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.