Posts Tagged plastic surgery complications
Reader Laura’s Comment:
The ladies in this story have had a “new” form of lipo instead of a tummy tuck. Their stomachs do look thinner but their skin in wrinkly. Would they have been better served by having a tummy tuck and then lipo? Is it just their age that has their skin looking that way?
VASER liposuction has been around for a while. I have used it and it is effective. The main question with newer lipo technologies is: “Are they worth the added expense and can they increase problems?”
Many of them (VASER included) make it even easier to take out more and more fat. As we have discussed here before of course more fat removal is not always desirable.
The concept of “oversuctioning” has been around far longer than these newer tweaked lipo technologies. It can happen with liposuction in any of its forms as each technique requires a judgment call. When a surgeon over suctions an area it can lead to an increased tendency for the skin sag unattractively making some of these people almost look like prunes. In the UK they are calling it “Turkey Tummy.” The age of the patient and any previous surgery are part of the story making the judgment call harder at times. Of course some patients will not agree to a tummy tuck even if it offers real skin tightening and this might also be part of the problem. I can do the “right” operation but only if the patient allows it.
John Di Saia MD
Originally posted 2009-12-30 07:30:54.
I did labioplasty after I saw some ads that suggested that big labia were abnormal. Before that I had no physical discomfort or insecurities. But after I heard about labioplasty I got extremely ashamed of myself. Now that I have done it I look mutilated and after 7 months I still have agonizing pain and sex is impossible.
To what extent do we have to butcher our normal bodies to catch up with the media created “ideals”?
What can you say to a comment like this?
First of all, although I feel for your situation, patients really need to educate themselves before having this type of surgery and choose good surgical talent. I am not sure you did this. This surgery has many variants so what exactly you had done is unknown to me as you are not my patient. Some operations are obviously better than others.
I do not recommend people have surgery based upon advertisements alone and my practice does not advertise for this type of work. I never suggest that a woman’s Labiae are “abnormal” or “need surgery.” This is a matter of philosophy.
My labiaplasty patients do not have the experience (or the complications) you describe. They are examined periodically until they are healed and back to sexual activity. They report they look and feel better. Not one of them to date has desired to go back (even if she could) to her pre-operated condition. Long term pain is extremely unusual when the operation is properly performed by modern techniques.
It seems very likely that you had the wrong operation by the wrong surgeon. Better research by others will help them avoid your unfortunate mistake. I do hope you are able to have your result improved to your satisfaction.
John Di Saia MD
Originally posted 2010-02-22 17:00:19.
A Costa Mesa cosmetologist was charged Thursday with practicing medicine without a license after she allegedly caused second-degree burns while attempting cosmetic surgery on a tummy tuck scar with a laser.
You gotta love this one: a lady gets burned when allowing a Cosmetologist to use a laser to treat her tummy tuck scar. When you want a scar treated maybe look into a plastic surgeon for a scar revision?
John Di Saia MD
Originally posted 2009-01-15 08:30:00.
“Lisa Rinna Lips” is the real topic of this story:
News of the burglary overshadowed Rinna’s earlier revelation that she’s had that famous, artificially enhanced upper lip of hers reduced through cosmetic surgery. The actress, 47, revealed to People magazine she underwent the surgery in August to reduce the pillowy upper lip she had injected with silicone on a whim back in 1986. In the couple’s first segment on TODAY Tuesday, she told Meredith Vieira, “I did it because I no longer wanted my lip to define me. I had never thought that you could do anything about it, and I found out there is something you can do. I had no idea you could reduce it, so I was like, ‘Yes! Let’s do it.’ ”
As Ms Rinna was doing her media rounds for her reality show, the subject of her famous lips of course came up. She apparently described her recent procedure as a lip reduction. This was much more likely a “removal” operation designed to cut out the silicone scar from her silicone injections of years prior. Liquid silicone when injected into soft tissue does not usually stay soft over time. It frequently becomes encased in firm scar at times forming hard lumps which can hurt.
Lip surgery to remove old silicone injected there is the only real way to improve people who have had silicone lip injections. Ms Rinna’s lips were becoming kinda funky. It is difficult to know how much of this was the silicone and how much might have been something else she had used. Surgical excision (in Ms Rinna’s case reduction) is not always feasible. Hers worked out well by report.
The better alternative when first considering lip augmentation is to choose a safer filler and use a moderate amount at most. Silicone injections are best avoided. Hyaluronic acid based fillers (Restylane, Prevelle, etc) are much safer, but do not last too long.
John Di Saia MD
Originally posted 2010-10-06 07:30:49.
