Brazil has almost as many plastic surgeons as the U.S. (around 5,500) but with just half of the population. (just over 200 milllion) As a result there are a large number of cosmetic surgeries done in Brazil and it is well known that the cultural standards of beauty and its pursuit have contributed much to the high number of procedures done there. In Brazil it is usually seen as a badge of honor (and status) to have had cometic surgery and people do not make much effort in camouflaging their aesthetic experiences. Some have phrased that visiting a plastic surgeon’s office is as common as visiting a shopping mall for many Brazilians.
But the high demand for cosmetic changes throughout the population creates a ripe environment for ill advised procedures and a subculture of unqualified and unscrupulous providers. It is estimated that while there are about 5,500 certified plastic surgeons, there are over 10,000 other doctors, paramedics and people with no medical training at all performing cosmetic procedures according to the country’s medical licensing counsel. Such unqualified providers, low prices and the hope of a quick fix set the stage for what has become a bit of an epidemic that is not exclusive just to the country of Brazil.
The Brazilian Andressa Urach became a reality TV sensation after having had numerous plastic surgery procedures from breast implants, rhinoplasty and other injectable treatments. As a result of her ‘success’ and celebrity status, she was a highly visible and outspoken advocate of cosmetic surgery. But after having some injectable material placed into her thighs recently, she went into septic shock and was placed on life support.
Such events are both tragic and completely avoidable and they always come from the same cosmetic procedure, injectable body augmentation with synthetic materials. While such injections create an instantaneous change, such as in buttock, hip or thigh augmentation, they are fraught with potential complications both immediate and long-term. The cause of Urach’s medical crisis is always the same when large volumes of synthetic material are injected into the body…the risk of pulmonary embolism and infection. The very small particles of the synthetic material, often plastic beads, gels or oils, when injected under pressure can find their way into blood vessels which are often bigger in diameter than the material. When entering a vein they can be carried back to the heart and into the fine vessels in the lungs where they become trapped creating a life threatening pulmonary embolus. They can also enter a small artery blocking blood flow to a segment of the overlying soft tissue and skin causing necrosis and tissue death of portions of the augmented area. (tissue ischemia)
These ‘black market’ injectable complications, which happen in the U.S. as well as Brazil and other countries, result from a combination of women focused on attaining beauty through a quick fix. As plastic surgeons we often wonder how people could be so oblivious to the risks of untested and unapproved materials by some providers that have less training than their electricians or plumbers. Body augmentation is a surgical procedure and should only be done by established methods and materials board certified plastic surgeons who have the training and experience to do them. Even in the best of circumstances there are risks and potential complications. In the worst circumstances lifelong disability/deformity and death could be the outcome.
Dr. Barry Eppley
Indianapolis, Indiana