Ninety-three U.S. citizens have died as a result of cosmetic surgery in the Dominican Republic from 2009 to 2022, according to a report from the Centers for Disease Control and Prevention.

Over half of the deaths occurred after 2018, reflecting the increasing popularity of overseas cosmetic surgery. The fatal cases examined involved liposuction and 92% involved gluteal fat transfer, “in which fat is harvested from the patient and then injected into the buttocks to augment the body silhouette.” This procedure is also commonly known as a Brazilian butt lift.

All but one of the Americans who died were women, and their median age was 40.

Most of the deaths investigated were caused by embolisms, or blockages in the bloodstream, either from blood clots or fat buildup. In most of the fatal cases, multiple procedures were done during the same surgery, consistent with the CDC-identified risk factors for cosmetic surgery.

“The findings in this report highlight the importance of considering patient and operative risk factors when determining whether to proceed with elective cosmetic surgery,” the CDC researchers wrote.

The analysis stated that a “high proportion of patients who died had risk factors for embolism, including obesity and having multiple procedures performed during the same operation.”

According to the report, due to the increasing prevalence of cosmetic surgery-related deaths, the U.S. Embassy in the Dominican Republic reached out to the CDC, which then conducted an investigation in collaboration with the Dominican Ministry of Health.

NBC News has reached out to the Dominican Republic health ministry and the government for comment on the report.

Americans have been traveling to other countries for medical procedures, known as medical tourism, drawn in by the lower costs and wait times compared with the U.S.

Such travel is not limited to the Dominican Republic, though it’s a popular destination because of its existing tourism industry and because some Dominican doctors advertise in the U.S., according to the CDC.

Medical tourism can have other risks, including before patients ever reach the operating room. In March 2023, four Americans were kidnapped at gunpoint in Mexico after one went for a cosmetic surgery procedure; two of the Americans ended up dead.

Infections and complications arising from plastic surgery are not limited to overseas, with reports of botched procedures in the U.S. that have caused death or irreparable damage.

A separate CDC report published Thursday found 15 cases in nine states of an antibiotic-resistant bacterial infection after patients underwent cosmetic surgery that all originated from the same medical center in Florida.