Sunday, June 27, 2010

IPL and Laser Damage

I came across this messageboard today and feel it is well worth visiting by anyone interested in any cosmetic procedure.

Also worth reading: What is IPL and Laser Damage Support All About?

The people who truly have the power to put an end to the devastating harm caused by the cosmetic surgery industry are out there.. You. You can "just say no" to subjecting your normal, healthy body to the trauma of unnecessary cosmetic procedures! What? Sounds too simple? If you can't say no, then at least realize that you are gambling with more than your looks. You are gambling with your health and your life.

Friday, April 9, 2010

FDA Warns About Lipodissolve Product Claims

It's a tempting premise: Get a series of drug injections and see pockets of fat on your body go away for good.

But the Food and Drug Administration (FDA) is alerting consumers about false and misleading claims being made about products used in lipodissolve, and about other misbranding of these products.

Recipients of lipodissolve get a series of drug injections intended to dissolve and permanently remove small pockets of fat from various parts of the body. The process is also known as injection lipolysis, lipozap, lipotherapy, and mesotherapy.

“We are concerned that these companies are misleading consumers,” says Janet Woodcock, M.D., director of FDA’s Center for Drug Evaluation and Research. “It is important for anyone who is considering this voluntary procedure to understand that the products used to perform lipodissolve procedures are not approved by FDA for fat removal.”

The drugs most regularly used in the lipodissolve injection regimen are phosphatidylcholine and deoxycholate (commonly called PC and DC, respectively). Other ingredients may also be used, including drugs or components of other products such as vitamins, minerals, and herbal extracts.

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What Consumers Should Know

FDA is alerting consumers that

  • it has not evaluated or approved products for use in lipodissolve
  • it is not aware of evidence supporting the effectiveness of the substances used in lipodissolve for fat elimination
  • the safety of these substances, when used alone or in combination, is unknown
  • it is not aware of clinical studies to support medical uses of lipodissolve

In addition, FDA has reports of unexpected side effects in people who’ve undergone the lipodissolve procedure. These side effects include

  • permanent scarring
  • skin deformation
  • deep, painful knots under the skin in areas where the lipodissolve treatments were injected

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FDA Actions

On April 7, 2010, FDA announced it had sent warning letters to six medical spas in the United States—and a cyber letter to a company in Brazil—for making false or misleading statements on their Web sites about drugs used in the procedure, or for otherwise misbranding lipodissolve products. (Cyber letters are letters sent to companies whose U.S. online sales of products may be illegal.)

The U.S. medical spas receiving warning letters make various unsupported claims about lipodissolve, such as assertions that the products used in lipodissolve

  • are safe and effective
  • have an outstanding safety record
  • are superior to other fat-loss procedures, including liposuction

Additionally some of the letters indicate that the companies have made claims that lipodissolve can be used to treat certain medical conditions, such as male breast enlargement, benign fatty growths known as lipomas, excess fat deposits and surgical deformities.

The U.S. companies receiving warning letters in regard to lipodissolve products are

  • Monarch Med Spa, King of Prussia, Pa.
  • Spa 35, Boise, Idaho
  • Medical Cosmetic Enhancements, Chevy Chase, Md.
  • Innovative Directions in Health, Edina, Minn.
  • PURE Med Spa, Boca Raton, Fla.
  • All About You Med Spa, Madison, Ind.

FDA is requesting a written response from these U.S. companies within 15 business days of receipt of the letters stating how they will correct these violations and prevent similar violations in the future. These firms were told that failure to promptly correct the violations may result in legal action.

The Brazilian firm getting a warning letter markets lipodissolve products on two Web sites: and FDA will notify regulatory authorities in Brazil of this action. The agency has issued an import alert against the and entities to prevent the importation and distribution of unapproved lipodissolve drug products into the United States. Importing and distributing unapproved drug products is a violation of the Federal Food, Drug, and Cosmetic Act.

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How to Report Side Effects

Consumers and health care professionals may report serious side effects with the use of lipodissolve products to FDA’s MedWatch Adverse Event Reporting Program either online, by regular mail, by fax, or by phone.

This article appears on FDA's Consumer Updates page6, which features the latest on all FDA-regulated products.

Date Posted: April 7, 2010

Thursday, March 25, 2010

Botox death lawsuit filed in Indiana over death of young girl

The parents of a 10-year old girl with cerebral palsy who died in 2008 have filed a lawsuit against Allergan, Inc. and the doctors who treated their daughter because they used Botox in an attempt to treat her conditions. The doctors at the Riley Hospital for Children in Indiana used the controversial cosmetic drug to appease the girl’s muscle spasms, despite the fact that Botox has never been approved for such use by the U.S. Food and Drug Administration.

The parents allege that the doctors and drug makers failed to warn them or inform them of the possible life-threatening side effects that are associated with Botox. The drug contains a small amount of toxin that is widely recognized as a cause of Botulism, a paralytic condition that considerably restricts muscle use. The daughter passed away within days of her Botox treatment, as the toxin spread and inhibited her breathing.

The FDA placed a Black Box warning on Botox in 2009, after the administration had received numerous reports of complications stemming from using the drug for treating cerebral palsy. In February 2008, the FDA issued a warning about the possibility of complications, despite the fact that the drug has only ever been approved for use in cosmetic treatments such as wrinkle reduction and smoothing of the skin, as well as alleviating crossed eyes, combating heavy sweating, and appeasing involuntary muscle contractions and eye blinking.

At least a dozen lawsuits have been filed against Allergan and various medical professionals and other parties, as people are alleging that the drug has been falsely pushed as a treatment for cerebral palsy and other similar illnesses. The parents of the 10-year old girl had to first present their claim to the Indiana Department of Insurance, which will then allow a panel of medical professionals to determine if their case can move forward to state or federal court. Allergan recently won a lawsuit filed in California alleging that the company was negligent in the death of a 7-year old girl, who was also being treated for cerebral palsy with Botox.

Thursday, March 4, 2010

Suit ties death of woman to face lift

By Jonathan Saltzman
Boston Globe Staff / March 4, 2010

Donna Ames, a recently divorced mother of three, was depressed and wanted to look younger. So the 49-year-old woman went to the Waltham office of Lifestyle Lift, a national cosmetic surgery company that markets its face lift as a way to “transform your life.’’

Instead of making her wrinkles vanish, the procedure killed her, Ames’s family and lawyers say in a lawsuit filed yesterday.

Minutes after a doctor administered local anesthesia on July 10 last year, Ames’s body jerked violently, and the oxygen in her blood plunged, according to a summary written by her family’s attorneys. By the time the clinic called an ambulance, the Lowell woman was brain dead.

