For Some, Cost of Cosmetic Surgery Is Personal Health

[Guest guest]

Millions of people every year are damaged in some way by allopathic medicine. No

one will ever be able to calculate the damage done. How do you prove causuality

of all the people damaged by drugs, surgury, xrays, etc.? How do you prove that

someone's life was shortened.?

 

Most IBS, fibromyalgia, etc. is caused by prescription drugs, but how will

anyone ever prove which ones? How many people suffer from some form of brain

damage that shows up as many different varied symptoms such as eating disorders,

learning disorders, sleeping disorders, mental disorders brought on by

prescription medcal treatments? How about all the hearts, livers, kidneys,

pancreases, etc. are damaged each year? All of that and thousands more are

impossible to calculate even if it were the case that someone really wanted to

know as opposed the reality which is that the medical/regulatory authorities

work in the opposite dirrection and try " not to see " and to actively to hide

any cause/effect relationships. Bottom line is that they are interested in the

bottom line rather than the health of patients.

 

Frank

 

 

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_knigt_3037-0038-MED-COSMETICSURGERY%7ETB%7Eew%7Exml,00.html

 

For Some, Cost of Cosmetic Surgery Is Personal Health

 

May 07, 2004

 

Chicago Tribune

 

Chicago Tribune

 

(KRT)

 

MIAMI BEACH, Fla. - There are few cities in America where the marvels of plastic

surgery are more on display than this one. The beaches and bars are walking,

breathing billboards for eye jobs and nose jobs, tummy tucks and thigh tucks,

new breasts and new chins and feet sculpted to fit better into shoes with

unnaturally pointy toes.

 

But the story of cosmetic surgery here, as in much of America, is not as simple

as entering a clinic feeling imperfect and leaving looking beautiful.

 

In Florida, a state that has been touted as a national example for its

regulations on plastic surgery, the statistics clearly illustrate how risky

these procedures can be.

 

In less than two years at least eight people have died here, including a

72-year-old retired postal worker who saved for years to pay for liposuction and

a well-known real estate agent who never emerged from a coma after a face-lift.

 

At one wildly popular clinic, five people have died after surgeries since 1997,

and dozens of multimillion-dollar malpractice lawsuits have been filed.

 

And then there are the scores of profoundly botched jobs: the woman whose doctor

went ahead with implants after discovering a potentially cancerous lump in one

breast; the patient who ended up a quadriplegic after suffering a heart attack

during a face-lift; the homemaker whose bowel was pierced during liposuction who

ended up with an infection so severe that her legs had to be amputated.

 

" I don't think there is another place in the country where as much surgery is

going on - or where as many mistakes are being made and lawsuits are being

filed, " said Stuart Ratzan, a Miami attorney who specializes in medical

malpractice cases.

 

That's not to say that other states don't have problems. New York and California

- also bastions of plastic beauty - have recently seen some high-profile plastic

surgeries go wrong.

 

Manhattan socialite Olivia Goldsmith, who wrote the novel " The First Wives Club "

and once mocked those who would go to such lengths to look young, died in

January from anesthesia complications at one of New York's most respected

cosmetic surgery clinics. California has revoked the licenses of several doctors

found to be performing unsafe surgeries.

 

But Florida, which tightened its regulations on the surgeries several years ago,

prompting a number of other states to follow suit, is important to watch for a

number of reasons: The safeguards the state implemented, including the mandatory

reporting of deaths and a limit on how long someone can be under anesthesia

during plastic surgery, do not seem to have worked.

 

People still are dying and being disfigured on the tables of physicians who have

next to no plastic surgery training. And the state's Board of Medicine again is

analyzing what steps it should take to correct the problem and protect

consumers.

 

" The current office surgery limitations may not be enough to protect patients, "

Dr. Lisa Tucker, chairwoman of the Florida Board of Medicine, said two months

ago when the board announced it was temporarily banning some cosmetic procedures

while it investigated their safety.

