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.

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"?

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The Post-Meeting “Wear-You-Out” Syndrome in Cosmetic Surgery
PLASTIC AND RECONSTRUCTIVE SURGERY, September 15, 2001
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
rod.rohrich@utsouthwestern.edu

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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?

Message about my videos on You Tube

Every so often I receive a private message which serves to make the Hell of my life worth the effort it takes to continue for another day. In the face of being ridiculed by members of my own family, alienated by all but a few close friends and demeaned by those in the medical profession most able to help me, I ask myself each day: Why don't I end this nightmare now?

Then I receive a message like this and have my answer:

moooingcow has sent you a message on YouTube:

botched surgery

I feel for you and totally understand how some medical professionals are harsh and unsympathetic. I had a terrible accident in 1992 where it left adhesions in my intestines and nothing would show up in the tests but I would end up in the ER with excruciating pain 2-5x per year. It took 15 years to diagnose and they all told me it was in my head. My heart goes out to you. When I saw you doing the tests and they kept saying you had an unobstructed airway, it was making me mad that they could not see that you were obviously having trouble with the airway. There is probably so much scar tissue that doesn't show up in your tests and who knows what else lost it's nerve conduction. You'll never have one surgeon say another made a mistake. I KNOW that from experience. I only hope you can find some relief and some how find a doctor to fix or relieve the problem. Some problems like mine and not fixable, but they are manageable. I hope you have some luck. You're in my prayers. Hang in there. If you can educate others you could be saving many others from a life of hell. Thank you for the videos.

Cheers,
Laura aka Moooingcow

Plastic Surgeons, Not Immune From the Economic Slump, Report a Decline in Cosmetic Procedures

HOTELS and clothing chains are not the only businesses feeling the pinch from consumers who are cutting back on retail spending.

On Tuesday plastic surgeons reported a significant drop in a range of cosmetic procedures. About 60 percent of plastic surgeons who responded to a questionnaire said they performed fewer cosmetic procedures in the first six months of this year compared with the same period last year, according to an e-mail survey conducted earlier this month by the American Society of Plastic Surgeons. Read more....

More on patient blacklisting

Victims of botched cosmetic surgery often end up on the blacklists of surgeons most skilled and qualified to help them. Frequently, it takes years for such patients to realize they have been blacklisted. From "DEADLY MEDICAL PRACTICES" by Trudy Newman:

"There are basically two different stratifications with patients being given a designation of either “high priority” or “low priority.” Patients with a high priority status will receive the best care available. Patients who, unbeknownst to them, receive a low priority status will get only minimal, rationed or experimental care. Patients are under tested and under treated—if they are treated at all. Alternatively, patients with a low priority status may be over tested, but they will be denied proper care or treatment. The patient may find that he is tested to death with the wrong tests being ordered for his condition. Especially vulnerable are those with chronic illnesses, the elderly, and any others whom physicians deem undesirable."

"Patients who dare to question or challenge their doctor’s authority, or the medical treatment that they receive, may find that they become BLACKLISTED ... Physicians demonstrate a stronger allegiance to their colleagues, than they do towards their innocent and trusting patients. Patients with iatrogenic illnesses often become victims of the blacklist. The problems usually start when medical mistakes are made (either intentionally or unintentionally) and denied. Then the lies and cover-up begin. Documents are often modified, falsified, mysteriously disappear, or important information is excluded from the record. Doctors will go to great lengths to avoid being held accountable, and are generally protected by their professional associations. Once the patient is blacklisted he can then expect to be subjected to character assassination from the medical profession. The patient can anticipate being attacked, discredited and demonized. How dare a patient challenge a doctor's authority? To avoid taking any responsibility for their errors, actions or behavior, doctors--and their governing bodies--will often employ the same tactics that communist countries use to quash political dissent. The patient will be labeled "difficult" or "psychiatric." Such pejorative labels are given to divert attention away from the negligent, incompetent or malpracticing doctor. Patients should not take such labels personally, because these labels say more about the physicians than they do about the patients. Blacklisting is not an error. Blacklisting is an intentional act."