“My mom wanted to make her life better, and they sort of took it away,’’ Evan Ames, her 18-year-old son and ad ministrator of her estate, said yesterday of Lifestyle Lift. “I’m very mad.’’

The Middlesex Superior Court suit is not the first time the company, based in Troy, Mich., has been accused of wrongdoing.

Last year, Lifestyle Lift, which says it operates more than 40 centers nationwide and advertises its procedure as safer and less invasive than traditional face lifts, agreed to pay $300,000 in penalties and costs to New York State for publishing bogus consumer reviews on websites.

Lifestyle Lift said in a statement yesterday that it was “very sorry about the sudden and unexpected passing of Ms. Ames.’’ The company has not seen the suit but said its face lift “is known as one of the safest facial procedures available because it uses a local numbing medication rather than general anesthesia.’’

The statement also said that Ames did not disclose a history of seizures or allergies to anesthesia and that staff called 911 when she became ill.

The defendants named in the suit are Lifestyle Lift and two physicians, Dr. Sanchayeeta Mitra and Dr. James C. Alex. The center, which has moved to Burlington, referred inquires to the company’s headquarters.

Evan Ames, a freshman at the University of Massachusetts Dartmouth, said his mother had talked about getting a face lift for some time, although he had no idea she had gone to Lifestyle Lift until after she died.

His mother, he said, had struggled for years with bipolar disorder and had been depressed since getting divorced from his father about two years ago. She had owned a maternity clothing store in Burlington for seven years, he said, but was not working at the time she had the surgery.

“She was trying to turn her life around and get another start,’’ said Ames.

Donna Ames paid $4,700 for the elective surgery, considerably less than for traditional face lifts, which cost more than $10,000 on average, according to the Ames family’s lawyer, Andrew C. Meyer Jr. of Boston. She went to the Waltham center with a friend, who planned to drive her home after a procedure that was supposed to take only about an hour.

Ames’s vital signs, including her blood pressure and oxygen levels, were stable when she entered the center, Meyer said. But minutes after she received anesthetic injections, she had a seizure and her blood pressure and oxygen levels fell, which Meyer said is a potential side effect from anesthesia.

Ames was not hooked up to any continuous-monitoring equipment, and no anesthesiologist was present, according to Meyer, so the medical staff did not know immediately how little oxygen she was getting. Forty-eight minutes after Ames received her first injection, the staff called for an ambulance; she was deprived of oxygen for far too long, Meyer said.

It was not immediately clear yesterday whether continuous-monitoring equipment and an anesthesiologist were required by law. But Meyer said a medical specialist hired by the family contends that they should have been present in case of potentially dangerous side effects from the anesthesia.

Ames was taken by ambulance to Mount Auburn Hospital in Cambridge, where her heart stopped twice and she was diagnosed as brain dead, Meyer said. Her family took her off life support a week later.

“She goes in [the Waltham center] with a friend, expecting to be out in an hour or so, and was brain dead in half an hour,’’ Meyer said.

Lifestyle Lift says on its website that it has treated more than 100,000 people since 2001 and that “the results have been life-changing.’’ The procedure, it says, is less expensive than traditional face lifts and avoids “the anesthesia risk and physical trauma’’ of the conventional process, which employs general anesthesia.

Unlike traditional face lifts, Lifestyle Lift is not a full face lift or neck lift but creates muscle tension using sutures instead of patients’ skin, Meyer said.

The Lifestyle Lift has been featured on numerous television programs, including “The Montel Williams Show,’’ and has been advertised widely in infomercials. But the company agreed to pay a $300,000 settlement last year after New York’s attorney general, Andrew Cuomo, determined it had engaged in “astroturf marketing,’’ *creating bogus grass-roots buzz by having employees fabricate online testimonials.

“I need you to devote the day to doing more postings on the Web as a satisfied client,’’ employees were told in one internal e-mail, according to Cuomo’s office.

After the settlement, Lifestyle Lift said it had changed its informational material to reflect actual patients’ comments.

Jonathan Saltzman can be reached at

My note:
* This is exactly what some plastic surgeons do who maintain an online presence. I know of one Indianapolis surgeon who pays people to boost his online persona. Consequently, he has also engaged in the most brutal, unethical legal take-down of a patient's website.

Friday, February 5, 2010

What Happens If Your Mother Has Plastic Surgery?

by Delia Ephron
Posted: February 3, 2010 01:13 PM
The Huffington Post

I haven't been watching many reality shows lately because of the crying. There is simply too much of it. Last season on Project Runway, Christopher cried because he was sure that he was the only person in the world who would design a dress inspired by a rock (something I am sure he is wrong about). I have no idea how much crying there is on The Hills, since I was never a fan, but it did catch my attention in People magazine that Heidi Montag, star of the show, cried after she had ten plastic surgery procedures in one day. Heidi, I know from a quick Google search, is 23, although since her plastic surgery she looks 33. Which is actually something to cry about.

I have been interested in and done research on this subject spun slightly different: What happens if your mother (not your favorite reality star) has plastic surgery? This is the subject of my new novel for teenagers, The Girl with the Mermaid Hair.

If, as a teenager, you spend hours in front of a mirror deciding, say, whether one nostril is larger than the other or worrying whether your breasts point in different directions (typical teenage obsessing), do you outgrow this madness or make more radical choices if your mother comes home with larger lips, a smaller ass, a new chin, a different nose, bigger breasts? How do you feel if your mom suddenly doesn't have any expression in her face? Or if you look into your mother's eyes and no one is home?

Your main job as a teenager is to learn to love yourself. How can you do this if your mother hates herself?

In my research, what was so startling was how aware all the teenage girls were of their mother's fear, or, more accurately, their hatred, of aging. One girl said, "Every time I wrinkle my forehead, my mother points it out and tells me not to. Even if I'm in the middle of a really important conversation." Another spoke about "competitive dieting" with her mom, how she couldn't help but engage in it even though she thought her mother's obsession with fat was "crazy." There is a study out this week from the Girl Scouts of the USA telling us what we already know, which is that the fashion industry and its use of ultra-thin models is making teenage girls too obsessed with being skinny, and distorting their body image. In my more limited unscientific research, the mothers are as strong an influence. Going on shopping trips with mom, usually a bonding experience, became all about hearing moms moan about their fat and rolls. Or seeing your mother trying on something, look in the mirror and say, ""I look ugly."

I have vivid memories of my own adolescence when the main purpose of shop windows was not to see the clothes in them but my own reflection, when hours could be spent in front of a mirror deciding if my eyebrows matched. Emotionally, teen life is no different today, but now you can act on your own insecurities. You can fix them.

