into a game, and American proposals to tax all cosmetic surgery.

Some problems on alleged risk can arise from differences in interpretation in differing countries, and problems in translation – particularly when Asian and South American clinics and agencies refer to plastic surgery that in Europe and elsewhere would be called cosmetic surgery. In the US, some surgeons make the distinction; others refer to everything as plastic surgery. Cosmetic surgery, sometimes called aesthetic surgery is purely elective, a lifestyle choice undertaken to enhance physical appearance, improve self-esteem and boost confidence. It is a treatment for want rather than for need. Cosmetic surgery differs from plastic surgery, which is generally surgery to repair or reconstruct tissue or skin damaged by congenital (inherited) disease, injuries or burns. The primary role of plastic surgery is to restore function, and aesthetic improvement is secondary.