"Because a patient is dealing with their doctor in good faith, it will often take a patient several years to realize what is happening. Once the veil has been lifted and the trusting patient realizes that he is being blacklisted, and is no longer in denial, he may initially experience a sense of shame questioning what he did wrong to deserve such treatment. This shame is usually transient, because after careful examination and reflection the patient rightfully realizes that he is truly the victim. Sensitive patients may experience shame for the doctor’s depravity and lack of moral character. The patient will then move on to experience a righteous indignation. Because of the incredible abuse that a patient endures, he will often experience unbelievable pain and intense anger. Unfortunately, patients are often isolated and left to try to deal with this trauma on their own. "

"Patients who pursue the complaint process through the College of Physicians and Surgeons [in Canada- in the US through State Medical Licensing Boards] because of the substandard care that they have received--often find that they are victimized a second time, because their complaints are not dealt with honestly, fairly or objectively. In the letter that outlines the conclusions of the review, the patient may find that he is attacked by the very organization he was petitioning for assistance. Patients discover that there isn’t an independent outlet to correct and resolve physician error or problems. This additional abuse from the complaint process exacerbates the existing trauma and isolation that the patient is already trying to deal with. "

"Because of the medical profession’s CODE OF SILENCE, the public is often unaware of physicians’ corrupt practices of covert rationing and blacklisting patients. Many patients are afraid to speak out about these abuses, because they fear RETALIATION by the medical community. Retaliation is a legitimate fear. Patients will often find emotional healing only when they are able to connect with other patients who are also being abused and bullied by the medical profession. " [ However, emotional healing cannot restore the victim's functional LIFE as denied appropriate medical treatment can. How many blacklisted patients lives could be restored, but are left to suffer and die because the medical profession engages in blacklisting as a normal and accepted practice?]

MGH Plastic Surgery - Not interested in learning from "unfavorable outcomes"

Going through some older files, I happened across a phone message from Dr. James May, cancelling my appointment after suffering severe tissue damage after a rhinoplasty supervised by Dr. Joel Feldman. The rhinoplasty was performed too soon after a facelift, causing massive swelling which permanently stretched and detached the newly forming adhesion of the facelift. Dr. May's message (and Dr. Feldman's inadequate physical examination) exemplify the tendency of these professors of plastic surgery to ignore/discount problematic outcomes. They just sweep the dirt of their mistakes under the rug and move on to the next patient/victim.

Brian West MD - Bad Plastic Surgery

Blog dedicated to the memory of the former patients of Dr. Brian R. West who have lost their lives and to the patients who live with the lingering effects of errors and to the families and friends whose loss continues.
This blog is a must read.

Doctor keeps botched cosmetic surgery quiet

by Deidre Mussen - Sunday Star Times

A DOCTOR made a patient sign a confidentiality agreement about her botched breast enlargement at a top Auckland private hospital, a women's health group has revealed.

Her horror story comes as the Medical Council ups the ante against rogue doctors performing cosmetic procedures.

Women's Health Action Trust director Jo Fitzpatrick told the Sunday Star-Times that the doctor waived some of his fee in exchange for the woman's silence.

Fitzpatrick said the woman was too terrified to speak out and a friend contacted the trust at the end of last year to urgently seek help.

"She had weeping wounds she was a complete mess. She ended up getting so disfigured, she wouldn't go out. It's the worst case we've come across."

The doctor tried to repair the damage but failed.

The woman was worried about breaching the confidentiality agreement, so the trust told her to say she had been operated on overseas.

"We hoped once she got help, the real story would come out."

Last October, the Medical Council released guidelines setting standards doctors had to meet to perform various cosmetic procedures after a number of botched cases raised concerns. Doctors had until this year to ensure their skills were up to the required level.

"There had been procedures that had gone wrong and we felt we had to make clear what sort of training is required," council chairman John Campbell said.

Some doctors had stopped offering certain procedures, particularly liposuction, because they failed to meet the new criteria, he said. Two doctors contacted the council this year to check whether they had sufficient training for the cosmetic surgery they offered, discovered they did not and had to stop. Another doctor was under investigation after the council received a complaint about him performing cosmetic surgery.

This week, as part of a safety push in the growing cosmetic surgery industry, the council plans to release a new brochure educating patients on what to expect. It specifies the training doctors require and how patients can find out if their doctor passes the council's criteria. It also gives patients questions to ask doctors, details information needed and highlights possible risks.

The brochure also discusses what should happen before and after procedures, plus what to do if anything goes wrong. It will be sent to medical centres, GP practices and plastic and reconstructive surgeons nationwide.

But Foundation for Cosmetic Plastic Surgery president Tristan de Chalain, an Auckland-based cosmetic and reconstructive plastic surgeon, said the council's guidelines were too lax.

The foundation recently complained to the council about an Auckland dermatologist who was performing breast augmentation.

"We have very little protection for the public here. There are still huge loopholes."

However, he praised the council for its efforts to tighten standards.

Health commissioner Ron Paterson had called for tighter restrictions on cosmetic procedures, including better patient education, after some high-profile cases, including one involving a botched genital operation.