A lot of healthy acting out occurs in the mirror, as my research showed. Singing and dancing and even telling off people who hurt your feelings or trying on new identities. But there was also a lot of obsessing about body image. One girl got dressed using four mirrors, running from one to the next: one had good indoor lighting, one was a "skinny" mirror, one had natural light, one she could get the closest to. "If something is wrong with you," a teenage girl said, "the mirror magnifies it." Another said, "If I think something's wrong with me, like my thighs are too fat, when I look in the mirror that's all I see."

God knows, I am not advocating growing old naturally, just to remember what a tender fragile time adolescence is. In my research, one teenage girl confided, "Seeing my mother after her surgery scared me to death." We need our moms to be stable and secure. I have so many friends who will tell me with surprise, when looking at photos of themselves when they were younger, "Hey, I was really cute. I didn't realize it." No one does. You have to get older to realize it. Imagine if you got older and realized that you'd destroyed your younger self. You had operated it away.

Now that's something to cry about.


* Take it from one who knows..... that IS something to cry about. -Lucille

Sunday, August 9, 2009

Business owner files suit over hidden cameras at Meridian Plastic Surgery Center

(Update: I just learned from a reliable source that the laptop IP connected to the cameras was used by the office manager, and did not belong to any of the surgeons. Still.. hard to believe they were not aware of the cameras. They must have been. They jointly own the building and business. )

Carmel - The owner of a tanning company is suing a Carmel plastic surgery practice over secret surveillance.

The lawsuit accuses the surgery center of pointing hidden cameras at naked women. Pam Sanders says she and dozens of women were violated by prying eyes.

"There was a hidden camera that was in the room that I had been spray-tanning my clients in, partially nude, nude, as well as myself nude," Sanders said. "I don't want this to ever happen to anyone else again."

Sanders filed a civil lawsuit Friday against Van Natta Plastic Surgery and Meridian Plastic Surgery Center in Carmel. A former client of the practice, she ran her spray tan business in a makeup room at the center, where women also typically changed clothes.

The suit claims concealed pinhole cameras were hidden in a sprinkler on the ceiling.

"I believe there's a presumption that the camera was there, was on, and it showed whatever it showed," said Sanders' attorney Robert York.

"I never ever would have put my clients, myself, my friends in a room where they were, you know, it's very personal," Sanders said.

The lawsuit was filed class action because Sanders says she spray-tanned at least 40 people, all of whom were unaware that a camera was allegedly watching their every move.

"I don't know if it's going to pop up on the internet or pop up here or there," Sanders said.

The lawsuit alleges the secret surveillance was connected to an IP address and a laptop computer, belonging to a member of the plastic surgery practice.

Sanders says she found out about the cameras in May from an employee. She filed a police report and says she confronted the doctors.

"They admitted there was a camera in there. They told me it was originally in there to deter theft," Sanders said. "He did tell me that he had disconnected the camera awhile back."

But Myra Borshoff Cook, a spokesperson for the practice, says the cameras were on. She says the surgery center mounted two cameras - one in a break room, the other in the makeup room - because of a problem with theft.

"They were installed for security purposes," Borshoff Cook said.

When asked if clients were made aware that there was a camera in the room, Borshoff Cook said, "I don't know."

"We have no reason to believe that any of the taping that might have inadvertently been done in the room where they were doing the tanning was viewed by anyone," she added.

But the mere presence of a camera doesn't sit well with Pam Sanders.

"I was beside myself. To have found this out is beyond gutwrenching," she said.

The surgery center says it hired a forensics company to analyze the tapes to determine if they were viewed by anyone. As for a criminal investigation, Hamilton County police say the case is open, but not active.

Tuesday, June 9, 2009

Worthy of a second read

How the pitch for cosmetic surgery co-opts feminism

-It’s debatable why cosmetic medicine has become so popular. Might it be the result of articles on “scalpel slaves” and “secret surgeries” that saturate women’s magazines? Or could it be a result of makeover-focused reality TV shows that have proliferated since the 2003 debut of Extreme Makeover?

-Once considered clandestine and risky, cosmetic procedures are currently treated across a variety of media as if they were as benign and mundane as whitening your teeth. Advertisers, TV producers, publishers, PR personnel and even physicians themselves are touting it as an effortless, egalitarian way for women of all backgrounds to “enhance” their looks and “stay young.”

-Not only have cosmetic procedures become more acceptable, but they’re being promoted in less sensationalized ways to whole new markets. Increasingly, reality TV’s Cinderella tale of surgical transformation is being replaced with a smart woman’s narrative of enlightened self-maintenance. Media sources now compliment potential customers as mature women who are smart, talented and wise. Such women are supposedly savvy enough to appreciate their own wisdom— but, then again, they should want to soften the telltale marks of how many years it took them to acquire it. “I am not using these injectables to look 25...I don’t want to be 25. I just want to look like me.”

-Alex Kuczynski in her book 'Beauty Junkies' calls these appeals “the new feminism, an activism of aesthetics.” That ignores the work of feminists from Susan Faludi to Susan Bordo, who have argued for years against the global beauty industry and its misogynistic practices. Ironically, the term “feminist” has long been wielded by right-wing politicians, comedians and talk-show hosts as a pejorative label for a “masculine” woman who “lets herself go.” Yet the cosmetic surgery industry is doing exactly what the beauty industry has done for years: It’s co-opting, repackaging and reselling the feminist call to empower women into what may be dubbed “consumer feminism.” Under the dual slogans of possibility and choice, producers, promoters and providers are selling elective surgery as self-determination.

-The cosmetic-medicine industry also appeals to the power of sisterhood. The blurb for a popular book entitled The Smart Woman’s Guide to Plastic Surgery describes the author, Jean M. Loftus, as a female plastic surgeon who will offer “compassionate advice for...any woman considering plastic surgery.” Similarly, the cover of the Internet Guide to Cosmetic Surgery for Women sports a collage of women’s faces of various ethnicities, suggesting that the reader is in this with her sisters. Women with supposed insider knowledge give other women advice and support on how to revamp their faces and bodies through surgery. (Does this make them “aesthetic activists”?) The implication is that the male physician, advertiser, network producer or cosmetic-medicine mogul has been sidestepped, and women are empowering each other to be more informed consumers.

-Moreover, much of the media covering cosmetic surgery centers on the idea of choice... just another lifestyle choice with little difference from working out and eating well, Cosmetic Surgery for Dummies promises the reader will discover how to “decide whether surgery is right for you,” “find a qualified surgeon,” “set realistic expectations,” “evaluate the costs,” “make the surgical environment safe” and ultimately “make an informed choice.” The word “choice” obviously plays on reproductive-rights connotations, so that consumers will trust that they are maintaining autonomy over their bodies. Yet one choice goes completely unmentioned: The choice not to consider cosmetic surgery at all.

