By Alan Mozes
MONDAY, Sept. 26 (HealthDay News) -- "I was in shock," recalled 40-year old Dinora Rodriguez. "It was a nightmare."
Rodriguez had woken up from cosmetic surgery only to find that she could not move her arms or even close her eyes. And so begins a harrowing account of plastic surgery, in her case involving breast implants and a facial scar, gone terribly wrong.
As a cautionary tale, Rodriguez' experience highlights the urgency behind a new safety campaign launched this week by the American Society of Plastic Surgeons (ASPS).
The goal: to draw attention to the physical disfigurement and emotional torment that can follow when patients fail to check a surgeon's credentials before they go under the scalpel.
"I already had implants put in five years earlier, in Mexico," explained Rodriguez, who lives in Los Angeles. "And that time, the first time, I had no problems. But I wondered if they were still OK, or if it was time to replace them."
"So I had this friend who recommended this doctor to me," she continued. "She said she had had liposuction done on herself, and both her daughters also went to this woman. So I went. I never checked on her background or if she was certified. I just went."
"And she told me," remembers Rodriguez, "that I needed a mammogram [to check the implant]. And after, she told me that it showed that one of the implants was leaking, and I needed to replace them right away because it was not good for my health."
It would be months before Rodriguez would find out the truth: her doctor had lied. There was no leakage, and thus no need for new implants.
"But that wasn't all," she said. "That day she also discussed a scar I had on my face [near the eyes], because of an accident. She said she could fix it. And I said I would think about it. On the day of the implant surgery she asked again, about my eyes. She said she could fix it at the same time. That it was simple. But I said no. I said, 'I don't want to deal with two pains at the same time.'"
"But when I woke up I found that she had operated on my eye, on both my eyes, without my permission! I was shocked and upset. And in pain. So much pain."
As it turns out, Rodriguez's physician had removed so much skin from around the eyes that Rodriguez was no longer able to fully close them. What's more, the breast surgery had been botched as well, the result of two breast implants having been inserted into one packet.
"We hear these stories over and over again," warned ASPS president Dr. Malcolm Z. Roth. "And worse. Situations arising from 'my friend who gave me the reference.' And to that I say: you spend time researching buying a car. You look for a safe car, and you put on your seatbelt. You take it seriously. But unfortunately people often think that getting cosmetic surgery is something else. It's not. It's serious. You're taking your life into your hands."
"Because these are not emergency procedures, you have an opportunity to do the homework," noted Roth, who is also chief of plastic surgery at the Albany Medical Center in Albany, NY. "You make sure that the person you're considering going to is first off a physician, of course. And most important, that they're board-certified in plastic surgery by the ASPS. Not in some other field."
Because appearances can be misleading. Part of the new ASPS campaign is focused on a problem the group calls "white coat deception": the fact that just because a doctor has a medical license does not mean he or she is properly trained and qualified to perform plastic surgery.
The problem stems from the fact that only four states (California, Florida, Louisiana, and Texas) have laws on the books requiring that physicians take steps to disclose the specifics of their medical background. In all other states, no such regulations exist. That leaves a pediatrician or a gastroenterologist, for example, free to cross over into the role of plastic surgeon at will and without disclosure.
"And because cosmetic surgery by it's nature can be done in an outpatient facility, doctors can -- and do -- promote themselves as a plastic surgeon, even if they have never held a knife in their life, and there's no one there to stop them," Roth said.
Some so-called plastic surgeons may not even be doctors at all, but con artists preying on vulnerable individuals. Last July a 22-year-old California woman died after being given silicone injections in the buttocks in an operation run by two sisters who did not have medical licenses to practice in the United States, according to Los Angeles Times.
To avoid such potentially deadly scenarios, the ASPS calls on patients to search for certification credentials at the organization's website (www.plasticsurgery.org), and confirm that properly sealed credentials are readily viewable in the physician's office.
"All our members have a minimum of six years of surgical training in plastic surgery," Roth said. "All have completed oral and written examinations, and continue to pursue 50 hours a year of continuing education, with an important emphasis on patient safety. And none operate in a facility unless it is accredited with all the bells and whistles needed for the rare occasion when there is a problem."
Unfortunately, Rodriguez was not so lucky.
"I looked deformed" after the surgery, Rodriguez said. The uncertified surgeon "tore skin from my cleavage, and I looked like I only had one breast. But she told me that she had done nothing wrong, that my breasts were only swollen, that I needed a couple of months to heal, and that my eye scar had looked so ugly that I 'needed' the surgery."
Unable to fully move her arms or even lay down comfortably, Rodriguez returned to the doctors a few months later, still racked with pain and unable to close her eyes. But the physician turned her away, declaring: 'I don't want to see you; you are not my patient anymore. I can fix it, but there's nothing I can do until you pay me more money.'"
That was four years ago. In the intervening years, Rodriguez said enduring pain has been accompanied by deep and recurring bouts of depression, at one point culminating in a suicide attempt.
On a positive note, reconstructive surgery conducted at a different facility has done much to restore the appearance of Rodriguez's breasts. But nerve and muscle damage lingers. And to date her eyes remain, in her words, "a permanent mess."
"This should be a wake-up call to anyone considering plastic surgery," stressed Roth. "The most important thing is patient safety. You don't want plastic surgery to be a game of Russian roulette."
For more on plastic surgery and patient safety, visit the American Society of Plastic Surgeons.
SOURCES: Malcolm Z. Roth, MD, president, American Society of Plastic Surgeons (ASPS), and chief, division of plastic surgery, Albany Medical Center, Albany, NY; Dinora Rodriguez, Los Angeles
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