Fitzpatrick said she knew of three women who had complained to the trust about that Auckland gynaecologist, but only one had laid a formal complaint.

"Cosmetic surgery is a very difficult area for women to complain about when things go wrong because they blame themselves. Only one woman was brave enough to complain and it's great that she got findings in her favour."

Judge Rejects Plastic Surgeon Brian West's Attempt to Get a Restraining Order Against a Former Patient

Not all judges grant restraining orders without legitimate grounds. This was an attempt by Dr. West to silence injured patients from publishing negative experiences with him on the Internet.

By DAFFODIL J. ALTAN Thursday, August 14, 2008 - 3:01 pm

Cutting Remarks

Plastic surgeon Brian West tries to get a restraining order against a former patient who got him into trouble with the state

Brian West, a plastic surgeon who practiced most recently in Huntington Beach and who is about to go on trial with the Medical Board of California for violating the terms of the board’s alcohol-abuse treatment program, is convinced one of his former patients is violently stalking him.

He’s so convinced that in mid-July, he filed for a restraining order against the former patient, Tina Minasian, as well as for one against the husband of another former patient.

“Whenever she loses in a court of law, she turns violent,” the burly, soft-spoken West nervously told a judge at a Los Angeles Superior Courthouse in Santa Monica last week. He held a stack of evidence, including printed copies of Web pages from MySpace and the site Minasian started, “Brian West MD—Bad Plastic Surgeon.”

With his buxom wife, Leighann West, by his side as a key witness, West described how he had received anonymous death threats and was afraid for his children’s safety as a result of Minasian’s relentless web activity. He told the judge he has opened a criminal stalking case with the Los Angeles Police Department.

Minasian is almost single-handedly responsible for the slew of medical-board accusations West will face in September. The hearings could result in the revocation of West’s license.

West performed a body-lift on Minasian in 2002 while practicing in Sacramento. Minasian filed a malpractice suit in 2005 after her wound healed horribly, she says. As reported in the Weekly (see “Under Wraps,” Jan. 10), just before her case went to trial, Minasian found out West was under investigation by the state medical board. She went to two of the board’s hearings and learned about West’s failure to stay sober while he was in the board’s Diversion Program—and while she was his patient.

The highly confidential program (the public were not allowed to know if their doctor was involved) gave practicing physicians with drug- and alcohol-abuse problems a way out of license revocation if they agreed to attend rehab sessions and take random urine tests. It was permanently abolished this year after failing five audits during its 27-year existence.

The board allowed West to keep his license in 2005 and put him on probation, despite his having relapsed four times while in the program. He relocated to Los Angeles and has practiced in Beverly Hills, Long Beach and Huntington Beach.

Minasian lost her malpractice case against West but learned that she could file a complaint with the state medical board. Minasian also learned the board was unaware of the dozen or so patients who had filed lawsuits against West because separate complaints were never filed with the board. She then began finding other patients who experienced similar bad outcomes after their surgeries with West—patients who had been seeing him during the time he had relapsed and been arrested for a second DUI. Minasian convinced many such patients to file complaints with the board. Many also detailed their stories, complete with gory pictures, on Minasian’s website.

Minasian’s journey didn’t stop there. She has made local and national rounds, along with other former patients, in an effort to advocate for patient safety and expose what she feels was a failed state diversion program. Their stories—and West’s—have been covered by the AP, CNN and Fox News.

All of this negative coverage has made his life a living hell, West told the judge last week. Minasian’s violent streak, he said, increases every time she suffers a loss in her battles with him. The latest, West stated in court documents, was the medical board’s recent decision that Minasian’s specific case would no longer be heard by them along with the others’ in September.

In the Santa Monica courtroom, an impatient Judge John Reid asked West if he had ever been physically assaulted or received death threats directly from Minasian, who lives hundreds of miles away in Sacramento. The ruddy-faced physician said no, not exactly. He pointed to a MySpace page that he alleged Minasian opened in his name.

That and the website with patients’ stories weren’t enough to convince the judge of her violent streak. “That’s cause for a civil lawsuit,” Reid said of the Internet activity. “To get what you want, you have to show that you’ve been attacked, stricken, assaulted and that there is perceived injury or threat to you and your family.”

In an interview, Minasian described West’s restraining-order efforts as “his attempt to compromise my First Amendment rights and to keep me from being called as a witness in September.” Minasian said she and Ken Mikulecky, the husband of a former patient who was named in the second restraining order filed by West, couldn’t afford to fly down for the brief hearing.