“What do you think the future of these patients will be? Will they be able to get saline implants now and/or reconstructive surgery? What health risks are there with the silicone still being in their body? Will they have to have multiple surgeries to remove all of the silicone?”
A children’s nanny whose breast implants split is one of more than 165 women preparing legal action against the French company that made them. Sarah Neale, 29, spent more than £4,400 seven years ago having her breasts enlarged from a 32B cup to a 32DD. But, two years ago, she was horrified when she found that gel had seeped out, leaving silicone lumps in nearby tissue.
All silicone gel implants leak to an extent. The Poly Implant Prothese (or PIP) implants have been found to leak more and reportedly contain a poor grade silicone. Silicone leakage within the body can cause problems requiring surgery to remove scar, calcium and gel remnants. It is usually not possible to remove all the gel and reactive change, but most can usually be removed. Few women will require multiple operations and more involved reconstruction. Some will have some residual deformity depending upon how little healthy tissue they have left when the implants and scar are taken out. It is debatable as to what may be the effects of the silicone that remains in the body. This also varies.
Interesting in the PIP implant debacle is the fact that these implants were the cheapest and therefore were widely used for a time. The difference in cost for the saline PIP implants that used to be marketed here in the US was very small compared to their US made counterparts. I used a few pairs years ago and stopped even before they were removed from the US market. I didn’t think it was worth the risk.
John Di Saia MD
Originally posted 2010-11-30 07:30:27.
Reader Laura’s Comment:
“A Bronx woman has been arrested for running a clinic inside of her apartment where she offered boob and butt injections. She used silicone imported from her native Dominican Republic. The feds even found a residue of crazy glue on some of the medical waste. I can’t even imagine what she would have done with the crazy glue. I can’t imagine how it is ever acceptable to ever go to someone’s apartment for a medical procedure. This woman even discouraged one woman who was having complications from seeking medical treatment. Do you think anything could have been done to prevent this from happening?”
Whalesca Castillo, 36, who the feds claim is an unlicensed doctor, was arrested at her home this morning on Inwood Avenue in the Mount Eden section after she was mailed, via FedEx, “a silicone substance” she used as part of an illegal clinic she was operating out of her apartment.
Silicone injections are dangerous. We have previously discussed stories of silicone injection-related death when large amounts have been injected into breasts and buttocks. We have also reported on the smaller injection related problems such as distortion and painful lumps like those experienced by Lisa Rinna leading her to having her enlarged lips reduced. The problem is that there are still people who are poorly informed and submit to less-than-qualified injectors injecting ill-advised substances into their bodies under sub-standard conditions. People have to exercise judgment when considering these treatments. Apartment-based clinics and other black market enterprises do not operate where law enforcement can easily find them.
To answer your “crazy glue question,” the hordes of the unqualified are reportedly using crazy glue to close their access incisions. If a surgeon can’t even get his or her hands on proper sutures to close your wounds, you are probably better off not having that procedure.
John Di Saia MD
Originally posted 2011-01-19 07:30:18.
Stacey Cavaliere’s story starts off pleasantly enough. After two years of diet and exercise she lost 135 pounds, and as a reward she was planning a Costa Rica vacation, where a nice relaxing trip awaited her. Or that’s what the tourist Web site promised her. It also promised that Caveliere, 35, would come back lifted, tucked and toned in places where her extreme weight loss yielded excess hanging skin. But upon returning to the U.S., Cavaliere wasn’t showing off her new body — she was rushed to the emergency room where her abdomen had to be completely reconstructed after a botched body lift. Only after eight surgeries did she end up with the body she wanted.
The problem with trying to offer large scale surgery on the cheap is that you often are short changed on the technical and safety aspects …the stuff that really matters. Any patient can get a wound infection, but if these are detected early in good follow-up they are much less damaging. Using the proper precautions they are rare, but what if some of those precautions are skipped because they are deemed too costly? You are the one who loses here.
When your surgeon lives on another continent, it is difficult to get good follow-up care even if the surgical care was good. This woman had a catastrophe requiring eight operations by a domestic plastic surgeon for repair. In this case, cheap became really expensive.
John Di Saia MD
Originally posted 2009-03-27 14:25:00.
Huge Breast Implant Removal?
Just wondering what your thoughts were on girls such as this. I understand these sort of implants were only available for a short time only….can’t imagine why they were ever invented actually! Are these implants able to be removed? What are the long term complications?
As we have mentioned before, silicone gel doesn’t do a body good. When this stuff is placed into your body, your tissues are best shielded from the bare silicone gel. The degree to which there may be a problem can be minimized, but the larger breast implants have more involved effects upon the patient’s body than smaller ones.
When the implants get really large, those changes affect not only the skin and soft tissue, but also the chest wall (ribs, and bones.) Really large implants actually wear into and bend bones and cartilage. These kinds of problems are most commonly seen in reconstructive breast surgery (re-creation of the breast after breast cancer treatment,) but would certainly affect patients with huge breast implants over time. The implants this woman has are in the “well over a 1000 cc each.” You can’t get them in the United States and I wouldn’t want to place them if you could. This makes my malpractice carrier happy.
Very few of these “super large” implant patients come to having their implants removed (without replacement) as the appearance afterward would be pretty unusual. Such a patient would likely have to have several operations to take in the stretched skin and would likely be left with noticeable contour defects visible under that stretched skin, that is, if the implants were not to be replaced.
I think it is safe to say that most people would categorize implants in this size as “ridiculous breast implants.”
John Di Saia MD
Lisa, 51, a twice-divorced mother of three who did not want her last name used, enters Clinica San Antonio in Laredo Mexico June 18 2004. She was rejected for plastic surgery in Texas because of a heart condition. Lisa says she is depressed about her appearance and plans to under go an eye lift, face lift, arm lift, leg lift, tummy tuck, breast augmentation, and bladder lift — all for $8000.
Do you really want plastic surgery in Mexico? This story of a woman who went to Mexico for a cheap plastic surgery overhaul has images of a dirty operating room and ants on the sink. She set forward to do massive marathon plastic surgery after having been turned away in Texas because of a heart condition. Despite her problems with the schedule she had set for herself she is fortunate not to have been more severely injured. She apparently got infected in her tummy tuck wound and was given incorrect antibiotics by the Mexican clinician. Patients with heart conditions can be high risk for even moderate length surgical cases.
The pictures are kinda graphic. This story shows the world of the “chop shop” and illustrates exactly what you avoid by going with a reputable plastic surgeon. Safer smaller scale surgery might have been possible but at a much higher price tag in the US and over a longer time period.
If you are thinking of cheap third world plastic surgery, here is the story of a woman who did just that.
John Di Saia MD
Originally posted 2006-08-31 15:55:00.
Can you explain why Dr Morris Ritz, from the Melbourne Institute of Plastic Surgery, who is a fully trained reconstructive/plastic surgeon, would have subjected a patient to an EIGHT HOUR SURGERY with MULTIPLE procedures, each of which was supposed to be done one at a time? This segment aired on Australian Sixty Minutes, Channel 9 on 27th August 2010 and the woman’s name is Kerry Mullins. I am in shock, as this poor woman has been mutilated. She developed a shocking infection and Dr Ritz did not offer her any after care- in fact, when he discharged her from the first hospital he never saw her again. How can this level of malpractice occur in such a well trained doctor, and is it common?
TARA BROWN: At 35, after having five children, Kerry Mullins thought cosmetic surgery was the quick-fix she needed to get her body back in shape.
KERRY MULLINS: I didn’t want to ever be a supermodel or completely change the way I was. Just to feel like a woman again, you know, like a normal woman again. That’s all I wanted.
TARA BROWN: Kerry Mullins went to see plastic surgeon Morris Ritz, here, at the Melbourne Institute of Plastic Surgery. She wanted a breast lift and tummy tuck. He sold her what is known in the industry as a ‘mum’s makeover’ – a $25,000 package, which included a breast lift, extensive liposuction and a tummy tuck. A three-in-one operation, which took eight hours to complete, and nearly cost Kerry her life.
KERRY MULLINS: I just remember closing my eyes and then, the next time I woke up, I woke up to a nurse holding my breast and prodding me and Mr Ritz then came in and he was stabbing my nipple with a needle to try and get it to – sorry, can I stop for a minute?
TARA BROWN: A massive infection was ravaging Kerry’s body, and she was rushed into emergency hospital care.
KERRY MULLINS: I was in there for three months, and each and every other day they’d take me down to theatre and so I had 22 operations all up, and every second day they would cut it away, cut it away, cut it away until it was just a big hole in my chest.
I cannot speak to the training an Australian plastic surgeon receives in residency training, but “Mommy Makeovers” are becoming more commonplace. Stacking large scale operations and entertaining longer anesthetics and surgical procedures is the trend. I have never said it was a good idea. Many times doctors defending such scalpel-fests do so by stating if they didn’t schedule such a case one of their competitors might have.
Malpractice in Australia may be hard to prove. It is here in the United States. The amount of aftercare that is appropriate is widely subject to debate. Poor outcomes happen even in cases involving lesser surgery although thankfully I have never had such a catastrophe in my practice. Then again I stage operations over a period of time when I feel it is appropriate.
John Di Saia MD