Plastic Surgery Should be Safe...Could the Death of Rapper Kanye West's Mother Have Been Prevented?

According to the American Society of Plastic Surgeons, over 11 million procedures were performed on people seeking to improve their appearance, up from 8 million just three years ago. The message is clear that Americans are embracing cosmetic surgery, and that these treatments are becoming more "main stream." With this large number of procedures across the country, and the diverse group of doctors that perform them, the number of patients dying from surgery is an extremely small fraction of one percent. So how does an affluent and educated woman like Donda West, a retired professor and former chairwoman of the Chicago State University English department, die from plastic surgery?

While we do not have all the specifics of the case, the Los Angeles Coroner states that preliminary information indicates West died from "complications of surgery", rumored to having had a tummy tuck and breast reduction. "Complications of Surgery" can mean many things, but the two primary issues are whether she had a complication from anesthesia or a complication from the surgical procedure.

Before we consider whether there was a physician error, the anesthesiologist or the surgeon, the first step in ensuring a safely executed procedure is that the patient is healthy enough to withstand the physical stress of anesthesia and surgery on the heart and pulmonary (lung) systems. This requires a complete medical pre-operative evaluation, performed by an internal medicine doctor (not a surgeon), including complete blood work, an electrocardiogram, and chest X ray. Sometimes more extensive testing is required if a patient has a history of heart problems; a stress test or echocardiogram, etc. Simply put, some people are not good candidates for surgery and one should never have surgery before having a medical clearance. I have patients that are in their 40s that have many significant medical problems and are not candidates for surgery, and others in their 70s who get a face lift after they had a full medical clearance. It has been rumored, but not confirmed, that the surgeon took on the Donda West's case after other surgeons told her it was not safe for her to have surgery.

The next step to a safely executed procedure is choosing the correct surgeon. The surgeon who cared for Donda West is Dr. Jan Adams. Dr. Adams is currently under investigation by the California state medical board, has been the target of malpractice lawsuits and has paid out nearly $500,000 in civil settlements. The board is also investigating whether Adams' license should be revoked or suspended after two alcohol-related driving arrests in the past four years, according to records.

Where do we start when looking for a qualified plastic surgeon? On the internet? In a television show, or a magazine article or a phone book advertisement? A referral from a friend? Cosmetic surgery is more acceptable today than ever before, especially with the media's coverage of Botox and television shows such as Extreme Makeover. Unfortunately people are still secretive, and trying to get information about a good cosmetic surgeon or a good experience with a cosmetic procedure, even from friends, can be difficult.

The reason for caution is that any physician with a medical degree and a license to practice medicine can legally perform plastic surgery in the United States. This is why OB/GYN doctors are performing liposuction, laser skin resurfacing, and Botox in their offices, and dentists are performing rhinoplasties.

Credentials are just the beginning when choosing a plastic surgeon. The public, in my opinion, is confused about this subject and with good reason. In today's competitive environment, in order to attract patients, it has been claimed that there exists only one board that certifies surgeons to perform plastic surgery. This is clearly not the case. There are five different legitimate boards that are either member boards of the American Board of Medical Specialties (ABMS) or equivalent boards. These boards include the American Board of Facial Plastic and Reconstructive Surgery and The American Board of Plastic Surgery.

You should also check your doctor's hospital affiliations. If a physician has privileges to perform surgery at an accredited hospital, this demonstrates that his or her performance and credentials are subject to regular scrutiny. While most plastic surgeons perform surgery only in their office, they do have privileges to perform surgery at a local hospital. If a doctor does not have these privileges, do not use that doctor.

Unfortunately, board certification is only the beginning to choosing your doctor. Board certification in Plastic Surgery or Facial Plastic Surgery means that your doctor has completed his or her residency training, passed rigorous comprehensive written and oral exams, and presented a series of surgical cases. But this does not mean he/she is a skilled surgeon; not all surgeons are created equal. Just as there are certain people who excel in sports due to their unique motor skills, there are a small percentage of surgeons who have the ability to use their hands to sculpt tissue in an aesthetic way. What I am trying to say is that there are good surgeons and there are great surgeons, and to use our sports analogy, your job is to figure out who the pros are versus the minor leaguers.

How do you do this? Ask your friends and your personal physician. Ask to see examples of the surgeon's work, or talk to one or more patients about their surgical experience. Physicians who do the procedure you are interested in regularly, and do good work, will have an abundance of examples. Do not accept statements from your surgeon like . . . "my patients do not want me to show you their pictures" or "my patients are very private." This usually means that there are no examples of their work that they would want you to see. Most of my patients come from word-of-mouth referrals.