-It seems that this pseudo-feminist message works. A British survey found that over half of the 1,000 women who were polled (average age 34) expect to have cosmetic surgery in their lifetime. And that’s music to the ears of all those who benefit from women’s insecurities about their looks, for cosmetic surgery is big, big business.

-Cosmetic surgery is now being packaged and sold in conjunction with other leisure activities for “smart” women. In every major U.S. city, there are “medi-spas” offering one-stop beauty shopping, from salon treatments to outpatient surgical procedures, including chemical peels and injectables such as Restylane . A company called Surgeon & Safari puts together medical tourism packages to South Africa that include airfare, hotel, meals, breast enlargement, a face-lift and a week at a wild-animal game reserve.

-Within such a marketplace, some cosmetic surgeons are no longer just doctors: They are vendors. Thanks to a 1982 Supreme Court ruling, all physicians may openly advertise their wares, and cosmetic surgeons have become particularly adept at working with professional marketing consultants to brand and promote their practices.

-To boost sales even further, cosmetic medical equipment and injectables are being sold to physicians who aren’t even cosmetic surgeons. One Maryland college professor found that out during her annual Pap smear appointment, when her gynecologist offered to “take care of her elevens”—unknit the “teacher’s frown” between her brows—with Botox.

-The beauty industry has long traded on women’s body angst and low self-esteem as a means of creating permanent customers. With consumers able to “choose” from among a dizzying array of procedures and providers, even the most minute areas of the female body are potential sites of worry and “intervention.”

-With the media’s suggestion that cosmetic surgery for the discriminating consumer is almost as easy as choosing any beauty product, it’s not surprising that the targeted demographic for cosmetic medical procedures has widened.

-While the vast majority of customers continue to be Caucasian women, “ethnic surgeries” are also on the rise. Eyelid surgery that remakes eyes from ovals to orbs is one of the top three cosmetic procedures for Asian Americans. The No. 1 procedure for African Americans was rhinoplasty to slim wide noses, and at the top of the list for Hispanics were breast implants to mold cleavage into a “standard” shape and size. The media pressures every woman—regardless of class, age or ethnicity—to modify herself in order to feel “normal.”

-The most graphic consequences of these trends are the stretched, alien, expressionless faces worn by certain celebrities and increasing numbers of “everyday” women. There are also the disfigurements and deaths that can result from surgeries gone wrong. While the ASPS keeps no statistics on botched procedures, permanent scars, severe reactions to injectables, burst implants or deaths due to hospitalacquired infections or administration of too much anesthesia, the stories certainly exist. Indeed, Kuczynski devotes an entire chapter to “The Fatal Quest for Beauty.”

But then Kuczynski ends her string of horrific examples by telling consumers to “educate themselves.” Time and again, even critical assessments of cosmetic surgery conclude in this way. Rather than grapple with the hard questions of whether such surgeries should be undertaken at all, or what the cultural forces are behind the pressures to undergo cosmetic surgery, even critical voices ultimately reaffirm the industry’s message: If the woman is an empowered consumer, she will be smart enough to shop safe. Ultimately, both promoters and detractors keep the question of choice to whether a woman will choose to do her homework, listen to other women and not overreach.

At the end of Beauty Junkies, Kuczynski asserts that “looks are the new feminism.” Yet it's feminists who have emphatically and persistently shown that cosmetic medicine exists because sexism is powerfully linked with capitalism— keeping a woman worried about her looks in order to stay attractive, keep a job or retain self-worth. To say that a preoccupation with looks is “feminist” is a cynical misreading; feminists must instead insist that a furrowed, “wise” brow—minus the fillers—is the empowered feminist face, both old and new.

For further information on feminists challenging cosmetic surgery, visit NOW,; About- Face,; and the Real Women Project,

Friday, June 5, 2009

10 Things Plastic Surgeons Won't Tell You

1. “I trained a whole weekend to learn this procedure.”

With skyrocketing malpractice premiums and the Kafkaesque insurance system, it’s little wonder M.D.’s are flocking to the plastic surgery biz. It’s easy to get into (legally, any doctor can do it), patients pay up front for surgery, and demand is up: The number of cosmetic procedures increased 59 percent from 2000 to 2007, making it a $12.4-billiona- year industry.

The best surgeons spend years honing their chops in residencies; by contrast, those hoping to offer a little Botox along with flu shots tend to opt for less rigorous training—like the popular weekend classes at the International Society of Cosmetogynecology, an odd but official-sounding organization that promotes plastic surgery as an extension of gynecology. Its three-day courses cover liposuction and injectables. Empire Medical Training offers an even thriftier nine-hour seminar on lipo—two hours of which are devoted to marketing.

Real plastic surgeons are appalled. “Any licensed physician can put up a plaque and say they do plastic surgery regardless of training, and that’s scary,” says Roxanne Guy, president of the American Society of Plastic Surgeons (ASPS).

2. “I make a mint off other surgeons’ mistakes.”

When 35-year-old Kelley Young of Fresno, Calif., looks at her wedding photos, all she can see is her plastic surgery disaster: Young’s nose is bent to one side and its tip is misshapen. “Those photos just look ugly, ugly all over,” she says. Later, when Young went back to her doctor for a fix, he tried snapping her nose back into place—without anesthetic. A year later she finally found a competent plastic surgeon to fix the problem.

Young is hardly alone. In fact, she’s part of a new growth area in the field: fixing botched cosmetic procedures. According to a survey by the American Academy of Facial Plastic and Reconstructive Surgery, one in five nose jobs are corrections of a failed procedure. Stanley Frileck, an associate clinical professor of plastic surgery at UCLA, says that 35 percent of his work is fixing the mistakes of other surgeons. Botched rhinoplasty, face-lifts, and eyebrow procedures are the most common. Not only are these repairs more complex than the initial surgery but they can cost up to three times as much, Frileck says—and the result is never quite as good as a welldone procedure would have been in the first place.

3. “Sure, I can turn back the clock, but it just starts ticking again.”

Just because you shelled out $10,000 for a face-lift doesn’t mean you’re set for life. Even the most skillful work will need some attention a decade or two down the line. Some jobs may require supplemental fillers (compounds that are injected under wrinkle lines in the skin) or minor surgery to tighten up a few sags, while others could call for a repeat of the same procedure. “All cosmetic surgery has a life span,” says Richard D’Amico, president elect of the ASPS. “Procedures will not last forever.”

