WARNING: This story contains a graphic image.

Some go for a tummy tuck, some go for a Brazilian butt lift. Others, like Tonya MacDougall, went for both.

For Canadians looking for surgical enhancements, the lure of cheaper options abroad is obvious. They often come at a small fraction of the Canadian cost – MacDougall spent about C$4,500 for a butt lift that a Toronto clinic’s website priced at $10,500 to $16,500 before tax.

But they can also come with a steep health price, as some patients return with life-threatening complications.

Several women, including MacDougall, are raising the alarm after their cosmetic procedures in the Dominican Republic were botched, leaving them with dangerous infections, years of treatment, and lifelong scars.

When MacDougall came back from her surgery four years ago, she ended up spending two months in the hospital followed by a year and a half of home care after the promise of a safe surgery resulted in a severe infection that resulted in necrotizing flesh and a gaping hole in her abdomen.

"When we came back, I knew something was terribly wrong," said MacDougall, describing pussing tissue that had turned black.

"When I removed the bandages, I had a hole in my stomach probably the size of my fist. I could fit my fist through it. It was bad."

MacDougall was diagnosed with a drug-resistant mycobacteria, contracted from non-sterile equipment and contaminated water supplies at the Dominican Republic clinic where she had the surgery. Doctors at a Toronto area hospital had to remove seriously infected tissue from her belly as part of her treatment.

"I went through a depression. I was crying all the time. It was hard," she said.

MacDougall is not alone. There have been a number of similar cases over the years.

Two years ago, the U.S. Centers for Disease Control and Prevention was notified of 52 patients from nine states who had suffered from surgical infections after having cosmetic procedures in the Dominican Republic. At the time, the agency issued a travel warning for one particular clinic where the majority of the cases originated.

Meanwhile, medical journals and other sources have published studies and articles highlighting the issue.

One such study noted how the rare mycobacteria pathogen was becoming more prevalent as a result of an “increase in lipotourism” and advised greater awareness from both the medical community and the public for this type of infection.

Despite the warnings, medical tourism remains a draw for patients looking for affordable options, and at least three deaths related to botched surgeries in the Dominican Republic have been reported in the U.S. in recent months.

Another Canadian patient, "Carmen", said she went to the Caribbean country for a tummy tuck.

Carmen, who did not want to use her real name, returned to Toronto with an infection so severe that she was hospitalized for six months and was on antibiotics for two years. The pain was so severe that she could not stand straight, she said. In addition, doctors gave her an unrequested butt lift during her stomach reduction surgery.

"I got basically worked on in the Dominican with dirty tools … you just want it so bad so you just go - but you don’t think about it afterwards," she said. "But it's not worth it."

"Julie", who also did not wish to be identified, became sick three weeks after she returned to Canada following surgery in the Dominican Republic.

"I was dizzy. My stomach was expanded. I looked about five to six months pregnant and I had ooze coming out of my belly button," she said. She too had a similar drug-resistant infection that required a lengthy hospital stay and aggressive antibiotic treatment.

Medical tourism has grown in popularity over the years, but the public remains unaware of the risks, said Valorie Crooks, a Professor at Simon Fraser University who studies medical tourism.

"It's untracked, untraced, and unregulated,” she said. “We have no clue how many people have gone abroad, whether from Canada or any other country."

Health Canada warns of the risks of medical tourism on its website and offers recommendations for travellers considering the option, but it does not have any statistics on infections or complications from travellers returning to Canada after undergoing procedures overseas.

"Be aware of the risks, talk to your physicians at home … pursue all the information that you can get, especially information that is not directly provided to you by the physician or the clinic," said Crooks.

But not all patients who travel are ignorant of the dangers.

"I was aware of the risk before I went to the Dominican Republic but I was so desperate to achieve the look ... I never thought that it would happen to me, and it did," said Julie.

"I beat myself up about it because I not only put myself through the physical pain, the financial debt, and the pain and the suffering that I had watched my children go through – that they watched their mother suffer."

For these women, their experiences are a warning for others tempted by low cost surgical alternatives abroad.

"I could have died. Yeah, I'm lucky that I am alive today," said MacDougall.