Check out the surgeon's office and staff; be sure you will be treated the way you expect and that you feel comfortable there. Be sure the doctor is easy to talk to and is someone with whom you can relate. If you do not get along with your surgeon before surgery, do not expect things to get better after surgery.

In the end sum, you have to be your own best advocate, ensure you overall health first, and do extensive research on your doctor.

Comments

[shmillermd]

Consumers should do their homework and check physician qualifications before selecting a physician for plastic surgery or before any surgery or treatment. To clarify your point on which boards certify surgeons to perform plastic surgery, the American Board of Plastic Surgery is the only plastic surgery board that is part of the American Board of Medical Specialties (ABMS) and its 24 Member Boards. ABMS is often considered "the gold standard" for quality patient care and is the most recognized by hospitals and insurance companies. Consumers can and should check physicians" certification status at www.abms.org, as one more way to be sure that they are getting quality care from competent medical professionals.

Stephen H. Miller, MD, MPH
President and CEO
American Board of Medical Specialties

[eaglecapri]

ANY surgery is a risk! Sometimes there are complications, physician mistakes and physicians that perform surgeries on patients that should not be cleared for surgery. And then there are times patients are willing to undergo the risks in spite of knowing the risks. Life...

[sheila]

shouldn't the question be:

"So why does an affluent and educated woman like Donda West, a retired professor and former chairwoman of the Chicago State University English department, feel so badly about herself that she seeks plastic surgery, even though it will risk her life?"

If we answered this question, then solved the underlying problem (see, eg, Naomi Wolf's "The Beauty Myth"), I'm pretty sure we would not have frantic, obsessive people risking their lives to conform to some commercial bullshit about "buying" beauty.

If we could eliminate that factor, and convince women like Ms. West that it is their uniqueness that makes them beautiful, no doubt we would still have plastic surgeries, but they would be well-considered, not desperate, so they would factor in all the suggestions you make.

This was not about that. this was about someone willing to risk everything to try to look less like herself because the outside world had told her she was inadequate, despite her accomplishments and inherent beauty.

This tragedy took place long before the surgery.

[schmuckwithearlaps]

As ugly as the facts are, Donda West's death is a result, at least in part, of a conspiracy against African American women who are pressured by the media as well as the public at large to conform to supermodel standards. The result is that full figured black women are beautiful to everyone but themselves.
The unrelenting pressure of television, magazines and clothing merchants is devastating enough by itself, but Donda West also bore the additional burden of living at the edge of show business, where supermodel standards no few exceptions. Let's face it, every time Oprah gains five pounds it is headline news.
The next time we feel smug about how in the good ole USA we can chastise other cultures and rue the status of women in India and Africa, let's all feel at least a little bit guilty about how and why Donda died.

[TXfemmom]

I cannot disagree with this surgeon. I gave anesthesia for hundreds of plastic surgeries and we had plastic surgeons try to do far too many procedures at the same time on patients with significant health problems. I got stuck with one of those, told the surgeon I would not be part of more than two procedures, in a single day if it went well. The next morning, I appeared and he was back to do the rest on the same patient. Honestly, patients can be their own worst enemies, by insisting that things such as that be performed and the doctors are too GREEDY to say no. As we started, the surgeon wanted me to limit fluids, because she would have swelling. On that note, I informed the Anesthesiologist that he was going to relieve me. Thee procedures involved required huge amounts of fluids and blood products, on occasion, to meet standard of care. They looked at one another, at me, and realized that I WASN'T GOING TO DO IT, and if they did it and anything happened, they were going to be in deep you know what. It was decided that she would receive what I deemed to be necessary and that I had veto rights on procedures, if the situation dictated. That is what I did. I cut him off after two more procedures, and sent her to ICU, with him screaming bloody murder, and she needed to go there, because of what he had done.

That patient survived because of my actions and transfusions because her heart could not tolerate anemia from the surgeries and I treated it. The fool did another patient the next week under similar circumstances, and the wishy washy anesthesia team didn't object and the patient DIED shortly after reaching the recovery room after twelve hours and the heart gave way. That team, and the surgeon, had difficulty looking me in the eye from that day forward. I know that I saved mt patient's life, and no one should loose their life in order to have purely cosmetic plastic surgery.