First Amendment lawyer James Leonard, who flew in from Oakland to represent the pair pro bono, didn’t have to make much of a case. The judge rejected West’s request after about 15 minutes of deliberation, reiterating several times that a restraining order was not “the proper vehicle” for what West was seeking. “If you were defamed, file your lawsuit,” he told the doctor.

daltan@ocweekly.com

Lethal Games Doctors Play

I receive lots of e-mail from people who have suffered devastating injuries from cosmetic procedures. More than 90% of these injuries are serious, did not involve risk factors associated with the procedure, were not due to patients' idiosyncratic physiology , but were the direct result of surgeons' negligence, lack of skill, lack of experience in executing certain procedures, etc.

Yesterday I received a message expressing what I have heard numerous times from victims of negligent surgery. I will not reveal the details of her heartbreaking physical dysfunction and disfigurement, which involve the face and neck, and were eerily similar to my own condition. What I want to share is her excellent description of the way injured patients, who most deserve the BEST care, cannot get ANY care at all. I have written about the many times I have consulted surgeons about my own life threatening condition, and never received a physical examination appropriate to the problem. My friends did not believe me until they actually accompanied me to doctors' appointments where I actually took the doctors fingers and placed them in the area where it is impossible NOT to appreciate the lack of support to the inner structures in the neck, making it necessary for me to provide this support externally with a piece of wood. You cannot make a doctor perform an adequate physical examination.

This says it all:

"I have learned all to well how doctors stand in line behind each other. If I'd been in a car accident they'd be falling all over themselves to help. But because this was another doctor's mess no one wants anything to do with me. They won't even examine me. I have fabulous insurance and enough money to get stuff fixed but they won't get involved. It is so painful to get assaulted the first time and then get rejected over and over again. I can't believe this has happened to me. I trusted this guy and all the doctors that came after him. I hate that I no longer trust anyone. I miss that part of me. I want my life back. But I can't be fixed if no one will fully examine me. The only analogy I can think of is it is like being raped and assaulted by a policeman and then having to go to the police station to get help. Having to tell your story over and over again hoping to get someone willing to help you. "

"There definitely needs to be a better way. There is no recourse against them. In California even if a doctor kills you they get a slap on the wrist. The only thing that we can do is get our stories out there. The lawyers don't make a dime so they don't want to sue. The doctors know that and feel like they are untouchable."



It is impossible for anyone who has not suffered this experience to understand how it kills the soul. It kills you thoroughly- inside and out. People who have not personally been through this Hell cannot understand how a doctor can refuse to examine you. They do not refuse outright.. . The do not elevate the interaction to that degree of honesty! It is done through subterfuge and manipulation. It is a strategic maneuver intended to make the medical record appear as if there is nothing wrong. They are expert in covering failure to perform an adequate physical examination and appropriate diagnostics through their manipulation of the language in the medical record. Risk management manuals tell doctors exactly how to legally drive injured patients around in circles... until they just drop dead. From the perspective of the medical profession, that is the point- stall off long enough and sooner or later the patient will just disappear, i.e: die.

Patient left in dark after ‘odyssey’-Suit outlines nightmare surgery at Beth Israel

A major Boston hospital that touts its commitment to “disclosure and honesty” faces legal action from an anguished veteran who says he was left in the dark for weeks after a simple cosmetic procedure spun into an “odyssey” of pain and suffering.

“I am furious that nobody at Beth Israel Deaconess cared enough to tell me what happened,” said Michael K. Hicks, 39, of Quincy. He has filed a civil suit accusing the renowned medical center of not owning up to its errors in the hours and days after his elective June 27 liposuction.

Prominent plastic surgeon Dr. Loren J. Borud, 44, was fired several weeks after the surgery, on July 18. Beth Israel first reached out to Hicks, who suffered bleeding, pain and emotional turmoil, after the Boston Herald began inquiring about Borud’s past on July 16.

More...

What brings you here?

What brings people to this blog? Here are some examples of what people enter into search engines (mostly Google) to arrive here:

I have an ugly face

rhinoplasty swelling journey

ugly plastic surgery (very common search)

bad male rhino

ugly plastic surgery pictures (very common search)

splitting sutures facelift

ugly breast photos

ugly lips photos

plastic surgery ugly (very common search)

cosmetic surgery nightmare

ugliest plastic surgery

ugly surgery pictures (very common search)

disastrous plastic surgery pictures

neck swelling tissue hard plastic surgery

plastic surgery for very rich

ugly breasts

ugly need plastic surgery

cosmetic lip surgery malpractice

cosmetic surgery for true medical reason

you tube ugliest face operations

ugly breast implants

cosmetic surgery victims

medical malpractice breasts

does having rhinoplasty too soon after facelift cause damage to facelift (My favorite)