Surgery to tighten droopy eyelids, for example, often needs to be revisited after a decade, and any work on the lower face will age more quickly than that on the upper face, since the lower face is fleshier and has less bone for sagging jowls to hang onto. Breast implants are the most predictable: Like any foreign objects in the body, they’ll eventually be surrounded by scar tissue, which can make breasts hard and painful. That’s why every decade or two, depending on the patient, most implants need to be replaced. While 300,000 women receive implants annually, 25,000 have them removed. “It’s strictly a function of time,” Frileck says.

4. “You’d be better off spending this money on a good therapist.”

Plastic surgery doesn’t make you crazy, but those who have had it, both men and women, are more likely to suffer from psychological problems. Several studies in the mid-1990s found that women who chose to get breast implants were two to three times more likely to commit suicide; other studies have found that 20 percent of plastic surgery patients have undergone some form of psychological treatment.

Up to 15 percent of plastic surgery patients suffer from “body dysmorphic disorder (BDD),” marked by obsessive and exaggerated concern over aspects of one’s appearance. It may sound like a convenient diagnosis for our beautyobsessed culture, but it is a very real, very dangerous condition, says David Sarwer, an associate professor of psychology at the University of Pennsylvania School of Medicine. “At the extreme, people will not leave their home, they’re so preoccupied with how they look,” Sarwer says. BDD sufferers often seek plastic surgery hoping it will magically transform their lives, and when it doesn’t, they may harm themselves. Every plastic surgeon worth his salt asks probing questions to gauge patients’ motives, but to date there’s no standardized screening tool for BDD.

5. “Of course I’m board certified—for what that’s worth.”

A board-certified plastic surgeon should be the best, right? Not always. Because any doctor can perform any cosmetic procedure, and because certification boards are self-regulating, many certifications aren’t so telling. The American Board of Laser Surgery, for example, certifies nurses, veterinarians, and oral surgeons in laser surgery— through a take-home written exam. Meanwhile, two different boards certify practitioners of “mesotherapy,” the use of injections to dissipate cellulite, although there’s little evidence to suggest it works. “To say you’re ‘board-certified’ is meaningless,” says Michael McGuire, of the ASPS.

There are some certifications that matter: The American Board of Plastic Surgery is the most rigorous for this specialty and the only certification body for plastic surgery recognized by the American Board of Medical Specialties. Members of the ABPS have completed residencies in both general surgery and plastic surgery and are trained to do all procedures from liposuction to nose jobs. Likewise, physicians with board certifications in either otolaryngology or in facial plastic and reconstructive surgery also have reliable training in procedures above the collarbone.

6. “You can get this done for a fraction of the cost overseas.”

When Janette McNeal decided to get some work done, the Tulsa, Okla., homemaker balked at the $10,000 cost of a faceand neck-lift. McNeal decided to look overseas, and wound up having surgery in Malaysia, where the same $10,000 bought her the face-lift plus liposuction in three areas, a tummy tuck, and an eyelid lift.

It’s not for everyone, but “medical tourism” is less risky than it used to be. Since 2000, Joint Commission International, the international wing of an organization that accredits U.S. hospitals, has okayed 110 facilities overseas. Also, private companies that do their own screening have sprung up to guide patients through the process. One of those, MedRetreat, visits each hospital it uses and guarantees that the best surgeons will be on the case.

But medical tourism still has its hazards. It can be tough determining doctors’ qualifications, and eager patients may try to cram in too many surgeries at once, requiring a longer recovery and boosting the chance of lethal blood clots, a risk already increased by flying. Travel following surgery can also up the possibility of infection. And if something goes wrong, well, forget a malpractice suit.

7. “I make my living off the fat of the land—literally.”

The number of Americans who lose 100 pounds or more is increasing. But dropping the weight is just part of the process; next comes what’s known as body contouring. After a person loses so much weight, his skin does not snap back, leaving folds of excess skin on his thighs, back, torso, abdomen, and neck, which can cause rashes and make fitting into clothes and exercising problematic. In many cases the extra skin must be removed through extreme versions of mastopexy (or breast lifts), tummy tucks, and other procedures. And there are often complications: The remaining damaged skin can die or separate after the procedure, requiring additional surgeries. Despite all the problems, body-contouring surgery is increasingly popular; between 2004 and 2007, the number of procedures increased by 20 percent, to nearly 67,000.

After Michele Fitch, a teacher in Melbourne, Fla., lost 190 pounds, she waited eight years to have the follow-up surgery. She wanted to make sure she could keep the weight off, and she needed to save money—insurance often pays for the gastric bypass, but it rarely covers contouring. First she had skin removed from her arms and chest. Then 10 pounds of skin was cut from her sternum to her bikini line and from hip to hip. Out-ofpocket cost to date: $33,000. And Fitch still faces two more surgeries on her legs.

8. “Long-term effects? Beats me.”

More than most other specialists, plastic surgeons are under pressure to compete with one another, and an easy way to get the upper hand is to offer all the latest technology. “There is great pressure for physicians to jump on the bandwagon of a new filler or technique before it is really evaluated,” McGuire says. “And their ethics are not too high to begin with.”

Doctors are often happy to try new techniques before the long-term effects are known, and in some cases they’re performing procedures that already have poor track records. Injecting a person’s own fat from other areas into her breasts for enlargement is on its way to popularity again. When this was tried years ago, much of the fat died, causing unsightly rippling and lumps. But that wasn’t the worst of it: The tiny calcifications that resulted from the dead fat were easily confused with tumors and rendered mammograms less effective. While some argue that new techniques and better mammograms have eliminated these problems, McGuire is certain that this rush to the latest and greatest will once again produce disastrous consequences.

9. “Silicone’s back—and putting my kid s through college!”

Fifteen years after the U.S. Food and Drug Administration banned them for elective use and after massive class-action lawsuits bankrupted their manufacturer, silicone breast implants have gotten the green light again. Though there’s no conclusive evidence that silicone from ruptured implants causes the problems once associated with it, the FDA is staying cautious, recommending that patients undergo a long list of expensive follow-up tests over the long term. Due to concern about leaks, the FDA has required labeling that instructs those with the implants to get MRIs to check for ruptures after three years, then once every two years after that. Silicone implants should also be replaced every 10 years.

There’s no actual mandate for these procedures, and some doctors say that patients won’t follow through, especially once they start tallying the bill: The initial surgery can cost between $5,000 and $10,000; MRIs are about $1,500 apiece, and you’ll need four over a decade; and the replacement surgery can cost about as much as the original procedure. Grand total: between $11,000 and $16,000 every 10 years.

10. “Those who need surgery the most will benefit from it the least.”

