Archive for category plastic surgery news
Too Much Plastic Surgery?
Should surgeons say “No” when patients visit too often?
Reader Laura Question:
“Alicia Douvall is back in the news after spending a reported million pounds on plastic surgery to look like a barbie doll. She is now claiming that it’s the Dr’s fault that she had so much surgery and that they should have told her no when she asked for surgery. What do you think is the Dr’s responsibility when it comes to designer plastic surgery?”
She has had more than 330 cosmetic procedures and operations – far outstripping American Cindy Jackson, usually credited with being the world’s most surgically-enhanced woman.
Former English glamour model Alicia Douvall – best known for her kiss-and-tell affairs with celebrities including music mogul Simon Cowell – claims to have spent more than £1 million on boob jobs, facelifts and even toe shortening operations.
A grown woman saying her primary reason for wanting cosmetic surgery is to ‘look more like Barbie’ would be a cause for concern, even to those with no medical training. Yet unscrupulous surgeons agreed to operate on her for just this bizarre reason not once, but more than 50 times.
It is somewhat laughable when an obvious plastic surgery addict tries to blame someone else. The public doesn’t often think that surgeons get paid to operate and when one says “No” there are likely many others who do not. Saying “No” costs money.
As we have discussed here before, that which constitutes “Too Much Plastic Surgery” is a matter of a surgeon’s philosophy. While I have turned away patients who have requested surgery which I feel was problematic, I am in the minority and suffer financially for each such ethical denial. Many other doctors are less selective and justify their policies with their own beliefs. Suffice it to say that if a patient seeks surgery with money to spend, there will very likely be someone there to take that money.
John Di Saia MD
Human “Ken doll” Justin Jedlica has spent more than $100,000 on plastic surgeries to transform himself into remarkably plastic-like man he is today. Jedlica appeared on the UK talk show, “This Morning” to talk about his plastic surgery. He told hosts Eamonn Holmes and Ruth Langsford that he doesn’t think of his multiple plastic surgeries as an addiction rather he sees it as “being artistic,” The Daily Mail reports. Comparing himself to Picasso he said to the hosts, “It’s creative, would you ask Picasso not to paint? Why is it any more offensive because I choose to be creative through surgery?”
It is funny in a way how philosophy makes such a difference in the land of cosmetic surgery. Most plastic surgeons are taught in residency to aim for natural looking enhancements. Some clients however aim for results others would find freakish. The Barbie and Ken Doll phenomena are evidence that in this society in which “judgment” is a bad word and a lack of standards have become the order of the day that we have opened a door. The door now leads to wherever a client wants whether or not the rest of society might secretly gag.
I do not deny that people have the right to do whatever they want with their bodies, but I do not always seek to be a part of it. This is much to the chagrin of my accountant at times.
John Di Saia MD
The United States used to be quoted as the land of decadence. The Chinese might be making a move on this position however:
A dog breeder in China is suing an animal hospital after his Tibetan Mastiff died while undergoing a face-lift procedure, according to reports in local media. The canine — a trophy dog among the nouveau riche in China — died on the operating table in November after suffering heart failure, possibly linked to the anaesthetic used. The breeder, named as Mr Yu and the owner of a dog farm in Shunyi district of Beijing, said that he had hoped the plastic surgery would make his Tibetan Mastiff more attractive to other owners looking for a breeding partner for their dogs.
So it sounds like the owner here was trying to defraud some dog owners by making his dog look like a good breeding partner. I can’t help but think that many would feel plastic surgery on a dog would constitute cruelty to animals. I doubt the mastiff cared much for how he looked. Then again the prevailing opinion in the US likely means little in China.
Mr Yu probably didn’t read my other relatively recent lawsuit story in which a man sued his wife for fraud after she had plastic surgery that was unknown to him. We’ll see how the Chinese courts treat him.