plastic surgery to be ugly

plastic surgery rules to revision

cosmetic surgery side effects

plastic surgery business suffering

plastic surgery victims

plastic surgery lawsuit

power lift cosmetic surgery complaints

how to fix ugly plastic surgery

am i crazy to want cosmetic surgery

plastic surgery catastrophe

malpractice liposuction documentary

what is the bad side of cosmetic surgery

ugly after plastic surgery

you tube cosmetic facelift

you tube defamation complaints

10 things plastic surgeon

rhinoplasty for my birthday

cosmetic surgery peer review

cosmetic surgery deaths

botched trigger finger surgery

malpractice of plastic surgeons

botched cosmetic surgery

patient accuses plastic surgeon of inappropriate

consent form for cosmetic surgery by a resident

false operative reports

malpractice and comments of plastic surgeon

facelift tough skin male

swallowing difficulties with neck lift surgery
~~~~

I have excluded surgeons' names entered into searches which direct them to this blog, but they are surprisingly numerous. Most just search the doctor's name, but some are phrased:

Dr. X facelift
Dr. X malpractice
Dr. X in City, State

You get the picture. I hope they find what they are looking for.

You come from all over the world:

Japan
Finland
Australia
Spain
UK
Canada
Israel
Netherlands
Italy
Belgium
France
Germany
India
Poland
Denmark
Mexico
Greece
Aland Islands
Ireland
Singapore
Hungary
New Zealand
Switzerland
Philippines
Latvia
Nepal
Hong Kong
Egypt
Austria
Luxembourg
Sweden

Just a little FYI

Doc slammed with $20.5 million in damages after lipo death

A jury deliberated for 14 hours over three days before awarding an 18-year-old Penn State freshman's parents $20.5 million in damages, finding the Montco doc who did her liposuction liable.

read more digg story

The Bad & The Ugly... More Common than You Think

When other cosmetic surgery victims share their stories with me, I know why I continue my effort in exposing the side of this business which rarely reaches the public. Rachael Landes contacted me several weeks ago via private e-mail after joining Losing Face. Her story is compelling and all too familiar. Like many others who have been seriously injured, she wants the public to know how devastating this nightmare can be..not only its physical aspect, but the hidden repercussions attached to such injury..like patient blacklisting.

I suggested she post her messages to to Losing Face, knowing many of its readers have been victimized by the medical establishment, but think they are only part of a minuscule minority. They are not. The carnage is out there, but those who have been damaged in this profound manner are reluctant to go public for many reasons. From a personal perspective, I often wonder why I continue to subject myself to the barrage of criticism I receive, including exploitation by the media. Then I think: If I remain silent, who will expose this travesty of medicine? You develop a tough skin and must be willing to endure trashing by the public and character assassination by the medical profession to stand your ground when openly criticising high profile surgeons and institutions. More often than not, the price exacted may be your only chance to obtain medical treatment necessary for survival.

Patients and surgeons alike fall victim to the conspiracy of silence within the medical profession. Doctors are justified in their fear of blowing the whistle on incompetent colleagues or disrupting the status quo. The thanks they receive for standing the high ground are few to none. Rather, they are ostracized by peers and their livelihoods threatened. (The Cost of Courage: How the Tables Turn on Doctors) I have personally witnessed good doctors remain silent while they attempt to fix botched operations by incompetent colleagues, and the patients on the receiving end of their skills tacitly agree to remain silent as well.

Rachael is more than willing to share her story so that others may benefit from her experience, but she was not able to post long messages on the board. She gave me a green light to post her e-mail, so I have opened up pages especially for her voice - a voice that needs to be heard.

Do they tell the kids Mommy might end up maimed for life or dead?

New Kids' Book on Plastic Surgery Skirts Breasts

Source: Newsweek, April 15, 2008
How does a mother explain to her children why she's having a breast augmentation, a tummy tuck or a nose job? Help is on the way -- a new book for kids about plastic surgery, My Beautiful Mommy. The story features a handsome, musclebound, superhero-type male doctor and a Mommy who says that as she got older, she couldn't fit into her clothes any more. Mom explains to her child that the doctor is going to help her fix all that. Mom comes home after surgery looking slightly bruised and bandaged, but with fuller, higher breasts. The text of the book doesn't mention breasts, though; only Mom's "tummy." Michael Salzhauer, the plastic surgeon who wrote the book, said, "The tummy lends itself to an easy explanation to the children: extra skin and can't fit into your clothes. The breasts might be a stretch for a six-year-old."

PHOTOS
Gallery: Mom's New Look
Excerpts from a new picture book for the children of women who have cosmetic surgery.