Recently, an article appeared in the South Florida Sun-Sentinel after a death from “complications of liposuction and a buttocks enhancement procedure.”
The patient was a 35-year-old woman. There has been scant additional information available concerning that tragedy. Florida, of course, has been a hotbed of difficulties in terms of high-profile complications and deaths following cosmetic surgery. The article related that “State regulators have restricted the number of procedures surgeons can perform at one time, increasing training requirements, and required inspections of surgery offices.”
Last month, an article in the Los Angeles Times entitled “Orange County Plastic Surgeon To Surrender License After Sexual Misconduct Accusations,” reported on a very problematic physician.
This particular doctor was a plastic surgeon who had been under investigation by the Medical Board of California for sexual misconduct. Further, a surgicenter that he owned had been the subject of an extensive expose by the newspaper concerning very lax regulations of that surgicenter, and the “mishandling of 2008 vaginoplasty that left a 39-year-old mother of five dead from what coroner’s officials determined was an “accidental puncture wound.”
Right here, in the Los Angeles area, there was a report of problems with a cosmetic surgeon in Encino who had a long history of complications and possible deceptive acts with respect to acquiring patients.
All of this is very disturbing to those of us who consider ourselves mainstream. I believe the significance of these terribly negative reports is that each patient needs to do some homework to establish the credentials, reputation, and abilities of surgeons that they are considering to have perform cosmetic procedures.
In my experience, the common denominator, in physicians who misperform and operate outside the range of normalcy, is that they either have inadequate credentials, such as not being board certified in their specialty, straying beyond their specialty, or operating in a facility that does not have the proper credentials or appropriate coverage by anesthesiology specialists.
So, I will now repeat my short list of absolute requirements that you should be aware of before making any decisions regarding physician selection and point of service:
1. The doctor should be board certified in his specialty and performing procedures within the realm of that specialty.
2. A fellowship in a cosmetic surgery specialty is a very strong credential.
3. The procedure should be performed in a qualified and credentialed hospital or outpatient surgery center. Credentialing means that the facility has been awarded a stamp of approval by either the State Department of Health, the United States Department of Health & Human Services, or independent accrediting organizations.
4. A specialist in anesthesiology should be in your service. My personal preference is a board certified doctor anesthesiologist because I have always favored the concept of “two doctors in the operating room.” Some surgeons are comfortable supervising the work of a certified registered nurse anesthetist. If that is there choice, and the patient is comfortable, that is fine. But the patient does need to know the nature and qualifications of the anesthesia specialist.
There is a raft of information and advise re “being safe” in my category best-selling book, Secrets of a Beverly Hills Cosmetic Surgeon: The Expert’s Guide to Safe, Successful Surgery. Check it out; it can be your best friend.
- Robert Kotler, MD, FACS