Wednesday, January 5, 2011

Young Woman Dies Getting Liposuction

Thanks to blogger,  Dr. Bates at Suture for a Living for tipping me off to the article about the 35 year old woman in South Florida who recently died while getting liposuction.  Lidvian Zelaya went to Strax Rejuvenation Center in Lauderhill, Fla to have fat liposuctioned from her waist and added to her buttocks, according to her husband.  Three hours later she was rushed to an emergency medical center where she died.  An autopsy is pending.

This horror story is more common that you think.  Breast augmentation and liposurgery are the most common procedures in the U.S. and over 1.5 million cosmetic surgical procedures are performed annually.  Most of these are not done in a hospital and Med Spas in strip malls, doctors offices and surgi-centers have no emergency capacity to handle complications.  High profile patients who die, like Kanye West's mother or the former Miss Argentina,  make the news but most complications (infection, blood clots, bleeding, poor outcome) are never made public.

I went to one site on the Internet called "Smart Plastic Surgery" and it mentioned "pre-op steps".  As a comprehensive Internist I thought great, this will steer patients in my direction.  Wrong.  Their steps included costs of the procedures, good candidates for surgery (just about everyone) and finding the right plastic surgeon.

When I say "Pre-op" I mean an appointment with your primary care physician at least 2 weeks prior to surgery where you undergo a physical exam and all other risks of surgery are fully analyzed with your personal health conditions considered.  The pre-op assessment is critical before any surgery.  We are looking for heart and breathing problems, diabetes, silent heart attacks, risks of blood clots or strokes, prior anesthesia history, blood abnormalities and silent infections.  Even mild systemic diseases put a patient at higher risk for complications.

I don't know if Lidvian Zelaya underwent a pre-op exam but I am willing to bet she did not.  I do not know if a pre-op exam would have uncovered what ever problem led to her death.  There are many questions here that have not yet been answered.

I do know that I have adjusted medication and halted or delayed surgery in the past on patients that needed further "tuning-up" before surgery.  I have also insisted that their surgery be done only at accredited facilities.  I believe those delays may have saved their lives.

18 comments:

Sonya Johnson said...

Oh, what a sad story! I used to be a podiatrist, and when I was practicing in northern AZ, a young woman died during a routine plastic surgery procedure at the surgery center owned by the surgeons. She was actually one of the employees there. The facility itself was not the problem - I used to do cases there myself.

In her case, I believe the death was due to a reaction to IV antibiotics administered, so it was negligence on part of the anesthesiologist. Still, it was shocking and sad.

And, even when it wasn't required by the facility, I *always* had pre-op H&P's done by the patient's PCP, to check for any possible surgical or anesthesia risks. Most of the foot surgery I did was low risk in itself, but I did occasionally have to do non-elective surgery on high-risk patients, like diabetics with cardiomyopathy who required debridement of ulcers and bone infections. They had to get clearance from their cardiologist as well before surgery.

As a result of judicious patient perioperative management, and luck, I never had any outcomes that resulted in a bad outcome for my patients in the 8 years I was in practice.

Anonymous said...

In California isn't a Pre-Op physical required as mandatory to be done with in a certain time frame ahead of time before a surgeon could go ahead with surgery?

I'm surprised anyone would want to go to a non accredited hospital or surgery center. Thanks for this I'm passing it along to someone who asked me for a referral to a plastic surgeon for breast augmentation surgery.

BrainDame said...

As a surgeon, I am ALWAYS shocked by how lightly people go "under the knife" for purely elective procedures. Unfortunately, every surgeon knows that any operation can end in disaster for the most unexpected reasons. I always insist on a pre-op by a PMD, even in my young, healthy patients but this is also a warning beyond that-think twice before augmenting, tucking, trimming, etc.

Michael Kirsch, M.D. said...

Very tragic. Must make sure that the pre-op physician is independent and is willing to cancel the surgery, if necessary.

Jonathan said...

And what is driving this need to augment nature? We aren't landscapes after all. And speaking of landscapes and man perfecting nature, think British and Capability Brown, it strikes me that a large proportion of British actors and actresses are ordinary looking people. Again, what is it about us Americans that demands we look just so... Perfect? Maybe the Brits have it right. We should go back to our gardens.

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Anonymous said...

Lidvian's story is so sad and she's not the only one who's died at the hand of a Strax Rejuvenation surgeon: http://www.browardpalmbeach.com/2011-06-02/news/deaths-at-one-of-south-florida-s-most-popular-plastic-surgery-centers-raise-questions-about-the-safety-of-cheaper-nips-and-tucks/#disqus_thread

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SmithGreham said...

Liivian Zelaya go to Strax Rejuvenation Center in Lauderhill, Fl having liposuction fat to its size and added to his buttocks, according to her husband.

Lipo

Kristy Martin said...

Sad to hear about this. However, I also underwent a liposuction procedure in Toronto by Dr. Edelstein and everything went well, without any kind of problems. I think that depends from person to person... She didn't died because of this procedure... she had complications during it and that's why! :)