Makeover Nation
Americans are opting for cosmetic surgery in record numbers. But do they know the risks?
Risks of surgery. For major transformations, surgery remains the answer. And any way you slice it, cosmetic surgery is still surgery, with all the risks that entails. Consider liposuction. This popular procedure sounds deceptively simple: Vacuum that bulge, and voil a ! But liposuction is also the most dangerous cosmetic procedure out there. Complications include clots that travel to the lungs, organ puncture, and infection, all of which can be fatal. No national tally of liposuction complications exists, but data gathered in the 1990s put the death rate as high as 20 per 100,000. By comparison, deaths from hernia or gall bladder removal average 2 per 100,000. In recent years surgeons have tried to reduce risk by limiting the amount of fat removed and other measures. A 2001 survey of surgeons found that the death rate from liposuction alone was about 2 per 100,000 procedures. But that rate soars when multiple procedures are performed. Combining liposuction with abdominoplasty (a tummy tuck) increased the risk 14-fold. "The longer the procedure, the more likely you are to have a pulmonary embolism," says Hector Vila, a Florida anesthesiologist who has studied cosmetic surgery safety.
Mona Alley learned those dangers the hard way. She had seen ads on TV for the Florida Center for Plastic Surgery, based in Fort Lauderdale, which promotes "fly in" specials. The Hollywood, Fla., woman was hoping that liposuction could eliminate her belly fat and perhaps reduce health problems associated with her Type II diabetes. When Alley, then 47, talked with surgeon John Pinnella about liposuction in November 2000, she says, "he assured me it was 100 percent fantastic for diabetes." She says the doctor also told her there would be no down time. "I was planning to be back bowling the next week." She paid $2,700 for the operation.
Alley wasn't too surprised when her stomach hurt so badly the next day that she wasn't able to go in for a postoperative checkup. But she says that two weeks later, she was so ill she couldn't walk or eat. Alley was hospitalized with a massive infection caused by a perforated intestine. She suffered blood clots, required a colostomy, and had pressure sores so big she needed skin grafts. After nine months of repeated infections and hospitalizations, both of Alley's legs were amputated above the knee. She is at home, in a wheelchair. "Look at me," she says now. "It's not all this glamour they put on TV." She is suing the physician and clinic; in court papers, the doctor denies that he was negligent in any way.
Although no surgery is without risk, patients can minimize it by doing their homework. For one thing, any physician can legally perform cosmetic procedures. "In our area there is actually a cardiologist who injects Botox," says Leroy Young. "That's where he thinks the money is."
Ask questions. The picture is further clouded by this country's diffuse regulation of medicine. The federal Food and Drug Administration oversees the safety of devices such as silicone implants. States regulate the practice of medicine. Most people are clueless about this, with three quarters of respondents in a new Harris Poll saying they thought the American Medical Association or the surgeon general regulated cosmetic surgeons. They don't. Instead, consumers need to check a physician's record with the state board of medicine and should also check with the American Board of Medical Specialties (abms.org) to make sure their doctor is board certified in his or her specialty. Few people do. "Nobody's ever asked me in 30 years if I'm board certified," says Robert Bernard, a plastic surgeon in White Plains, N.Y. "Patients should ask: Are you board certified? Where are you going to do the surgery, doc? Is your facility certified? Do you have privileges in a hospital?"
advertisement
