Writers who specialize in plastic surgery often work to educate the public about the meaning of terms like “plastic surgeon” and “cosmetic surgeon.” But it doesn’t hurt to revisit the topic from time to time, especially when a patient suffers a poor outcome, or worse, loss of life, at the hands of a non-credentialed practitioner.
This is exactly what happened in 2007 in Toronto. The doctor in question, Benhaz Yasdanfar, is being sued by the family of a young woman who died after liposuction. The hearing has gone on for over a year now with no decision. But more to the point, what’s to stop a patient—in Canada or the U.S., where regulations are similar—from suffering at the hands of a relatively untrained physician in the future?
This question—to which the answer is “nothing”—is what troubles many with an interest in plastic surgery.
Oddly enough, in the field of medicine, where bureaucracy and red tape are abundant, the requirements for hanging up a sign in your practice saying “cosmetic surgery” are laughably few. Do you need to have spent time during your internship and residency doing a plastic surgery rotation? No. Do you need to have spent time performing any kind of surgery? No.
To be perfectly clear: any doctor with a current medical license can position himself or herself as a cosmetic surgeon. The term “cosmetic surgeon” means nothing more than the fact the doctor offers cosmetic procedures. General practitioners, gynecologists and dermatologists are among the physicians that add cosmetic procedures—usually breast surgery, tummy tucks and liposuction—to their repertoire to bolster the bottom line.
They may take a weekend course, a kind of internship or another type of training. And they may be able to handle routine cases without incident. But the potential problems that go hand in hand with minimal experience include:
• Cookie cutter approach to patients
• Inability to spot a surgical problem early on
• Lack of training to handle an emergency
• Lack of tools for emergencies, such as IV meds and crash carts
• Absence of hospital privileges
The rather lax requirements for performing cosmetic procedures in the U.S. and Canada concern many medical professionals as well. In an unusual occurrence, another Canadian doctor raised a red flag about Dr. Yasdanfar in 2006, a year before the liposuction death of one of her patients. He complained to the Ontario College of Physicians and Surgeons that Dr. Yasdanfar was being deceptive about her credentials in her marketing materials and he questioned her qualifications for performing invasive procedures.
Tragically, the College’s complaints committee found that although Dr. Yasdanfar is a general practitioner who transformed herself into a liposuction doctor, she was qualified to perform the procedures she offered patients. And a year later, a healthy young woman was dead. Charges point out that more fat than usual was suctioned during the procedure and that the medical team waited too long to call 911.
A blog called “Liposuction Watch” published some of the copy from Dr. Yasdanfar’s Web site in 2006, perhaps some of the material that appealed to the patient who ultimately lost her life:
"Falling under the broad category of plastic surgeon, a cosmetic surgeon in Toronto is a certified doctor who performs surgical procedures that alter the aesthetic appearance of a patient."
This is so misleading as to be downright unethical. There is a recognized specialty called “plastic surgery.” To characterize yourself a plastic surgeon, you must have performed up to five years of combined general surgery/plastic surgery as an intern and resident. And you must pass rigorous examinations. As a plastic surgeon, you may perform both reconstructive surgery (like cleft palate surgery and breast reconstruction) and cosmetic surgery, like liposuction. Or just cosmetic surgery, as many do. There is no recognized medical specialty called “cosmetic surgery.”
To know exactly what you’re getting when you’re planning a cosmetic procedure, make absolutely sure you’re working with a board-certified plastic surgeon. Whether they perform both reconstructive procedures as well as cosmetic surgery may not matter to you. But verifying their training and experience should matter a great deal.
As of right now, with regulations the way they are, no one else is going to make sure of this for you.