Most people turn to plastic surgery when they feel age has finally caught up with them and nothing else will rid them of that troublesome bulge. But the dirty little secret of plastic surgery is that with many procedures, the more you need it, the less you can expect.

Those who have damaged skin, more common as we age, can expect some serious complications. Skin stretched by weight gain, for example, loses its elasticity; following liposuction it may not snap back into place but hang like an apron over the area that was suctioned. Because smokers have poor circulation to the epidermis, their skin can die after surgery, meaning months of unsightly scars and possible additional surgery. And procedures such as a face-lift done on sun-damaged skin won’t last as long and may result in more-prominent scarring. Likewise, those hoping for dramatic weight loss from liposuction are looking in the wrong place; surgeons say it’s meant only to shape a certain part of the body in conjunction with diet and exercise.

Ironically, those who need cosmetic surgery the least—generally, those who are younger and opt for a little tweaking here and there—are going to fare the best. “How well a person cares for themselves throughout life is very important,” says Mark Jewell, former president of the American Society for Aesthetic Plastic Surgery.

Saturday, May 30, 2009 - Just plain awful

During the past few weeks, I have received email from 5 different people who tried posting responses on Awful Plastic Surgery only to have their messages deleted or not go through at all. I know they are telling the truth, because my own messages appeared for a minute and then were deleted.

This site seems to be a favorite place for my sister to spew her venomous lies, yet when I posted cold, hard evidence proving her lies, the site administrator deleted them. Why? One poster who frequents that site expressed her anger to me at being duped this way. She isn't alone. Apparently, the site enjoys the traffic generated by my sister's bizarre messages, but would rather not have her falsehoods revealed.

They certainly get lots of mileage out of my misfortune. One hoped they would have the decency to publish my posts.. and ALL posts shedding a true light on the issue at hand. Those who wrote to me were disgusted and said they no longer want to participate in its discussions. Perhaps if their stats go down, they might take a more fair and balanced position.


Wednesday, May 27, 2009

Saying Good Bye to my Best Friend

sierraball1Shortly after 5:00 pm today, my vet will make a house call to euthanize my beloved companion, Sierra. For the past 5 years, this loyal, loving cocker spaniel has shared every moment of my life… has given me a reason to get out of bed in the morning.. has consoled me through the worst physical and emotional devastation. Now she is dying. Tonight my vet will ease her passage from this life and take away her warm body.. a body which has lain beside me as my loyal guardian, healer of my heart, keeper of my soul. Sierra will be gone before the sun sets tonight, leaving a void in my life that can never be filled again. One thing I can say with complete certainty of my life…my dogs have shown me what true unconditional love is all about. If not for Sierra, I would have given up long ago. Sierra has given me the most precious gift possible when I most needed it.

I cannot even imagine what tomorrow will be without her.


First moments with Sierra 9/2004


Christmas with Sierra 2006

Monday, May 18, 2009

Allergan hit with 'Botox deaths' suit

This lawsuit was filed last year. Anyone know what happened?

Several Botox users and their relatives filed a lawsuit Wednesday in Orange County, Calif, contending that the drug injured them or killed their relatives. They blamed maker Allergan Inc for failing to warn them of the dangers.

The suit links the drug to 4 deaths, including a 69-year-old nurse who received Botox injections for neck and shoulder pain, a 7-year-old girl with cerebral palsy who allegedly receivied injections to control limb spasticity, and a 71-year-old woman allegedly got Botox injections for wrinkles around her mouth at a mall clinic, and a New Jersey man who died, the suit contends, as a result of Botox injections.

Three of the deaths allegedly involved off-label uses of Botox.

In addition, the suit says that both approved and unapproved uses of Botox left 12 other plaintiffs with a range of disabilities, including blurred vision, numbness, allergic reactions, flu-like symptoms, muscle weakness, and difficulty breathing.

"Allergan emphasizes that Botox is a miracle drug and has often compared it to 'penicillin,' " the suit says. "Meanwhile, Allergan obscures that Botox is a highly lethal toxin with serious and life-threatening side effects."

Ultimately, what happened to these unfortunate people is a tragedy and a terrible ordeal for their families. However, common sense should also apply in assessing their chances of a clear victory in this case.

For example, say that somebody shot and killed your relative using a Smith & Wesson firearm. Would you sue Smith & Wesson?

From the Los Angeles Times: Allergan failed to warn of dangerous Botox side effects, lawsuit claims:

"Botox is causing major injuries and death, and it's well-documented but not widely known," said Ray Chester, a Texas lawyer who leads a nationwide team of lawyers involved in the suit. "So thousands of people are getting these injections with no warnings to speak of. Then they fall ill with serious illnesses and, in some cases, they are not even aware that it's the Botox that caused it."

Thursday, May 7, 2009

Hurt by Economy, Plastic Surgeons Find Hope in New Products

Always looking for new ways to suck you in.

One way or another, they will find ways to exploit and capitalize on our insecurities and mutilate our self-esteem.

Liposuction needle display

Flesh-cutting tools

LAS VEGAS — They can lift breasts and firm up thighs, but the nation’s cosmetic surgeons admit they are powerless over a sagging economy.

And yet, hope is rising, along with the Dow, what with the first competitor to Botox just approved last week and potentially revolutionary new treatments on the horizon, including stem cell injections and a cream that can remove unwanted facial lines.

“Business has definitely been flat,” Dr. Brian Kinney, a Los Angeles surgeon, said at the annual meeting of the American Society for Aesthetic Plastic Surgery, which concludes here Thursday. “I can think of a particular woman who said in October she wanted a facelift but she said, ‘Well, I need to sell a house because I want to make sure I’m secure.’ And then she told me in March she was still waiting, the real estate market’s down.”

The number of cosmetic procedures in the United States last year fell 12.3 percent from 2007, to just over 10.2 million, according to the organization. That is a setback for a business that had seen unabated growth since 1997, when about two million procedures took place.

The biggest growth area has been nonsurgical procedures, owing largely to the success of Botox, a botulinum toxin that works by numbing and relaxing facial muscles that create wrinkles. Yet the company that markets Botox, Allergan Inc., is bracing for new competition now that the Food and Drug Administration has approved the second botulinum toxin for similar use, Dysport, produced by the French drugmaker Ipsen Biopharm Ltd.

“Everybody is excited about it because it’s the first competitor to Botox in seven years,” said Dr. Z. Paul Lorenc, who practices in Manhattan and who views Dysport as a faster-acting, longer-lasting and potentially less-expensive option. “It’s also a softer look.”

Also pending are studies into topical versions of these muscle-numbing medications, although none are expected to come to market for years. Already, though, doctors here are debating how useful or practical it might be.