John Di Saia MD
Malpractice suits are not all that interesting unless you work as an expert witness which is amongst my job descriptions. In this case a former Dr 90210 doctor was sued by a former patient who’s attorney was to make some silly claims:
Del Carlo’s lawyer, Michael Gulden, said his client was hurt by the inability of an expert witness to be present as scheduled and testify on her behalf. He said the witness would have told jurors that Li should have instructed Del Carlo after the September 2010 surgery to avoid letting shower water hit her wounds and to keep those areas dry for a specified period of time. Del Carlo eventually developed an infection, Gulden said.
I do not tell my patients to keep their wounds dry in all cases. I usually tell them to let the shower water run off them and pat them dry. I do however advise they avoid immersion for a specified period of time. The exact advice relates to the exact wound.
The myth that shower water is uniformly risky for wounds is like many others in medicine. For clean closed surgical wounds, the shower is usually not a danger. In fact, it can help keep them clean when properly applied.
John Di Saia MD
When you dine out, an inspection lets you know the restaurant is safe. The same is true with your car and your daycare. The state looks at all these things to protect you from harm.
But sometimes we just assume things are getting a closer look, especially when it comes to health care. That’s not always the case according to Dr. Peter Pronovost, VP of Patient Safety and Quality at Johns Hopkins Hospital. He says, “Your average viewer would never dream that that’s the case. They think when you’re delivering care, there’s got be some oversight.” There is tremendous oversight in the operating rooms in hospitals. But in Maryland, some other locations where surgery is done simply don’t. Maryland’s Health Secretary, Dr. Joshua Sharfstein, acknowledges some clinics where cosmetic surgery procedures are done don’t get licensed or inspected. In Maryland, he says medspas and plastic surgery clinics that don’t bill insurance as “ambulatory surgery centers” aren’t overseen like hospitals, even though they may do some of the same procedures.
Regulation in medicine varies by location. The writer of this piece seems to feel that regulation brings safety. This is a a matter of philosophy. Mine is that making good choices is the safest thing a potential medical client can do.
We have discussed the Caveat Emptor atmosphere of cosmetic surgery. It is really up to the prospective patient in choosing her surgeon and facility, to look into the quality of these critical components. In this case, a woman died after liposuction in a Medspa apparently from an aggressive post-operative infection. In the right circumstances, these infections are extremely rare, but the review by the State involved found some irregularities in the anti-infective practices that probably made this more likely. Most qualified surgeons operating in certified operating facilities don’t see a case like this in their entire careers.
It is too late for Eula Witherspoon who died in this Maryland Medspa. She apparently assumed that the facility was certified and that her surgeon was qualified to do her surgery; a mistake that many seem to make. All because a business offers a medical procedure does not make it risk free and risk varies by location and practitioner.
Liposuction can be safe, but don’t expect the State to make it safe. You must screen your surgeon and facility. To limit risk, liposuction should be done in a proper operating room by a qualified surgeon utilizing proper anti-infective precautions. This increases the cost which explains in part why some patients fall into the Medspa liposuction trap.
John Di Saia MD
Reader Laura Question:
A recent study showed South Korea as the place where people are most likely to have plastic surgery with the US in fourth place. It lists Botox and breast augmentation as the most common procedures being done. Are these the most common procedure that your patients request?
Plastic surgery trends vary between practices as much as they do between nations and as we’ve discussed before not all practitioners are plastic surgeons. I am a “breast and body” surgeon, so my cosmetic requests include more in this line: breast implant cases, liposuction, tummy tucks are the like.
And despite the international trend towards non invasive procedures, many of these are done by non plastic surgeons due to lesser cost. I believe in moderation anyway and offer these as support for current clients more than anything else
John Di Saia MD
ABC news [abcnews.go.com/Nightline/video/plastic-wives-cosmetic-surgery-free-18298699] ran a piece on the wives of some plastic surgeons who also happen to be the stars of a new reality show. As usual, hyperbole was everywhere. On one hand, of course they get their plastic surgery for free when their husbands are their surgeons. Mine did.
