Summary:. Necrotizing soft tissue infection (NSTI) is an acute life-threatening complication of cosmetic surgery. We present a case study of a 48-year-old woman diagnosed with NSTI of the abdominal wall following liposuction, abdominoplasty, and ventral hernia repair performed in Latin America. In the operating room, bowel perforation at the hepatic flexure was observed requiring emergent fascial debridement, bowel resection, and broad-spectrum antibiotics. She required multiple washouts and split-thickness skin grafts. Complications such as NSTI are possible after lipoabdominoplasty and are prevalent in cosmetic medical tourism, due, in part, to varying institutional standards and accreditations, and in some cases lack of consistent adherence to set standards. Complications after medical tourism contribute a significant burden to medical staff and the healthcare system in patients’ home countries. Patient education by their surgeons and plastic surgery societies should be prioritized. It is important for domestic emergency physicians, plastic surgeons, and other care providers to understand complications postcosmetic surgery to promote timely management.