(show aired 2/22/14)

THE HIDDEN DANGERS OF PLASTIC SURGERY.

Today’s show is about Hidden Dangers in Plastic Surgery – dangers that may be brought about due to your lack of understanding or your failure to properly disclose information.  The question begging an answer is:  Are you your own worst enemy? Cosmetic and plastic surgery procedures are still medical procedures, people are so captivated by the cosmetic aspect they fail to look at the underlying medical issues.

You wouldn’t believe it but that is often the case – people can get pretty desperate to get what they want, when they want it – they are willing to risk it all – and simply for  not being totally aware of what is at risk. You would be surprised at what people take for granted. Medical professionals – sometimes in their haste – may fail to emphasize some information because everyone is making certain  assumptions. Sometimes they assume you already know things that are just routinely part of what they do day to day.  

A Scenario for Disaster – Common Red Flag Statements

  • I want to have this procedure done and I need it done next week
  • What is the best price I can get it done for or I have $XX dollars I want to spend
  • I really have to have this done now
  • I am so depressed and I’ve got to get myself together

The first thing that stands out to me is that it sounds like the person is too much in a hurry to have surgery.  What’s the rush?  I wouldn’t think this is a decision to rush into – in order to get information that is reliable I would think you have to take time to do your research. This is the wrong approach to surgery and ultimately, a disaster waiting to happen.  Moving forward with any procedure should never be taken lightly. This is not a simple stroll through the park yet so many  take a very casual approach to a serious decision.

Even in the case of a well trained,  board certified plastic surgeon, does not mean he has had extensive experience in every procedure.  That is why board certification is not the only criteria you need to consider.  You’ve got to dig deeper.

Secondly, when someone tells me what they need to have done – it’s often an emotional response to something they’ve seen advertised that sounds just perfect – but, usually its not based on a professional medical opinion. It is based on their limited understanding of the procedure they heard someone else have or they’ve seen on the internet. They may have heard of some catchy sounding procedure and decide to have it, not knowing if they are a good candidate for the procedure – there may be medical reasons why this is not a good choice.  Not every surgery is for every patient.  

If you have the right amount of money you will find someone out there who is willing to trade their services for your cash.  They may not even be qualified to do a certain procedure. There have been many high profile cases where patients have  died as a result of rushing into surgery before they are healthy enough to do so. Good doctors who won’t compromise their standards and personal integrity will turn these patients away – and that is probably the majority of responsible plastic surgeons – they hold to a certain standard that ensures your safety.  

The other issue with this is wanting surgery when the patient is depressed.  When it’s obvious there is a strong emotion tied to the decision to have surgery – like depression – one really has to be careful.  Depression is a serious medical concern.  Is the patient taking medication for depression?  How deep does it go?  Are they currently seeing a therapist?  Does the patient suffer from Body Dismorphic Disorder in which case they may never come to terms with even  the best surgical outcomes.  Depression also affects a person’s autoimmune system – causing delayed healing.  Your state of mind before surgery is important; a patient should have a positive outlook prior to surgery.  It’s not uncommon to experience some mild depression after surgery but why compound the problem with a negative mindset going in?  In the long run, it creates difficulty all around.

Most surgeons really make an effort to educate their patients responsibly.  Patients, on the other hand, wanting to cut to the chase do not always act in their own best interest.  I really don’t think this is a conscious decision – I think its an emotional choice – they simply have not thought long and hard about the risks. 

Medications, Supplements and Surgery 

The general public doesn’t always understand that prescription medications can interfere with other  medications in the body during surgery – and have an adverse reaction and affect the healing process.  For example, taking diet pills prior to surgery can cause the heart to race and they are extremely dangerous after surgery because they can deplete your electrolytes causing dizziness and even fainting.   I know about that one – it happened to me a week after an elective procedure.  If you fail to mention that to your surgeon, what can happen during surgery could be mistaken for a more serious issue.  

