The well publicized death of Donda West in November 2007 after undergoing cosmetic surgery has given rise to a new California law. Governor Arnold Schwarzenegger has taken a step towards making more strict laws pertaining to cosmetic surgery following the tragic death of rapper Kanye West`s mother. The new bill is designed to provide greater safety for people who seek cosmetic surgery.
The bill introduces the Donda West Law which requires anyone undergoing plastic surgery in the state to receive a mandatory physical examination first. The Governor had vetoed the first phase of the bill last year, but has now finally signed it after it was resubmitted in February this year. Ensuring that a patient is healthy enough to go through surgery is an obvious important consideration to decrease risks after the procedure. While some patients may think they are well enough for cosmetic surgery, in reality, they may not be for certain types of procedures.
While this law is certainly only a good thing, it is a shame to see that the government has to enact legislation that is really only good medical practice. All practitioners of cosmetic surgery are physicians who graduated from medical school and are licensed in their state. Regardless of what specialty they come from before performing cosmetic surgery, every physician has the medical training to evaluate a patient’s health status. At the very least, they have a medical history which lists their medications, allergies, past surgeries, and known medical problems. Based on this information, they can make the judgment whether further medical testing and work-up is warranted by the patient’s own physician. To require legislation to ensure this is completed (we are talking about a simple physical examination here) suggests that cosmetic practitioners can get a little complacent and forget that we are still practicing medicine, albeit not life-saving.
But despite a good medical evaluation and/or work-up before surgery, risks and complications can and do occur after cosmetic surgery. Even a clean bill of health does not guarantee a complication-free recovery. Fortunately, such significant complications are rare given the millions of cosmetic surgeries that are performed per year in the United States. Certain plastic surgery procedures of the body, particularly tummy tucks and liposuction, present higher risks of potential significant complications (e.g., deep vein thrombosis, pulmonary embolism) given the surface area that is being traumatized. Limiting the length of the surgery, recovering patients overnight under medical supervision if necessary, and encouraging early physical activity is just as important as a good preoperative evaluation.
Dr. Barry Eppley
Indianapolis, Indiana