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After Donda West death, California Senate approves new rule for elective surgery ~ Patty W. Kovacs

A new measure passed by the CA Senate recently requires that CA patients be given physical exams prior to any elective surgery and comes in response to the 2007 death of rapper Kanye West’s mother, who died of complications related to cosmetic surgery. The Senatorial majority vote on AB 2968 was an overwhelming 37 to 1.

Sen. Mark Ridley-Thomas (D-Los Angeles) said the measure was in response to the 2007 death of Donda West, mother of the rap musician, of complications related to cosmetic surgery. The family believes that a physical exam would have uncovered coronary artery disease.

“Many of us are concerned about the quality of care extended to those who receive elective surgery,” Ridley-Thomas said.

These days, turning on the television it's easy to see the impact cosmetic surgery has had on national TV.   Mass media has been attributed with the surge in cosmetic surgery procedures in recent years. Some experts are concerned with the way cosmetic surgery is being presented in a 1-hour reality TV show which potentially minimalizes the dangers of cosmetic surgery.  

Donda West, 58, died a year ago at Centinela Freeman Regional Medical Center in Marina del Rey a day after having cosmetic surgery. West was recuperating at home when she fell ill and died shortly after arriving at the hospital.
Surgeon Jan Adams, host of Discovery Health Channel’s Plastic Surgery: Before & After, reported that he performed a tummy tuck and breast reduction on West.  

Adams was not certified with the American Board of Plastic Surgery and had previously been ordered to pay settlements on malpractice suits.  The Medical Board of California also reported Adams would be reviewed to (potentially) lose his license after two arrests in four years on alcohol-related offenses.

Adams performed a tummy tuck and breast reduction on West and said that her death was unforeseen. But another Beverly Hills cosmetic surgeon said he had previously refused to perform a procedure on West until she had a medical clearance for a condition he feared could lead to a heart attack.

While the matters of this case are vital to the course of continuing safety for all elective procedures, the fact is patients must realize that plastic surgery is a serious matter and all information needs to be revealed to one's surgeon. Nutritional supplements, medications, even occasional use of over-the-counter medications should be reported. General anesthesia is a major procedure and should never be considered too lightly. Many patients, so eager to have surgery, do not disclose their entire medical history. Many forget some of the medications or nutritional supplements they are taking. Many are embarrassed and care not to reveal all their medications, a potentially dangerous decision. Many are even unaware of 'hidden' physical conditions and prescreen pre-surgery exams can indeed help discover such conditions

Any patient choosing to undergo cosmetic surgery needs to understand both the benefits and the dangers of cosmetic surgery, but for many of the very young patients asking for plastic surgery procedures, it needs to be kept in mind that their depth of life experience may not allow them to understand fully the risks of long-term complications. Very young cosmetic surgery patients are sometimes easily impressionable and not fully matured. While the introduction of cosmetic surgery has provided many teens and young adults with beneficial results, being surrounded by flawless images in the media of digitally altered bodies creates a need for parents and surgeons to be extra cautious on young patients with unhealthy, unrealistic bodily images.

Considerations with how a young woman’s body will continue to grow and change are also important. Many young patients undergoing procedures are still growing and putting on even a little weight can affect the size of their breasts. Childbirth and nursing may be  experiences ahead and need also be considered.  

All patients need to determine if a procedure is right for them and if any potential dangers of a cosmetic surgery procedure outweigh the benefits. Patients must be evaluated to make sure they have a realistic expectation of what they can achieve through surgery.

Keep in mind that complications are actually extremely rare.  But medical difficulties, even death, have indeed resulted from anesthesia complications, high levels of topical lidocaine, and injections of imitation fillers. In liposuction, embolism may occur. This happens when fat is loosened and enters the blood through blood vessels ruptured during the procedure. Pieces of fat get trapped in the blood vessels, gather in the lungs or travel to the brain. In addition, ultrasound probes can become so hot they cause burns. After breast augmentation, silicone implants may rupture or deflate—some in the first few months and some after a few years. The silicone gel may then migrate away from the breast and cause lumps to form in other areas of the torso and arms. Even non-surgical cosmetic procedures can be risky. In extremely rare cases, a toxin found in Botox called botulinum can spread to other parts of the body and paralyze or weaken the muscles used for breathing and swallowing.

Board Certified surgeons usually approach each medical case with the utmost respect and caution, and deaths to due to cosmetic surgery are extremely rare. Some attribute this low death rate to the good health of patients seeking elective surgeries, some to the cautions taken by well credentialed surgeons.

Most plastic surgery risks are risks of surgery in general. Some of these include:

•  Infection at the site of surgery
• Excessive bleeding
• Hematomas (a collection of blood)
• Necrosis, or tissue death (smokers are at a higher risk)
• Hypothermia
• Numbness and tingling, sometimes permanent
• Seroma, or an accumulation of fluid beneath the wound
•  Stroke

You can reduce your risk of complications from cosmetic surgery by seeking a board-certified plastic surgeon and talking to your surgeon about any risks involved with your particular procedure. Also, verify that your surgeon has the credentials to perform surgery in a hospital. If your doctor opts to perform surgery in a private office, make sure that facility is accredited by the Joint Commission on Accreditation for Healthcare Organizations (JCAHO) or the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF).

Patty Kovacs

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