A recent report out of China was that of a death due to plastic surgery. What was most significant about this report, besides the obvious tragedy, is the procedure which ultimately resulted in the patient’s demiss. While deaths from plastic surgery procedures are extremely uncommon and have been reported in the past, most involve a cosmetic operation done on the body.Such lethal occurrences are even more rare in plastic surgery of the face.
A young prominent 24 year-old female (she was an aspiring pop singer who was on China’s equivalent of ‘American Idol’) died in November while undergoing ‘facial-bone grinding surgery’. According to the report, her jaw bleed uncontrollably at some point in the operation which lead to it accumulating in her throat. This blocked her ability to breathe and she subsequently suffocated and died.
What was this ‘facial bone grinding surgery? This does not sound like a very common cosmetic facial procedure and why would anyone have their facial bones ground on? While I don’t know any of the details of this specific surgery, it could only be that of a jaw angle reduction procedure. While very rarely requested or done in Caucasian patients and in the U.S., it is actually a fairly common cosmetic facial procedure in the Asian patient and in countries such as Korea and China. In the desire to have a more slim and less broad face, narrowing the prominent jaw angle is one facial procedure that helps achieve that goal. It is not usually done by grinding or burring of the bone but by actually cutting off the angle of the jaw bone with a saw. One of the known potential complications, albeit rare, is to inadvertently cut one of the large blood vessels to the surrounding masseter muscle which envelopes the bone. This may cause a lot of bleeding but it isn’t usually a lethal complication.
How is it possible for this young lady to have suffocated from the bleeding during her surgery? This could only have happened from the type of anesthetic she was having. Always in my hands, this isan operation that is done with the patient fully asleep (general anesthetic) and having their airway protected by an endotracheal tube. This breathing tube not only makes sure that one’s airway does not get blocked but also prevents any fluid that would enter the throat from being allowed to get into the lungs. For her to have suffocated from the bleeding, she must not have had a breathing tube in a place. This also means she was done under some form of local or sedation anesthesia…an almost unthinkable notion for this kind of surgery. Besides patient comfort, a general anesthetic with a protected airway also helps ensure patient safety should bleeding events like this one should occur.
Like many tragic outcomes from cosmetic procedures, close inspection of the story often bears out that uncommon and unusual approaches were being done. Taking shortcuts in cosmetic surgery should never over ride patient safety measures.
Dr. Barry Eppley
Indianapolis Indiana