“There’s a concern that if you were to give the patient the cream to take home, they’d just keep putting more and more and more on, and you’d have a dosing problem,” Dr. Kinney said. “And patients might start putting it on other places, like around the mouth, and then they might not be able to move their mouths properly.”

Stem cell treatments were on the minds of many as well, although the potential applications are vague. The thinking seems to be that doctors may some day be able to extract stem cells from a patient’s own fat and use them in lieu of breast implants to produce self-regenerative tissue that would provide a more natural feel than silicon-gel or saline, now the standard. No one is sure yet if it will work and several doctors voiced concern as to whether it is safe and how they would be able to regulate the tissue growth.

Another potential growth area is in nonwhite patients, who have long been underserved said Dr. Julius W. Few, a surgeon from Chicago who lectured at the conference on how to provide nose jobs for non-Caucasian patients while preserving their ethnicity.

“We know by our statistics that this is a growing group by interest in plastic surgery,” said Dr. Few, who performs as many as 40 nose jobs a year on nonwhite patients. “Being African-American, when I was growing up, it was said at my house and a lot of other houses that plastic surgery was only for wealthy white people. That seemed unfair to me.”

The four-day event was a serious medical conference of nearly 2,500 practitioners and exhibitors attending live demonstrations, listening to debates over newer techniques and browsing countless models of implants and needles that were on display.

Still, the convention offered provocative sessions like “137 Rhinoplasties in 20 Patients: What Went Wrong?” “The Weird Smile After Facelift Surgery: A Dynamic Investigation”. (My note: "Dynamic Investigation"? Who are they kidding? How do they "investigate" mistakes they refuse to admit they make? In all the years I have been reading plastic surgery journals, the last articles published about bad outcomes which actually involved the VICTIMS in such studies was in the late 1980's. How can surgeons properly investigate "what went wrong" when surgeons who perform botched operations do not accurately describe what they actually did in operative reports. Are these "investigators" bringing the actual damaged PATIENTS before a group of their peers to examine and discuss methods and techniques which may be responsible for these bad outcomes? Of course not! I challenge any surgeon to prove otherwise. Even in academic settings, this is not done. They do it with photos. They lie to each other. There is no such thing as rational, scientific investigation of bad outcomes in plastic surgery. It simply does not exist. Why? Because proper investigation would mean involving the PATIENT...the very person they will call "crazy" or say suffers from BDD rather than admit they made a mistake.)

Doctors at the conference hoped to get out the message that they were far from the stereotypes of predatory practitioners who take advantage of patients’ insecurities. They resent portrayals like that from a “Sex and the City” episode in which Samantha Jones, played by Kim Catrall is worried about aging and wants a small operation but is told by a physician that she ought to consider several other procedures. She eventually decides on “aging gracefully.”

Of the fictional surgeon’s behavior, Dr. Robert Singer of San Diego said, “That never happens.” Dr. Singer added: “I generally will turn that question in a different way when a patient asks me what I think she needs done. It’s not a matter of what I say. It’s what bothers you.”

Dr. Singer said that part of the challenge was managing patient expectations.

“The public wants something that has essentially no down time, that has maximum improvement, that is non-invasive, that has no discomfort and that has no cost,” Dr. Singer said. “They want magic. That magic pill doesn't exist.”

Gold plated instruments - Bought with suckers' $$$

Sunday, April 19, 2009

Patient as Teacher

A reminder to doctors and patients alike regarding the experimental nature of many new procedures. The surgeon does NOT always know more about certain techniques than the patient who is living with the outcome. The relevant question here: Is he willing to learn from his patients? More important: Is he willing to treat the "teacher-patient" with the respect she deserves, or does he stash the knowledge of his error away for the benefit of future patients while attempting to convince the "teacher-patient" that there is "nothing wrong"?
The Post-Meeting “Wear-You-Out” Syndrome in Cosmetic Surgery
Rod J. Rohrich, M.D.
Dallas, Texas

Events occur every day within a practice that can literally “wear you out.” Life can seem hard at times, even when all is well. At this time in my life, with a toddler and an infant at home, it has become even more important to minimize those events that disrupt my day. We hope we can learn from each other’s mistakes to find solutions for the everyday practice of plastic surgery. However, patients with unrealistic expectations are only one part of our daily challenge. What’s frustrating and perplexing is when a technique is presented at an educational meeting (intentionally or unintentionally) that sounds appealing, yet is filled with potential problems when incorporated into our practices. We return home to try the new procedures only to discover they really do not work. The result is the “wear-you-out” syndrome: a dissatisfied patient wearing you out with an unforeseen postoperative problem from a procedure that was supposed to work well by all reports.

At our national meetings, one occasionally hears about techniques that have an incredibly steep learning curve and probably do not work, and if they do work, the results are unexpected, sometimes surprising, and often not consistently reproducible. It is difficult to incorporate new procedures into your practice if you do not have the same experience and expertise as the individual who presented this new technique or refinement. If the presenter fails to clearly define the learning curve or explain the number and percentage of complications, this can pave the way for big problems. For instance, the surgeon who has just learned to perform liposuction or a face lift technique cannot immediately incorporate some advanced technique into his/her practice just by watching an expert present the procedure. We should attempt to make this clear in our teaching courses.

Everybody shows his or her best results and many minimize the complication rate and learning curve at meetings, seminars, and symposia. Perhaps this is human nature, but it is not acceptable. Even though a procedure has been demonstrated time and time again, it is not proper to minimize its risks and complications. Do not tell us it works every time. In my own experience, the role and use of fat injections in facial cosmetic surgery is a classic example. Fat injections have been touted to b the cure-all, end-all for all types of problems,
especially facial aging. My personal experience with the use of facial fat grafts and fat injections has been dismal, particularly when using fat injections for orbital rim blending of the cheek-lid interface. The results from this technique have worn me out from the perspective of patient complaints.

A word of caution: do not go home and incorporate a new procedure into your arsenal until you are very sure it works. Here are several thoughts to help avoid the post-meeting “wear-you-out” syndrome in your practice:
1. Do not be the first to use a new technique or technology or the last to give it up.

2. Be sure highly respected, experienced surgeons or a surgeon you know and trust is using and praising the procedure or technique before you attempt it.

3. Seek advice from the surgeon with the most experience and expertise using the same or similar techniques.

4. Call the surgeon who described the technique and put him/her under scrutiny. Does this really work? When does it not work? What are the author’s revision and complication rates?

5. Optimally, observe the new technique or rejuvenation procedure. See if the actual procedure is the same as presented. Ask to see follow-up patients if possible.

6. After you have performed 5 to 10 procedures using the new technique or technology, provide the author with your own feedback and follow-up on what works and does not work for you.

