Just as Al Roker and Carnie Wilson turned the obscure
gastric bypass into the operation du jour, extreme
makeover shows from The Swan to MTV's new I Want
a Famous Face are making plastic surgery seem as
mainstream as a manicure. In 2003 alone, Americans
had a whopping 1.8 million surgical cosmetic procedures
- a 12 percent increase over 2002, according to
American Society for Aesthetic Plastic Surgery.
But just like gastric bypass - a procedure in which
one in 200 patients die on the operating table -
aesthetic procedures have risks, a fact made alarmingly
clear earlier this year after First Wives Club author
Olivia Goldsmith and Connecticut doctor's wife Susan
Malitz both died during cosmetic surgery at the
prestigious Manhattan Eye, Ear and Throat Hospital.
And New York is not the only state where plastic
surgery fatalities are triggering investigations.
A rash of deaths in Florida in 2000 caused that
state's Board of Health to ban plastic surgeons
from using general anesthesia outside of hospitals
while officials drew up heightened safety measures.
But eight additional surgery patients have died
in the two years since the new rules went into effect,
and Florida instituted a three-month ban, which
ended May 11, on doctors outside of hospitals performing
liposuction combined with tummy tucks.
Sought-after New York plastic surgeon Daniel C.
Baker, who operates at Manhattan Eye, Ear and Throat
Hospital, calls the deaths of the two women there
- neither of whom was his patient - a coincidence.
Yet Baker, known for working his magic on Sophia
Loren, says "every surgery, cosmetic or otherwise,
can have complications. Because plastic surgery
is a procedure to beautify, people think of it as
just a beauty treatment. But it's not like going
to get your hair done. Like driving, skiing or flying,
there are undeniable, inherent risks."
Recent events notwithstanding, aesthetic surgery
has become much safer over the past decade, due
to smaller incisions, smaller instruments and faster
operations, which require less anesthesia. Here's
how to get the kindest cut.
WHO'S WHO
With opthalmologists offering Botox and some dentists
performing facial procedures, the cosmetic surgery
field is becoming harder to navigate. Complicating
the situation is the fact that, once doctors earn
their medical degrees, they are legally permitted
to work in any field - whether or not they are certified
by a medical board in that specialty. Plastic surgeons
(doctors trained in both face and body reconstruction),
otolaryngologists (ear, nose and throat surgeons)
and dermatological surgeons (laser and liposuction
specialists trained as skin experts) are now competing
for the same clients.
"You test drive more than one car, so you
need to interview more than one doctor," says
Park Avenue plastic surgeon Darrick Antell.
Consultations with top surgeons can run $250 to
$500, but Antell points out that "this is one
area of life where you pay retail." To find
the right surgeon, patients should "ask their
own internists for referrals or about a surgeon
they've heard does good work. If your own doctor
hasn't heard of the surgeon, ask him to find out,"
suggests plastic surgeon Gerald Pitman. He also
recommends asking medical specialties the doctors
are certified in.
Another tried-and-true strategy has been to ask
the American Society of Plastic Surgeons (ASPS)
for a list of board-certified surgeons in one's
geographical area; but with two recent deaths during
procedures conducted by one board-certified plastic
surgeon in Florida - who at press time was still
listed on the ASPS web site - even that method isn't
fail-safe.
New York dermatological surgeon and liposuction
pro Howard Sobel suggests patients call their state
boards of health (for information on doctors' malpractice
records) and ask doctors to arrange interviews with
patients they have operated on within the past two
months. "If he can't produce someone who recently
had the procedure you're interested in, it means
he doesn't do that operation often enough,"
says Sobel.
TIME AFTER TIME
Plastic surgery patients know they need to take
time off from work to recuperate. But there are
also some less obvious doctors' orders. "Hold
the phone away from your ear," says Antell,
"so stitches don't come out and your incision
doesn't get infected. And clean the receiver of
every phone you talk on."
Postsurgical patients should also temporarily forgo
the health club and the golf course. "I can
tell them not to do anything strenuous for two weeks
afterward - like exercise or sex - that might lead
to bleeding or swelling," says Silich. "But
of course," he says, laughing, "they have
sex right away, so I tell them to hold off hanging
from the chandeliers." In plastic surgery,
as with everything, risks have to be weighed against
gains.
- Excerpted from an article by Natasha
Singer
Other pages on how to pick a plastic
surgeon:
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