When Liposuction Goes Wrong, the Result Can Be Deadly
It is also extraordinarily lucrative. Because cosmetic surgery is rarely covered by insurance, doctors can set their own fees--anywhere from $3,000 to $8,000, depending on the length of the procedure. And anybody with a medical license can do it. Indeed, the 400 doctors who gathered to learn the latest liposuction and other techniques last month at the American Academy of Cosmetic Surgery in Orlando included oral surgeons, ear, nose, and throat doctors, and even osteopaths.
Melting the pounds. In a typical liposuction procedure, a doctor draws contour lines on the patient's skin, then places the patient under general anesthesia. Sometimes the doctor will run an ultrasound wand over the site to liquefy the fat. He or she then inserts a tube about the size of a ballpoint pen into the site and vacuums the fat into a beaker. With so-called tumescent liposuction, the doctor floods fat with fluids, making the suction easier and allowing more fat to be removed. One advantage of tumescent liposuction is that it can be performed with local anesthesia.
But as recent tragedies make clear, liposuction is not tooth extraction: It is invasive surgery, and particularly in the hands of an overly optimistic doctor or an anesthesiologist without emergency equipment nearby, things can go wrong. Rama B. Rao, a physician with New York University Medical Center, writing in the New England Journal of Medicine, linked five deaths in New York City from 1993 to 1998 to complications from tumescent liposuction, most of them caused by plummeting heart rates and dramatically reduced blood pressure. In Grazer and de Jong's study of 130 liposuction fatalities, the most common cause of death was a blood clot (which can occur after any surgery if a patient isn't carefully monitored), followed by perforations of organs or abdominal walls.
Lisa Marie Marinelli of Beachwood, N.J., was one of liposuction's unlucky victims. A 23-year-old secretary who stood 5 feet, 2 inches tall and weighed 115 pounds, Lisa went to a dermatologist because of a mild rash but made a liposuction appointment after reading a brochure in the waiting room. "I told her she was a nut to have this procedure done," says her mother, Kathleen. " 'You're beautiful; you don't need that.' " Yet the doctor, Rami Geffner of Toms River, N.J., gave Lisa a local anesthetic, removed a small amount of fat from her knees and thighs, and then wrapped her legs in Ace bandages. The next day, Lisa was dead from a blood clot in her lung that her family says was caused by too-tight bandages. The family sued the doctor, and a jury awarded them $558,600. Says Kathleen: "My daughter died for 2 tablespoons of fat." Geffner, who said he actually removed 10 ounces of fat, said he sympathized with the family and called Lisa's "an unfortunate case." But he denied responsibility for the incident and blamed emergency room personnel for not calling him until four hours after Lisa arrived.
The Marinelli case also highlights a challenge for prospective patients who want to check the credentials of doctors. Geffner, who has been a defendant in four other malpractice suits in 15 years--at least one of which he won--is listed as a doctor in good standing with the New Jersey State Board of Medical Examiners.
advertisement