 

---

 

The growing concerns and problems associated with plastic surgery come as the

procedures are becoming increasingly popular nationwide. In 1996 there were

696,904 procedures performed in the United States, compared to more than 8.6

million last year, according to the American Society of Plastic Surgeons.

 

A large portion of that increase stems from nonsurgical cosmetic procedures such

as Botox injections and chemical skin peels, but more than 1.8 million of the

procedures done in 2003 included major, invasive and potentially risky surgery.

 

" People are so driven to look young, feel young, appear fit, and we have become

willing to do virtually anything and risk virtually anything to achieve that

end, " said Lynne Luciano, a social historian who studies aging at California

State University-Dominguez Hills and wrote the book " Looking Good. "

 

With what amounts to free advertising from programs such as the hit reality show

" Extreme Makeover, " the economics of these surgeries also have shifted

dramatically over the past decade. Once considered an option only for the

extremely rich, plastic surgery now is accessible to the masses.

 

Clinics across the country advertise heavily to the middle class; one popular

facility in Miami saturates the airwaves during daytime television talk shows

and soap operas with ads that promise low monthly payments, no money down and no

credit checks.

 

As a result, doctors are switching their practices to focus on the lucrative

specialty - even if they have little or no education in it. Because most state

laws do not apply to the private offices where plastic surgeries increasingly

are being performed, and because there are no federal regulations governing

which doctors can perform plastic surgery, oral surgeons are doing face-lifts,

dermatologists are doing tummy tucks and allergists are giving clients nose

jobs.

 

Essentially, a doctor is a doctor under federal law, and state laws have focused

on hospitals and ambulatory care clinics, leaving private doctors' offices

almost completely unregulated.

 

" The judgment of a physician has been seen as sacrosanct, " said Arthur Levin,

director of the Center for Medical Consumers, a New York-based advocacy group.

" The government has not wanted to get in a position where it is intervening with

the private practice of medicine in the private offices of physicians. "

 

Two of the principal oversight groups in the field of plastic surgery - the

American Board of Plastic Surgery and the American Society for Aesthetic Plastic

Surgery - have long advocated minimum standards for physicians who perform

cosmetic surgeries. For example, to be certified by the American Board of

Plastic Surgery, a doctor has to complete seven years of training, including a

three-year residency in general surgery and at least two years of residency in

plastic surgery.

 

---

 

But being certified as a plastic surgeon is not a prerequisite for performing

such procedures in any of the 50 states, so long as the doctor has a license to

practice medicine. In California, for example, some studies have estimated that

up to 70 percent of oral surgeons also are practicing cosmetic surgery.

 

" In America you can call yourself a plastic surgeon, hang a shingle outside your

door and do these surgeries in your private office operating room with no

regulation at all, " said Dr. Rod Rohrich, president of the American Society of

Plastic Surgeons and chairman of the department of plastic surgery at the

University of Texas Southwestern Medical Center at Dallas. " Most patients don't

know the difference between someone who is certified and someone who's not. "

 

Therein, critics say, lies one of the greatest problems. Because of their lack

of specialized training, many doctors performing plastic surgery today would not

be permitted to operate in reputable hospitals or outpatient surgical

facilities. So these doctors instead are performing major, invasive surgery in

private offices that often do not have the same emergency resources or expertise

that a hospital would if something should go wrong.

 

Again, certification comes into play. Most clinics do not bother becoming

certified by the American Association for Accreditation of Ambulatory Surgery

Facilities, the group considered to be one of the gold standards for outpatient

surgical safety. Becoming accredited through the association is a long and often

expensive process that requires a checklist of compliances that " fills a book

you can't imagine how thick and precise, " said Dr. Robert Bernard, president of

the American Society for Aesthetic Plastic Surgery.

 

" The biggest change may not be how much of this surgery is being performed, but

where it is being performed, " said Levin, the consumer advocate. " I don't think

anyone yet knows how big of a problem that might be. "

 

The reason no one knows the extent of the problem is that no one is keeping a

national tally of the deaths stemming from plastic surgery. A few states - among

them Florida and California - have begun to, but there are few other states with

which to compare the results.

