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Thursday, September 29, 2011

Case of 'uniboob' a startling reminder to pick plastic surgeon with care

The procedure was supposed to be simple â€" swap out a pair of leaking breast implants for a brand new set. But for Dinora Rodriguez, a 40-year-old stay-at-home mom from Los Angeles, this simple cosmetic "fix" was the start of a plastic surgery nightmare.

"My breasts looked really bad," she says. "It looked like I had one big breast instead of two. And the pain was terrible."

According to Dr. Anthony Youn, a board-certified plastic surgeon in Troy, Mich., and an msnbc.com contributor, Rodriguez's surgeon left her with a bad case of symmastia.

"It's a uniboob," he says. "It's where the implant pockets are connected in the middle â€" and they definitely shouldn't be."

Normally, breast implants are placed under the breast itself or under the muscle behind the breast, each nestled in a separate "pocket" created by the plastic surgeon. If the pocket is mistakenly made too close to the middle of the chest, though, the implant can work its way through the small opening, migrating towards its twin until both implants are "kissing."

Rodriguez says her surgeon also operated on a scar near her eyes without her permission, giving her an unwanted eye lift that left her unable to completely close her eyes.

Unfortunately, Rodriguez's case is just one example of the many botched operations plastic surgeons like Youn are seeing these days. That's why the shocking case is being highlighted in a safety campaign launched this week by the American Society of Plastic Surgeons.

Rodriguez, who went to her surgeon on the recommendation of a friend, found out later that the doctor was not board-certified. A lawsuit followed, resolved by the Los Angeles Superior Court.

"It's like the Wild West out there," Youn says. "There are tons of doctors performing plastic surgery procedures when they have little or no training and little to no skill. There are ob/gyns performing liposuction. An ER doc will take a weekend course on breast implants and perform surgery in [his or her] office. It happens all the time."

Do-over or D'oh! Can you undo plastic surgery?

Dr. Malcolm Z. Roth, new president of the American Society of Plastic Surgeons (ASPS), says lack of proper training by plastic surgery newbies has resulted in a raft of problems for patients, including unsightly scars, infections, over-resections (in the case of liposuction) and even gangrene.

"Sometimes, lengthy procedures will be done on people who are not medically suitable for them," says Roth, chief of plastic surgery at the Albany Medical Center in Albany, N.Y. "If you have somebody who's not surgically trained, they [don't know] how to decide who's a good or bad candidate for surgery. We've had people go to the ER with deep vein thrombosis, heart attacks, and unfortunately, not infrequently now, we're hearing about death."

While statistics on plastic surgery mistakes aren't available, plastic surgeons report seeing more and more patients in need of "revision surgeries" following procedures performed by doctors who are either certified in some other specialty or not board certified at all.

"Our No. 1 concern is always patient safety," says Roth. "You don't want to play Russian roulette with your life."

How can patients avoid costly, painful -- or even lethal -- plastic surgery mistakes? Roth say it's all about doing your homework.

"You should shop around for a plastic surgeon as carefully as you shop around for a car or a house," says Roth "When you buy a house, you have a home inspector go and check it out beforehand. Patients need to do the same. Check the person's credentials. Ask if they have hospital privileges. Ask how many of that type of procedures they've done. Ask to see pictures. Ask around in the community."

Most importantly, Roth says, patients should make sure the doctor they're considering for plastic surgery is not just "board certified" but board certified by the American Board of Plastic Surgery, which along with passing written and oral exams, requires its members to have graduated from an accredited medical school and completed at least five years of additional training as a resident surgeon in an accredited program which includes a minimum of five years of residency training in all areas of surgery, including at least two years devoted entirely to plastic surgery.

He also recommends they be a member of his group, the ASPS, which guarantees he or she has completed the necessary training and met the standards needed to perform all types of plastic surgery.

"In the U.S., your pediatrician or your family practice doctor or your ob/gyn can say, 'I'm now a plastic surgeon and oh, I'm board certified,'" says Roth. "But they may [only] be board certified in pediatrics. Anybody can say they're a plastic surgeon."

According to the ASPS, only four states -- California, Florida, Louisiana and Texas -- require medical providers to be completely honest regarding their training (or lack thereof). In all other states, a medical license enables a doctor to practice in any medical field he or she chooses, including plastic surgery.

And thanks to the current economy, that's what more and more doctors are doing.

"Unfortunately, we have physicians -- and people who aren't even physicians -- trying to grab some of the pot of gold that is considered cosmetic surgery," says Roth.

Dinora Rodriguez, who had her botched implants fixed by a board-certified reconstructive surgeon but whose eyes are still a "mess," says she's definitely learned her lesson.

"You see them in a white coat and you trust that they're professional," she says. "But I would be very careful if I were to go in for surgery again."

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