irtual surgical planning with computeraided design/computer-aided manufacturing (CAD/CAM) for complex head and neck reconstruction is no longer novel. Surgeons have reported that CAD/CAM increases operative efficiency, lowers the rates of postoperative complications and surgical revision, increases the rate of bony fusion, provides superior postoperative dental occlusion, allows for more precise osseointegrated dental implant placement and more complex reconstruction designs, and results in superior functional and aesthetic outcomes. 1,2

All figures are projected. * Data unavailable in prior year. **87% of total 2017 breast implants were silicone; 13% were saline. ***Botulinum Toxin Type A numbers are of anatomic sites injected. ****Counts of procedures performed by ASPS member surgeons only. In 2000 figure included all animal bites.^I n 2000 figure included facial laceration repair.^^^I

Background: Medical tourism has become increasingly globalized as individuals travel abroad to receive medical care. Cosmetic patients in particular are more likely to seek surgery abroad to defray costs. Unfortunately, not all procedures performed abroad adhere to strict hygienic regulations, and bacterial flora vary. As a result, it is not uncommon for consumers to return home with difficult-to-treat postoperative infections. Methods: A systematic literature review of PubMed, Ovid, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases was performed to assess the microbiology patterns and medical management of patients with postoperative infections after undergoing elective surgery abroad. Results: Forty-two cases of postoperative infections were reported among patients who underwent elective surgery abroad. Most cases were reported from the Dominican Republic, and the most common elective procedures were abdominoplasty, mastopexy, and liposuction. Rapidly growing mycobacteria such as Mycobacterium abscessus, Mycobacterium fortuitum, and Mycobacterium chelonae were among the most common causes of postoperative infection, with M. abscessus involving 74 percent of cases. Most cases were treated with surgical débridement and a combination of antibiotics. Clarithromycin, amikacin, and moxifloxacin were the most common drugs used for long-term treatment. Conclusions: When encountering a patient with a history of medical tourism and treatment-refractory infection, rapidly growing mycobacteria must be considered. To increase the likelihood of yielding a diagnostic organism, multiple acid-fast bacilli cultures from fluid and débridement content should be performed. There has been reported success in treating rapidly growing mycobacterial infections with a combination of antibiotics including clarithromycin, amikacin, and moxifloxacin.