 

In February, after three high-profile cases in which patients died after having

combination tummy tuck and liposuction procedures, Florida decided to act again.

It imposed a statewide emergency moratorium banning that double procedure from

being performed in doctors' offices for 90 days while the board studied the

safety of such operations.

 

---

 

But critics say that is not addressing the root of the problem. They worry that

one of the biggest risks for patients is how long they are under anesthesia;

they would like to see the state lower its current eight-hour time limit on

cosmetic surgeries that require anesthesia.

 

Such critics point out that less-reputable doctors and clinics increasingly are

offering discounts to patients who have more than one procedure done at once.

What often happens is that a patient who comes in for a nose job will decide to

have his or her eyes done and tummy tucked. The more procedures the patient

undergoes, the longer the patient is under anesthesia.

 

" The bottom line when you look at what's going on in Florida is that the one

thing you can't legislate is good surgical judgment and being a good doctor, "

Rohrich said.

 

A study released recently seemed to confirm critics' fears. The study, done by a

dermasurgeon at the University of Cincinnati College of Medicine, concluded that

patients were more likely to die from complications related to anesthesia during

cosmetic surgery than from surgical error.

 

A number of states have changed their laws based on the potential risks

associated with the use of anesthesia in office settings. Illinois, for example,

has required that doctors and nurse anesthetists participating in surgeries in

offices must have specialized training in anesthesia as well as in advanced

cardiac life support.

 

Liposuction - regardless of how long the surgery takes and whether done in

combination with another procedure or not - is among the most dangerous of

plastic surgeries. A study done several years by two California plastic surgeons

ago estimated that the death rate from liposuction was 1 in 5,000, a rate nearly

20 times higher than that of other forms of elective cosmetic surgery.

 

The majority of liposuction deaths stem from factors that may be compounded

significantly when surgeries are done in office settings. Plummeting heart rates

and blood pressure can be deadly when an office does not have emergency

equipment nearby. Blood clots - a fear after any surgery - are particularly

worrisome because patients go home shortly after surgery without a doctor to

monitor them. And because the surgery requires doctors to suction out fat by

repeatedly jabbing a suctioning device deep into a person's body, there is a

risk of accidentally perforating vital organs.

 

---

 

That happened to Mona Alley, 50, a homemaker from Hollywood, Fla., who had

liposuction in 2000. A diabetes patient who struggled with the extra weight

around her waist, Alley had heard that liposuction was a good way for people to

lose the pounds that can complicate her disease. But during the office

procedure, Alley's intestine was unknowingly pierced, causing toxic waste to

spread through her body for nearly two weeks before it was discovered.

 

Alley's infection and perforated intestine required extensive surgeries and

hospitalizations for the next year. Over time, because she was bedridden for so

long, she developed bedsores and circulatory problems - complicated by her

diabetes - that required the amputation of both legs.

 

A lawsuit Alley has filed against the doctor and clinic is pending. The doctor

contends that the injury to her intestine could have come from another source

and that her circulatory problems stemmed from her diabetes.

 

On a recent spring day, Alley sat in her wheelchair watching a video of herself

before her liposuction. In it she is bowling, wearing a pair of shorts. She

smiles when she nails a strike.

 

" I used to have long, gorgeous legs, " she said.

 

Alley knows now that consumer advocacy groups recommend that patients check that

their surgeon is board-certified, that an office is accredited to perform

surgeries and that there are no lawsuits or complaints against the doctor.

 

Patients also are encouraged to get clearance for surgery from their

primary-care physicians, who are more familiar with their medical history. The

American Society for Dermatologic Surgery has gone so far as to recommend that

patients opt for procedures that do not require general anesthesia to be used in

an office setting.

 

Asked what she would do differently today, Alley is succinct: " I wouldn't have

plastic surgery. "

 

Her husband, Robert, turns his eyes away from the bowling video and looks at

her.

 

" I told her she was already perfect anyway, " he said sadly.

 

---

 

© 2004, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.

 

 

 

 

 

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