On the other hand, smart surgeons know that being judicious with the knife can make the wife look better longer. The way the statements on that ABC piece sound, its like those women are in their husband’s operating rooms all the time. Mine isn’t.
I do the occasional Botulinum toxin injection for her and a moderate depth facial chemical peel a few times a year, but she is not going in and out of anesthesia for surgery on any regular schedule. I did her tummy tuck and that’s it.
Realize that when your wife is a reality star, this is an opportunity to blow the practice up in the free marketing department. Add the fact that reality stars tend to make outlandish statements for a living and everything starts to make sense. Remember it is all just entertainment.
John Di Saia MD
…we might be seeing in Britain: the normalization of cosmetic surgery and the plasticisation of our faces and bodies. For the increasing number of us going under the knife has been scarily unaffected by recession. Borrowing for cosmetic surgery is now the third most common reason for getting into debt.
This week, the Government published the responses to its consultation on regulating the industry. For a medical process that can cause disfigurement and even death, the rules are astonishingly lax. Any doctor can practice as a cosmetic surgeon, with no specialized experience or training. When patients go for a consultation, it’s as often with a sales rep as a surgeon. There is no cooling-off period to allow people to change their minds, and some clinics take non-refundable deposits on the spot. They offer buy-one-get-one-free deals, as if boob jobs were packets of cereal, and they even bombard 17-year-olds with texts offering them procedures at their next birthday.
“Dyed in the Wool” feminists often have a hard time getting their head’s around the idea that not all women think as they do. That is not to say that all the points made in this article are false. Some are quite correct:
Cosmetic surgery has become big business with discounts and package deals as well as BS marketing fluff. And in the UK as well as the US, there are few laws regulating who can perform cosmetic procedures. Many of not most surgeons practicing cosmetic surgery are not trained plastic surgeons.
Part of the mayhem is client-mediated however:
With the relatively new concept of plastic surgery as a commodity, consumers do that which is natural with a commodity: they shop it. People want plastic surgery cheaper and entertain less qualified surgeons in poor quality facilities at times to get it. That is when things can get really scary. Death and deformity are virtually unheard of when qualified professionals exercise proper judgement, but in the contemporary plastic surgery circus this is not universal either.
Suffice it to say that even if the UK passes significant cosmetic surgery industry reform, the market will still be one of Caveat Emptor. Exercise proper judgement in choosing your surgeon and prospective surgery, and your risk will be small. Surgery however is surgery and you should not be led to believe that risk is a non-issue.
Regarding my hopes for any British regulatory changes, a reduction in the garbage that is plastic surgery marketing would be a nice change. The US following in that lead would be grand as well.
John Di Saia MD
A ban on cut-price deals and a clampdown on aggressive sales techniques for cosmetic surgery are among ideas submitted to a review of the industry ordered in the wake of the PIP breast implant scandal. A two-stage consent process for potential patients to allow them time to reflect before making a final decision were among suggestions given to the review into the plastic surgery industry being led by Sir Bruce Keogh, the NHS medical director.
I maintain my jaundiced view of legislation purporting to control the circus environment we call the modern cosmetic surgery marketplace. We have discussed the PIP implant scandal here before. These breast implants were made poorly and the silicone gel version caused quite a stir in Europe where they were used. This is a case in which the restrictions of the FDA saved American women from the harm that was a poorly made implant. I give them credit for that.
So given that the problem with the PIP implants was poor regulation in Europe, legislators probably feel the need to crank out a few laws if for nothing else other than to save face. This wouldn’t be a problem if the laws they produced actually did something. Add jaundiced eye here….
Apparently regulations that have been suggested are those that will lengthen the consent process and curtail aggressive advertising. So how would these have changed the use of breast implants that shouldn’t have been approved in the first place?
John Di Saia MD