To take the risk of possible death from surgery that is necessary to save life or to maintain or restore health makes intelligent sense. But to die from an elective cosmetic procedure performed for vanity, or for whatever reason, is obviously reckless and foolhardy.
In medicine, one death out of 100,000-300,000 surgeries, or at most, a one-to- two-percent mortality rate from, say, major heart surgery procedures, is considered acceptable and normal range. There are some less major procedures where practically zero death rate is the norm. The death rate from liposuction, which is done primarily for beauty’s sake, is about 19 out of 100,000, which is even higher than the mortality rate from car accidents. A recent survey of plastic surgeons in the United States revealed that “compared to other kinds of operations, more people die during liposuction.” The death rate for liposuction is indeed alarmingly high and unacceptable.
In Florida and a few other States, liposuction and tummy tuck have recently been banned as office procedures (pending results of investigations) in view of the overly high death rates.
However, some people appear to be willing to risk their life to get rid of some extra fat! Dying to look good seems to be a preoccupation among some individuals, not only among those in the show biz. Besides paying a hefty surgical fee for this risky procedure, whose benefit is not lasting or permanent anyway, the risk to life is too high and can never be justified by the sought-after gain, which is transient at best.
What is liposuction?
Liposuction or “lipoplasty” is a procedure that surgically suctions out fats from particular regions of the body for aesthetic reason. The procedure is done in the doctor’s office or n the hospital. The American Society of Plastic and Reconstructive Surgeons reports that “lipoplasty has become the most common cosmetic plastic surgical procedure in the US ”
In their report published in the Journal of Plastic and Reconstructive Surgery, Dr. Frederick Grazer of Penn State University and Dr. Rudolph de Jong of the Thomas Jefferson Medical College “suggest that outpatient elective lipoplasty may not be safe,” which is actually putting the issue quite mildly.
Any procedure for cosmetic purposes should have a near zero mortality. The risk/benefit ratio should be overwhelmingly proportionate, tipping the scale towards the benefit. In other words, it is only logical to expect that the safety and benefit of any procedure should be much greater than the risk. With liposuction, this is not the case. The risk is too high for the potential temporary benefit to be gained. To lose life in the pursuit of losing a few pounds of body fat is senseless. Besides, chances are the fat will “recur,” unless one goes on a strict diet and do daily exercises, which healthy regimen alone (if it was done religiously for years before) could have prevented the fat problem in the first place.
What causes the deaths in liposuction?
During the liposuction (which is like vacuuming the fats out), the fat cells are disrupted, and because the fats have veins that normally bring blood back to the pulmonary (lung) circulation, some of the fat cells could embolize (travel) to the lung circulation. Since fats are solid substances, they tend to block the circulation that brings blood to the lungs. A small fat embolus becomes a nidus that grows larger and larger, totally obstructing the blood flow to the lungs. This causes severe lack of oxygen in the blood (akin to choking, where a person could not breathe and unable to get enough oxygen to sustain life), resulting in cardiac arrest. There are also reports of other complications like anesthetic deaths and infection with “flesh eating” bacteria, causing deaths.
How about “Tummy Tuck?”
Abdominoplasty or “Tummy Tuck” is another major plastic surgery procedure that is very popular and which has a significant mortality rate. The death rate is one for every 617 procedures (0.16 percent), about the same compared to deaths from hang gliding, 1:600. The risk is higher when combined with liposuction. About 10% of patients undergoing a tummy tuck would need blood transfusion, a hospital stay of about 12.4 days, and a complication rate of between 24% to 65%. The data reported in Journal of Plastic and Reconstructive Surgery showed that on the average, only about 55% of patients got good or excellent result and about forty-five percent did not achieve positive results.
Is abdominoplasty benefit permanent?
Unfortunately, like in liposuction, the cosmetic benefit from tummy tuck is not permanent, unless the person changes his/her lifestyle, as far as dieting and daily exercises are concerned. For those morbidly obese, who have religiously tried dieting and daily exercises and have failed these two plastic procedures may have a justified medical role. If the patient, following these surgical procedures, continues to eat wantonly and not have adequate daily exercises, the weight gain will obviously continue, together with more fat accumulation in the body. The aesthetic benefit would be gone all too soon, almost as fast as the huge amount of money paid to the surgeon.
Dying to look good, are we?
As our culture and social pressure dictate, we must look our best, especially in public. I don’t think there is anything wrong with that. So far as our natural genetic features would allow, plus the wondrous help from the umpteen dozens of beauty aids in the billion-dollar cosmetic market today, we can certainly improve our look significantly. Some men, I included, can even turn Mr. Hyde to Dr. Jekyll instantly with the magical effects of hair grooming, after-shave lotion/cologne, and facial and body hydrating creams, and for women, mascara and the whole works. I admire men and women who are well-groomed. Many girls, with proper and stylish attires, are gorgeous even in their natural self, sans make-up. Appropriate make-up, when applied in good taste, adds to the beauty of any woman. Today, we do have almost everything (non-surgical) to make us look better. I strongly feel that major risky plastic surgery procedures are indicated only for those who, unfortunately, were born with birth defects that are disfiguring. But I won’t be adverse to cosmetic surgeries, if to be performed at all, that are simple and do not pose a significant risk to health or life. After all, it is not wise to fool with Mother Nature too much, because the consequences could sometimes be costly and devastating.
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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Email:[email protected]
