Assessing the Risks of Cosmetic Surgery
Some may have read the recent story of a 38 year-old ex-Miss Argentina who died from complications after undergoing plastic surgery on her buttocks. Solange Magnano, who won the crown in 1994, died of a pulmonary embolism three days after having buttock augmentation in Buenos Aires.
For many, this tragic story points to the inherent dangers of cosmetic surgery and that someone risked everything she had in life for a more firmer behind. On the one hand, there is some truth to that perception. Surgery of any kind always involves some risk. The potential for deep vein thrombosis and pulmonary embolus has become a big prevention emphasis in any kind of surgery these days.
But the ex-Miss Argentina did not die from a vein-clot related pulmonary embolism.
Closer inspection of this story shows that she died from a lung embolus that resulted directly from what was injected into her. When I first read this story I thought this woman died from a fat embolus from having had buttock enlargement by fat injections. It is rare but fat emboli have been reported to occur from liposuction and fat injections. But when pictures showed how thin she was, it became obvious that she had not enough fat to use. What was not printed was that a liquid filling material that contained tiny beads was used. Such a material is used here in the United States for facial injection purposes, but never anywhere else in the body. With many thousands of beads and clumps of beads injected, it would be very easy for some of them to get into the larger veins in the buttock…and be transported right upward through the heart into the lungs. Such a risk does not exist in the face where such materials were developed and intended for use.
What does this story tells us about the risks of cosmetic surgery? Does it indicate that cosmetic surgery is inherently dangerous? The answer is no…when done under the proper circumstances with good medical judgment. Almost everyone of these tragic stories that I have seen in my years of practice ends up showing some breach of the known standards of care. Whether it be how the surgery was performed, by whom, or in what type of setting and circumstance, violating established methods and standards of care can have catastrophic results.
Cosmetic surgery is real surgery…and there are no shortcuts. Sacrificing safety for what appears to be easy and quick has not usually proven to be a good trade-off.
Was the death of the ex-Miss Argentina preventable? By not doing the surgery… for sure. But if the surgery had been done with proper methods and materials (or not done at all if there was not enough fat to be used), the risk of such an outcome would have been no higher than a similar fate occurring from an accident while driving to work everyday. Outside of the United States, there are few rules governing what ‘cosmetic doctors’ do. In the United States the plethora of regulations and training requirements for plastic surgeons, while certainly contributing to costs, go a long way towards a much safer experience.
Dr. Barry Eppley