According to recently released reports, the former Miss Argentina, Solange Magnano, died of a pulmonary embolism, a blood clot that blocks the blood supply to the lungs. A pulmonary embolism is a known risk of undergoing silicone injections. As many news reports have revealed Magnano was going to a plastic surgeon to receive buttocks injections to give her a firmer, higher rear end. However, silicone injections are not an approved procedure for “butt lifts” in Argentina or the United States. Since Magnano’s death on November 29, Dr.Guillermo Blugerman, the President of the Argentina Association for Medicine and Cosmetic Surgery, has come forward to share his suspicions of what went wrong. Specifically, he claims that Magnano went in search of a different doctor that would give her the silicone injections after he refused to do the procedure in 2004.
This tragic incident reminds us that plastic surgery is not to be taken lightly. While plastic surgery complications are not common, they still do occur. In fact, according to the Food and Drug Administration, for every 100,000 liposuction surgeries, there are between 3 and 100 deaths. If you can’t resist having surgery, remember that plastic surgery is not to be taken lightly. As Dr. Angelo Cuzalina, president-elect of the American Academy of Cosmetic Surgery shares: “[s]ome people think of cosmetic surgery as not real surgery. They get the impression they are going to a spa…it’s still surgery. You get cut. You bleed.”
The best advice that Dr. Cuzalina can offer is to be your own investigator prior to receiving surgery. Specifically, he urges patients to ask their doctors the following questions before going under the knife:
- 1. Doctor, are you board certified? You definitely want a doctor who is certified by the American Board of Medical Specialties. You can view a list of certified doctors by visiting the American Board of Medical Specialties website.
- 2. Doctor, what’s your plan for deep vein thrombosis? Deep vein thrombosis is one of the more common complications of plastic surgery, where a blood clot forms in a deep vein. The clot can then break loose and travel to the lungs, causing a pulmonary embolism such as that suffered by Miss Argentina. Doctors can take preventative measures such as having a patient wear tight-fitting special stockings during surgery. Furthermore, doctors may urge patients to begin walking as soon as possible after surgery.
- 3. Doctor, do you have privileges at this hospital to perform this surgery? Even though you probably won’t be staying in the hospital, you want to make sure that the hospital has deemed your doctor skilled enough to perform the plastic surgery procedure. If your doctor says they have privileges, call the hospital to double-check.
- 4. Doctor, how many of these procedures have you performed? You want an experienced doctor. Good surgeons won’t be offended if you ask them tough or personal questions about their background.
In addition to these questions, Dr. Cuzalina also suggests not having too many procedures done at once. The more surgeries you have done, the longer the recovery time and the higher the chances for complications. Finally, make sure you talk to your doctor about any medications you are currently taking—before and after surgery. Some prescription medications can cause more bleeding or an increased risk of a blood clot.
Magnano left behind 7-year-old twins. As her good friend, Robert Piazza, stated: “[a] woman who had everything lost her life to have a slightly firmer behind.” Please consider the risks of plastic surgery, do your research, and don’t be afraid to ask your doctor questions. It’s hard to believe Magnano would’ve made the same choices if she had known the ultimate price of a dangerous procedure.
recently named in the 2009 edition of Best Lawyer's In America, David Mittleman has been representing seriously injured people since 1985. A partner with Church Wyble PC—a division of Grewal Law PLLC—Mr. Mittleman and his partners focus on medical malpractice, wrongful death, car accidents, slip and falls, nursing home injury, pharmacy/pharmacist negligence and disability claims.
3 Comments
Barry L. Friedberg, MD
One can no more maximize patient safety for elective cosmetic surgery with general anesthesia (GA) than one can assure chastity by fornication.
While both acts may feel good at the time, neither accomplishes their stated goal. Both propositions are physical impossibilities.
Propofol ketamine (PK) intravenous sedation (for all elective cosmetic surgeries) has been in use since 1992, and modified to include direct brain monitoring in 1997.
NO deaths, cardiac arrests, 911 calls, pulmonary aspirations, airway mishaps or hospitalizations for postoperative nausea and vomiting (PONV) or pain management
Since inception, there have been NO pulmonary embolisms with PK anesthesia primarily because patients' leg muscle tone is maintained throughout.
Perhaps even more importantly, PK give patients preemptive, non-opioid analgesia that allows them to ambulate promptly after their surgery without the PONV associated with either inhalational or opioid based GA.
Regarding pulmonary embolism post cosmetic surgery, The Doctors' Company (TDC) newsletter of 2005 (http://www.thedoctors.com/risk/specialty/anesthesiology/J4254.asp) comments the use of PK anesthesia to AVOID this problem to maximize patient safety.
TDC is a 'med mal' insurer with a high percentage of its insured as plastic surgeons. I have been covered by TDC since July 1977.
According to the TDC, the average anesthesiologist is sued every 8 years.
Last but not least is the astonishing fact that since 1992, in over 5,000 patients of more than 100 different surgeons, NO patient has named (much less sued) me in a malpractice action!
PK is so safe that the US military uses it on wounded soldiers in Iraq & Afghanistan, earning me a US Congressional award (see Media kit on web site).
BIS/PK anesthesia is SAFER, SIMPLER, more COST EFFECTIVE and has BETTER OUTCOMES the GA.
What more could anyone ask for anesthesia in elective cosmetic (or any other) surgery?
Sadly, no university anesthesia department has thus far been willing to perform a double blind Level I RCT validation study.
PK anesthesia has the lowest published rate of PONV in the anesthesia literature of 0.6%.
