Plastic surgery disasters – a Halloween primer

Riding in a plane has become commonplace and passe, so too has cosmetic surgery.  Many have forgotten that this is REAL surgery with REAL risks.

Death and complication in plastic surgery is something that people don’t want to think about but need to hear.  Like the sound clanking in your engine, it won’t go away if you ignore it.

How common is death in cosmetic surgery?

Statistics are hard to come by.  Many of the physicians performing cosmetic surgery are not plastic surgeons and are not required to report complications.  Unreported events don’t become statistics.

What cosmetic surgery is most risky?

Liposuction has come under a lot of scrutiny because of a few high profile and news worthy deaths that have occurred.  Recent statistics (Aesthetic surgery journal – May 2001) of board certified plastic surgeons performing liposuction over a two year period reported a rate of 1 death per 47,415 procedures.  A pretty low rate, but still higher than the generally accepted rate of 1/100,000 for elective procedures.

Alarmingly, the number of deaths from liposuction is certainly much higher than that.  This was a study performed by well trained board certified plastic surgeons.  Weekend course “cosmetic surgeons” were not included in these numbers.

The problem with liposuction is that it sounds so benign that many untrained physicians are jumping aboard.  Just suck a little fat here or there, can’t be that hard.  Do a google search regarding death with liposuction and you will generally find an untrained doctor is involved.

Florida Med Spa death – Doctor had 18 hours of training and felt this was adequate.

California cosmetic surgeons credentials questioned after death – He tried to cash the check after he killed her!

Family practice doctor with “extensive training” in cosmetic surgery.

Busy Boston cosmetic clinic was in a condominium basement

Sono Bello patient dies in hotel room alone.  Lidocaine toxicity found as cause of death.  Sono Bello is a nationwide liposuction “chain” which we have in Utah as well.  This one seems to have a pretty significant cover up as the physician responsible is still listed on Sono Bello’s list of preferred doctors.

I could easily go on and on as there are hundreds of similar stories.  One thing that definitely caught my attention is that I could not find a single one of these patients who were operated on by board certified plastic surgeons!

Now that I have your attention!

This post is not about scaring you.  It is about helping you make a wise decision.  The key is to identify and implement every step that can be taken to reduce these risks.  Here are some tips.

  1. Choose a plastic surgeon certified by the American Board of Plastic Surgery
  2. Avoid combining large procedures in one operation.  Kanye West’s mother Donda had a tummy tuck and breast reduction performed by a non-board certified surgeon.  Status and money are not immune.  The major risks are blood clots, infection and death.  The combination is significantly riskier than the separate operations.
  3. Avoid combining liposuction with significant other procedures.  The liposuction safety task force found this to be one of the major risk factors for a significant complication.
  4. Avoid liposuction under general anesthesia.  In my opinion, there is almost never an indication for liposuction to be done under general anesthesia.
  5. For that matter, avoid any procedure under general anesthesia that can be safely performed without.  I prefer local anesthesia with sedation for breast augmentation, breast reduction, breast lift, abdominoplasty (in the appropriate patient), rhinoplasty, facelift and any other cosmetic facial surgeries.
  6. Make sure your plastic surgeon operates in an accredited operating room, this will assure a standard of safety.
  7. In my opinion and experience, an office based operating room has a reduced infection risk as there are no sick or infected patients.  In fact, to my memory I have not had a significant infection in my office operating room in my 8 years of practice.  That is an exceptional statistic.
  8. Make sure your plastic surgeon has credentials to do the same procedure in a hospital (but choose that he doesn’t for reasons stated above).  This helps weed out the “board certified cosmetic surgeon” – which doesn’t really exist.

The only way to completely eliminate all complications is to stop operating.  Taking every precaution to avoid complications, particularly serious ones, is what allows me to look a patient in the eye and know that I have their best interests in mind.  It also helps me sleep at night!

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