7. Listen to your patients and follow them closely when you change a procedure or add a new technique to your armamentarium. Ask the hard questions. Is this new technique really improving your results?

8. Beware of the technique that continues to be “modified” significantly, especially 1 year after its introduction as the latest and greatest in plastic surgery. Obviously, something is not working properly if it requires constant revision even in the hands of the “experts”!

9. Be wary of those who are never in doubt when asked about a procedure they are advocating. They may often be in error.

10. Most complications relative to a new technique or technology occur within 2 to 3 weeks after an educational meeting. This is a very important statistic to remember!

In conclusion, do you find that your patients are “wearing you out” about their result from a procedure you are trying? If so, stop! Do not take everything you hear at a meeting as established fact. Analyze your results, compare them to old and new techniques, and formulate a plan that works best for you and your patients.

Rod J. Rohrich, M.D.
Co-editor, Plastic and Reconstructive Surgery
Department of Plastic and Reconstructive Surgery
UT Southwestern Medical Center
5323 Harry Hines Boulevard, Suite E7.210
Dallas, Texas 75390-9132

What does this article really say? To me, it indicates a duplicity amongst plastic surgeons about the real complication rates involved in certain techniques and procedures employed in cosmetic surgery. If they can lie, whether unintentionally or otherwise, to each other, where does that place the patient suffering with the botched results?

Saturday, March 14, 2009

The Cruel & Ugly Truth about Botox

Sign the petition:
Tell Allergan that Animals Should Not Die for BOTOX

Read more about the inhumane killing of helpless creatures:
Dark Side of Beauty: BOTOX Kills Animals

Saturday, February 7, 2009

More victims come forward in sexual abuse case against plastic surgeon

This story exemplifies the tendency of victims to remain silent. Only when other women came forward were the majority of these victims compelled to tell their stories. How many victims remain silent forever, allowing these sexual predators to continue their abuse? It takes courage to be the first to blow the whistle, and too often, it isn't worth the additional trauma victims suffer through public exposure.

Since the arrest of surgeon Peter Chi on Wednesday on charges of sexual abuse, more women claiming to be his victims have come forward to tell their stories.

STOCKTON — At least 26 women now say that a Tracy plastic surgeon sexually abused them during surgery or exams, investigators say.

The number has more than tripled since Wednesday, when 46-year-old Peter Chi of Livermore was arrested on charges that he raped or otherwise sexually abused several women. Since his arrest was announced, 18 more victims have come forward alleging sexual assault by the owner of Beauty Renewed, 1770 Tracy Blvd.

He faces 11 felony counts of sexual abuse, including three counts of rape by a foreign object.

A judge at Chi’s first arraignment Thursday ordered the doctor to stay away from his medical office and see no more patients at least until next week, when the court will consider whether to suspend his medical license. Chi also surrendered his passport in court and is free after posting $100,000 bail.

Chi will likely spend time in state prison and register for life as a sex offender, police said.

He showed up to court three minutes before his scheduled hearing with his wife and bondsman, his head held high, his demeanor upbeat in front of a crush of cameras and the presence of at least two victims and their families.

Despite the order to stop seeing patients, San Joaquin County Superior Court Judge Roger Ross allowed Chi to keep his medical license for the time being and issued a gag order to prevent anyone officially involved in the case from speaking to the public or the media.

Since investigators on Wednesday filed the first complaint charging the doctor with having molested eight women since late 2007, a slew of new victims have contacted police, according to Tracy police Detective Nate Cogburn.

Police said that in some cases, nurses watched Chi molest his patients, telling them it was part of the procedure, and at other times no one but the patient and doctor were in the room.

Tom Rios, the husband of one victims who attended Thursday’s hearing, said to news cameras that knowledge of his wife’s abuse has been a burden. Seeing Chi in person made him angry, he said, but relieved that the allegations against him are being seriously considered.

"It’s a weight that I had to carry around all this time," he said of his wife’s abuse. "Any man wants to protect his family."

Rios said the doctor’s license should have been confiscated this week.

Deputy Attorney General Jessica Amgwerd unsuccessfully argued for the judge to suspend Chi’s license to practice.

"I think the public demands protection," Amgwerd said. "Basically, Dr. Chi turned his patients into victims."

A judge on Thursday barred Peter Chi, a surgeon in Tracy, to stay out of his Tracy office. Glenn Moore/Tracy Press
Ross told her that it’s enough for now that Chi stays away from his practice, even the administrative office. Investigators said he took some patient files to his Livermore home. With that in mind, if allowed access to his office, Chi could tamper with evidence, Amgwerd argued.

The doctor’s story

Chi has performed upward of 5,000 surgeries since he started practicing medicine more than a decade ago, according to his Web site. He is a board-certified ear, nose and throat doctor and plastic surgeon. He studied medicine in Canada before moving to California to practice.

Chi nearly had his license revoked in 2008, when he found a cancerous cyst on the neck of a 59-year-old man at Sutter Tracy Community Hospital but failed to tell him about it, according to the California Medical Board. It took an exam by another doctor for the patient to find out he had cancer.

The petition alleged malpractice and charged Chi with "gross negligence," because he failed to share the results with the patient.

Chi also has three malpractice settlements on his record from recent years. Only 5 percent of physicians in his field have settlements to their name.

He was exempted from appearing at his next hearing, in which the possible suspension of his medical license will be discussed, at 8:30 a.m. Feb. 13 in Department 26 of the Stockton courthouse. His next arraignment is scheduled for mid-March.

At least two of Chi’s accusers have hired attorneys who are preparing to file civil lawsuit since the story went public.

One accuser is a Tracy woman in her early 40s and one of the 18 who called police after she saw the publicized reports about Chi.

She hired the surgeon in November for a steep discount to perform liposuction on her arms and stomach, but during the operations and post-operative exams, Chi massaged her vaginal area without gloves for 15 to 20 minutes, telling her it was part of the procedure, said Stockton attorneys Stewart Tabak and Steve Brown.

The woman said the infection from her procedure worsened , which could mean Tabak and Brown could bring up charges of malpractice in addition to the accusations of criminal conduct.

Another woman, identified in the original complaint against Chi as "Yvette Doe," 46, said she thought about hiring an attorney back in September 2007, when she said Chi molested her. But she thought she was the only victim and had little confidence about going ahead with a lawsuit. When she heard about other women sharing similar stories about Chi, she said she felt vindicated.

Tabak and Brown said the number of women claiming abuse could portend many more lawsuits in the near future.

The criminal charges "adds an incredible amount of strength to the civil case," Tabak said. "Our client felt a huge level of vindication when she heard other women had the same story. Before, she was very questioning."