This PONV rate is all the more impressive because it was achieved in an Apfel-defined high risk group; i.e. non-smoking females with previous histories of PONV/motion sickness, having elective cosmetic (emetogenic) surgery.
According the the current 'consensus guidelines' for prevention of PONV, this patient group SHOULD have received 2-3 anti-emetic drugs.
However, PK anesthesia produced 0.6% PONV WITHOUT the use of ANY anti-emetic drugs!!!
Why no Level I validation study for PK anesthesia?
MONEY or the fear of losing future drug company grants.
Neither propofol nor ketamine is proprietary. So no drug company stands to profit from a Level I study.
After being turned down by 7 universities to perform an Apfel-designed PK Level I RCT WITH funding, I concluded that no university wants to risk offending other drug companies by producing a study that eliminates the need for newer more costly (and profitable) anti-emetics for PONV.
BIS/PK anesthesia is SAFER, SIMPLER, more COST EFFECTIVE and has BETTER OUTCOMES the GA.
What more could anyone ask for anesthesia in elective cosmetic (or any other) surgery?
On a national basis, million$ of wasted resources could be saved by by giving $0.70 worth of ketamine 3 minutes before surgical stimulation.
Go try to 'sell' the idea. I've been trying for a long time. Your assistance would be greatly appreciated.
Please also visit www.GoldilocksAnesthesiaFoundation.org
Avoiding routine anesthesia over-medication by the standard use of brain monitors is my other 'crusade.'
Disclaimer: Neither I nor Goldilocks Anesthesia Foundation receive funding from brain monitor makers. This is my 'Don Quixote' self-funded program I began after my concern for my own brain when I was facing my total hip replacement last May.
Look forward to hearing from you.
Facebook User
One can no more maximize patient safety for elective cosmetic surgery with general anesthesia (GA) than one can assure chastity by fornication.
While both acts may feel good at the time, neither accomplishes their stated goal. Both propositions are physical impossibilities.
Propofol ketamine (PK) intravenous sedation (for all elective cosmetic surgeries) has been in use since 1992, and modified to include direct brain monitoring in 1997.
NO deaths, cardiac arrests, 911 calls, pulmonary aspirations, airway mishaps or hospitalizations for postoperative nausea and vomiting (PONV) or pain management
Since inception, there have been NO pulmonary embolisms with PK anesthesia primarily because patients' leg muscle tone is maintained throughout.
Perhaps even more importantly, PK give patients preemptive, non-opioid analgesia that allows them to ambulate promptly after their surgery without the PONV associated with either inhalational or opioid based GA.
Regarding pulmonary embolism post cosmetic surgery, The Doctors' Company (TDC) newsletter of 2005 (http://www.thedoctors.com/risk/specialty/anesthesiology/J4254.asp) comments the use of PK anesthesia to AVOID this problem to maximize patient safety.
TDC is a 'med mal' insurer with a high percentage of its insured as plastic surgeons. I have been covered by TDC since July 1977.
According to the TDC, the average anesthesiologist is sued every 8 years.
Last but not least is the astonishing fact that since 1992, in over 5,000 patients of more than 100 different surgeons, NO patient has named (much less sued) me in a malpractice action!
PK is so safe that the US military uses it on wounded soldiers in Iraq & Afghanistan, earning me a US Congressional award (see Media kit on web site).
BIS/PK anesthesia is SAFER, SIMPLER, more COST EFFECTIVE and has BETTER OUTCOMES the GA.
What more could anyone ask for anesthesia in elective cosmetic (or any other) surgery?
Sadly, no university anesthesia department has thus far been willing to perform a double blind Level I RCT validation study.
PK anesthesia has the lowest published rate of PONV in the anesthesia literature of 0.6%.
This PONV rate is all the more impressive because it was achieved in an Apfel-defined high risk group; i.e. non-smoking females with previous histories of PONV/motion sickness, having elective cosmetic (emetogenic) surgery.
According the the current 'consensus guidelines' for prevention of PONV, this patient group SHOULD have received 2-3 anti-emetic drugs.
However, PK anesthesia produced 0.6% PONV WITHOUT the use of ANY anti-emetic drugs!!!
Why no Level I validation study for PK anesthesia?
MONEY or the fear of losing future drug company grants.
Neither propofol nor ketamine is proprietary. So no drug company stands to profit from a Level I study.
After being turned down by 7 universities to perform an Apfel-designed PK Level I RCT WITH funding, I concluded that no university wants to risk offending other drug companies by producing a study that eliminates the need for newer more costly (and profitable) anti-emetics for PONV.
BIS/PK anesthesia is SAFER, SIMPLER, more COST EFFECTIVE and has BETTER OUTCOMES the GA.
What more could anyone ask for anesthesia in elective cosmetic (or any other) surgery?
On a national basis, million$ of wasted resources could be saved by by giving $0.70 worth of ketamine 3 minutes before surgical stimulation.
Go try to 'sell' the idea. I've been trying for a long time. Your assistance would be greatly appreciated.
Please also visit www.GoldilocksAnesthesiaFoundation.org
Avoiding routine anesthesia over-medication by the standard use of brain monitors is my other 'crusade.'
Disclaimer: Neither I nor Goldilocks Anesthesia Foundation receive funding from brain monitor makers. This is my 'Don Quixote' self-funded program I began after my concern for my own brain when I was facing my total hip replacement last May.
Look forward to hearing from you.
Diego Avila
Dr. Friedberg, thank you for sharing that information with us about alternatives to general anesthesia. We all want surgeries to be as safe as possible, and that includes reducing the risk for pulmonary embolism.
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