Another tragedy involving liposuction surgery was highlighted in a news story out of New York earlier this week. An alleged ‘plastic surgeon’ was charged with homicide in a model’s death in which he performed liposuction. The 51 year-old female suffered from heart disease and had heart transplant surgery in 2004 and was on anti-rejection medication. The patient collapsed in the doctor’s office during the procedure in which it was ultimately determined that she suffered a heart attack which was the cause of her death.
This tragic story has several relevant points that are likely not apparent to the casual observer. They merit reviewing because almost every time we see such a morbid liposuction event there is more to the story than this proves that ‘liposuction is a dangerous procedure’.
While the new story headline incriminates the doctor who performed this liposuction procedure as a plastic surgeon, nothing could be further from the truth. He was not a board-certified plastic surgeon…rather he was an internist with no formal plastic surgery training. He was ‘certified’ by the American Board of Anti-Aging Medicine…a board not yet recognized by the American Board of Medical Specialties and certainly not one that conveys any expertise in plastic surgery.
The real negligence part of the story is not that liposuction was performed in an office setting under local anesthesia, that in and out of itself is common practice. The fact that the patient had a history of being a heart transplant patient is a major oversight that merited a cardiologic opinion on the adviseability of lipsuction in such a patient. There is the allegation, although it seems like it is factual, that the doctor did know of her heart history and falsified her medical intake forms after her death to eliminate any such references. This suggests not only a complete disregard or lack of understanding of her medical condition (certainly an internist would know better) but a severe breach of ethics as well.
While it is often perceived that lipoosuction done under local anesthesia is safer, it is not an innocuous procedure either. High doses of infused lidocaine to get the treated area adequately numb are well known to result in cardiac toxicity. Higher doses of lidocaine are often used in liposuction done under local anesthesia than when one is put to sleep for adequate pain control. In the patient with a cardiac history, infused lidocaine done awake or asleep can result in disastrous consequences if too high a level is achieved.
While liposuction can be a very low risk procedure, it requires good judgment which comes from adequate training to keep it so. This behooves potential patients seeking a cosmetic procedure to be sure they are seeing someone who is properly trained. While there are doctors with widely variable medical backgrounds who perform liposuction surgery, your safest bet is to look for a plastic surgeon who is board-certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons. While any licensed physician can buy liposuction equipment and learn the basics of the liposuction technique, that does not convey the knowledge and judgment of how to use it well and whether it should even be done at all.
Dr. Barry Eppley
Indianapolis, Indiana