As of Jan. 1 this year, a new law took effect in California whose intent is to provide greater safety for patients undergoing plastic surgery.

Known as the “Donda West Law”, it is named after rap artist Kanye West’s mother who died a day after cosmetic surgery in 2007. According to reported autopsy results, Donda West died of pre-existing coronary artery disease and other unspecified postoperative events a day after she had undergone a tummy tuck, breast surgery and liposuction. The exact details of these events is not known by this writer but the surgeon who performed this surgery has apparently surrendered his medical license, suggesting there are deeper issues at work here as well.

This new law requires a physical examination within 30 days before a procedure and clearance from a doctor, nurse practitioner or physician’s assistant before cosmetic surgery is performed. In essence, this makes it illegal for doctors to perform elective cosmetic surgery without a physical examination and clearance from a medical professional.

This new law will actually change very little in most plastic surgeon’s practices because reputable plastic surgeons do take a medical history and perform a physical examination before any major procedure. But it does bring to light and reinforce several important concepts about cosmetic surgery and a patient’s preparedness for it.

First, a cosmetic procedure like Donde West went through is major surgery. It should be viewed in the same light by a patient as having a hip replacement or gastric bypass surgery. While it may not be exactly the same, the extent of the procedure does pose risks which can be magnified based on one’s medical history or pre-existing health conditions. It is therefore paramount that any medical problems be well controlled, one should try and be in the best physical condition as possible and make sure that your own physician is aware of what you doing. While the desire for privacy and discretion is understandable, this should not be done at the expense of your own health.

Secondly, while not every procedure needs laboratory testing beforehand, many do and that expense should be seen as just part of the procedure. In an otherwise healthy person (no known medical problems) under age 50, no laboratory testing is needed. This will change based on if the patient has medical problems. For any patient over 50 years of age, preoperative labs are needed and include blood work and and EKG. More may be needed if other medical problems warrant it.

Lastly, be concerned if this information is not required of you before any major cosmetic surgery. Taking a medical history and filling out such on forms is almost always the very first step you do even before you ever see a plastic surgeon in their office.

While the potential changes that cosmetic surgery can create can be somewhat euphoric when one is pondering the procedure(s), the most important consideration is your safety. If a plastic surgeon suggests that you should not have the operation or recommends a less extensive approach than you want, you would be wise to heed those suggestions. This is usually an issue in major body contouring surgery. In some cases, doing the procedure in stages is both easier and safer for you. It may cost somewhat more to do so and be an additional inconvenience to your life, but that is a small sacrifice to pay for your health.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis  

Prevention of complications after plastic surgery, such as bleeding and slow wound healing, can be aided by proper management of a variety of common medications. As an Indianapolis plastic surgeon, this is the medication to-do-list (and not-to-do) that I provide to each of my patients prior to their surgery.

Medications to avoid two weeks prior to surgery:

Discontinue use of any nicotine products. This includes cigarettes, cigars, nicotine gum, and patches. Nicotine reduces the blood flow to the skin and may impair healing; and quitting smoking drastically improves the body’s response to surgery.

Stop using medications containing aspirin and NSAIDS (non-steroidal anti-inflammatory medications, such as ibuprofen, Alleve, Advil) prior to (and following) surgery. Aspirin and NSAIDS thins the blood and can produce excess bleeding and bruising. Be sure to read the labels of any over the counter remedies you regularly take as many commonly-used medications contain aspirin. (e.g., Alka Seltzer) For the same reason, also avoid Vitamin E supplements and red wine prior to surgery.

Stop all herbal medications before surgery. The most common herbs used are Echinacea, Ephedra, Garlic, Ginseng, Ginkogo, Kava, St. John’s Wort, and Valerian. They may adversely effect anesthetic drugs, prolong bleeding and impair healing after surgery.

Medications to start two weeks prior to surgery:

Begin using an Arnica supplement 7 days prior to surgery and continue for two weeks following surgery. Arnica is a naturopathic remedy that not only helps prevent bruising but also aids in clearing bruising that has occurred faster after surgery. We have both orally-taken Arnica tablets and topical Arnica patches and gel tubes available at my OLOGY Spas for this purpose.

Begin a good multivitamin supplement at least two weeks or more ideally one month, prior to surgery. A normal dose of vitamins and minerals combined with a diet high in protein provides the necessary building blocks for wound healing.

Begin high dose Vitamin C supplements. (2 grams per day) both before and after surgery. This well known vitamin is the key nutrient needed for making collagen after surgery, which is what heals your tissues together. Because Vitamin C is water-soluble, there is no risk of overdosing on it. What is not used by your body will be excreted in your urine.

You might also consider adding Vitamin K to your diet. This fat-soluble vitamin plays an important role in blood clotting and can be found in spinach, broccoli, and kiwi.

Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis