Know your surgeon, it may save your life
New Straits Times  |  December 2009

THE recent death of former Miss Argentina Solange Magnano after elective buttocks surgery brings to surface the question of safety in cosmetic surgery again.

There have been many such misadventures worldwide but they have failed to deter thousands of Malaysians from doing what it takes for beauty.

One such person is Christina Chan.

Chan, a 38-year-old consultant, recently went for thigh liposuction. She was willing to go through with it even though her sister almost died from the same procedure a few years ago.

"Based on friends' recommendations, my younger sister chose to undergo liposuction at a private clinic in Klang. It turned out to be a scary experience for our family.

"Hours after the procedure, my sister started vomiting. The next morning, we found her lying unconscious in the bathroom. When she regained her consciousness, she could hardly walk as her legs were badly bruised.

"She has since recovered, but the procedure could have killed her."

Although Chan watched her sister go through the ordeal, it did not deter her.

"Some people may think it's crazy to take the risk but I needed the surgery for practical reasons.

"I live in the United States and it's difficult to shop for clothes, especially jeans."

Chan did some background check on the surgeon first.

"I turned to the Internet for information. I believe if proper research and consultation is done prior to cosmetic procedures, there is not much to worry about."

Although an increasing number of Malaysians go for cosmetic procedures, there remains a low level of awareness about safe practices. Laws and regulations are also in place to ensure safety, but there is not enough enforcement.

"I've seen people as young as 18 and as old as 60 seeking double eyelids, eye bag removal, nose enhancement, facelift, breast augmentation, liposuction and tummy tucks," says Dr Tan Geok Puan, a consultant plastic and reconstructive surgeon at a private hospital in Sunway.

"More people are aware of procedures available these days. Many are doing it to improve their self-esteem and to project a better image for work and promotions.

"There are also many non-surgical treatments that are popular, like Botox, fillers and laser skin rejuvenation procedures."

Dr Tan says cosmetic surgery is safe as long as it is carried out by a qualified surgeon in a credible hospital.

"There are associated risks and complications in any surgery. What is important is to make sure the patient is fit for surgery."

But patients, Dr Tan says, should not expect miracles.

"We have the patient's features and tissues to deal with and can enhance what is presented to us.

"But patients with unrealistic expectations should not undergo surgery because they will never be happy.

"Patients may refer to the Malaysian Association of Plastic, Aesthetic and Craniomaxillofacial Surgeons for consultation."

Consultant plastic surgeon Dr Yap Lok Huei says it is important for patients considering cosmetic surgery to research their options carefully.

"Regulatory enforcement tends to lag behind development of techniques in cosmetic surgeries and non-surgical treatments."

Dr Yap is keen to remind his patients that in any trade, there are always some less ethical individuals who are out to make a quick profit. This, sadly, is also true of cosmetic treatments and cosmetic surgery, he says.

"There are cases where the patients do not even ask to see their surgeon before their surgery.

"There have also been reports of some patients finding out just before the surgery that their surgeon is not registered to practise in Malaysia.

"However, at that stage, many patients feel they might as well go through with it due to embarrassment. Thus, they inadvertently take part in an illegal enterprise."

Dr Yap says some patients find out that their surgeon is not qualified only after complications have occurred.

"I suggest that the surgeon assess his patient to decide on the correct treatment and that the patient be given treatment options and time to ponder on the surgery.

"The fact that these patients meet their surgeon only on the day of the operation is unacceptable."

In situations like these, Dr Yap says, it is likely that a "sales consultant" would have seen the patient.

"Such consultants may not have the necessary medical expertise to deal with subtle yet important details that may require attention."

He feels that managing the risks of cosmetic surgery should be a shared responsibility between patient and surgeon.

"The patient should ensure that the doctor is a qualified specialist. Information on doctors and their expertise and training is much more easily available online these days.

"The consultation process should tell you whether the procedure is suitable and whether it would produce the results you want.

"The surgeon should also give you an honest appraisal of the likelihood of success and the cost, not just in terms of fees but also the healing and down time."

Dr Yap is concerned that non-specialist doctors are increasingly carrying out invasive cosmetic procedures, such as liposuction.

"Patients do not seem to be aware that they are exposing themselves to unnecessary risks by opting to go with such doctors.

"Botched jobs that are fatal happen due to technical errors and some due to the lack of safety equipment. These deaths could have been prevented."

So, how does one go about making sure safety can be guaranteed?

"There are no guarantees with any cosmetic surgery as mistakes can occur even in the best of hands. The secret is in minimising the risks of surgery.

"We can do this by selecting experienced surgeons who have a good reputation and accredited medical centres that are equipped with trained medical staff and equipment to deal with medical emergencies," says Dr Yap.

But how do you tell if you are dealing with a competent surgeon?

"I think recommendations from one of your surgeon's patients can be a positive factor. Ask your surgeon about his or her experience in the field you are interested in.

"Does your surgeon have before and after pictures of patients who underwent similar surgery?

"Are they recognised by other surgeons for their skills and experience?"

Dr Yap says it is important for patients to establish trust and rapport with their surgeons.

"Your surgeon should be someone who cares for you. If you feel you can't trust them, chances are you have the wrong person."

Dr Yap stresses, however, that patients should not be afraid of cosmetic surgery or treatments.

"The fact that there are many happy patients is testament that cosmetic surgery and treatments can be carried out successfully. However, it needs to be well-researched and well-planned.

"If the risks are managed properly, cosmetic surgery can be satisfying for both patient and surgeon, and ultimately produce the desired changes in a patient's life."

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