Even natural supplements and homeopathic remedies can have serious side effects for people undergoing a surgical procedure. Studies indicate that as many as 70% of  patients still don’t tell their surgeons and anesthesiologists about herbal supplements they are taking  and many doctors still don’t ask.  The reasons for this oversight is varied but when you consider that 55% of plastic surgery patients take at least one supplement a day which could lead to pre-operative complications. Here is a brief list of side effects from supplements:

  • an increase in the risk of bleeding (garlic, gingko biloba, fish oil)
  • greater cardiovascular risks (ephedra, garlic)
  • some supplements with sedating effects can prolong the effects of anesthesia (St. John’s Wort , Kava, Valerian root)
  • interact with other drugs (Licorice, Echinacea, Goldenseal, St John’s Wort).

On average most patients are asked to refrain from supplements two weeks prior to surgery; also patients should be given a list of herbal supplements to avoid prior to surgery.

Be sure you make a list of any and all medications you are taking and have taken in the past 6 months.  Some medications have contraindications prior to surgery, meaning, taking certain medications can have a harmful effect when mixed with other drugs.  Remember, anesthesia is being performed at the time of surgery and the anesthesiologist needs an accurate history of what is in your system.  Also, be sure they are aware of any over the counter medications you’re taking.  Aspirin is a big culprit – increases the risk of bleeding; other drugs can adversely interfere with anesthesia.  On a side note, do not discontinue any prescription medications without the permission of your physician.  Primary thing is to disclose everything you are taking – leave nothing out.

Click here for a list of supplements that may interfere with your surgery.

Blood Pressure & Surgery 

Usually there is a history and physical taken on your first visit. Your blood pressure and other vitals are taken.  Some people fall victim to white coat syndrome – which is a term that indicates high blood pressure which occurs only in the doctor’s office.

Checking simple things like your blood pressure and basic labs helps make sure your surgery is uneventful.  If you have a high reading do not attribute that to white coat syndrome or stress or too much caffeine.  Take this seriously, especially if you are considering surgery.  You can buy an inexpensive blood pressure cuff for under $50 and take it yourself 3 to 4 times a day at the same time and just begin to measure it.

Discuss your findings with the surgeon when in doubt.  These things should be caught by the physician’s office  but sometimes this can be overlooked.  You don’t want to go to surgery with this untreated – it can cause bleeding and other problems.

Diabetes & Surgery 

 As long as you have disclosed having diabetes with your doctor and it is controlled medically – that is the glucose levels must be controlled, you may be allowed to have surgery however there are a number of post operative concerns.  For example, the risk of infection at the site of the incision is greater because diabetics tend to have slower healing time.  There are other concerns but essentially, diabetes, if medically controlled  should not be a concern – it just cannot be overlooked.

Obstructive Sleep Apnea

 Now here is a real danger we do not want to over look – OBSTRUCTIVE SLEEP APNEA –   According to the American Sleep Apnea Association the overwhelming majority of sleep apnea cases have not been identified.  This is extremely dangerous for patients going to surgery. I’ve seen this actually take place – either the patient did not know or knew and failed to tell the surgeon. If you have a CPAP machine, it MUST be brought to surgery for use.

Hidden Dangers of Smoking

If you are a smoker – it is critical that your doctor be made aware of this.  Many surgeries require that you stop smoking far in advance of surgery and that you do not resume smoking for a period of time.  Patients don’t always see the seriousness of this and will often not tell their surgeons they are still smoking.  Some practices nicotine test just before surgery because they came to understand that when a surgery has been scheduled they are not willing to alter those dates – even if it adversely affects the healing process. Here is a list of potential side effects for smokers during surgery:

  • Complicates with anesthesia –  lungs are compromised
  • The Heart has to work harder – smokers are 77% greater risk of heart attack after surgery
  • Wounds take longer to heal – prevents oxygen to the tissues – creates delayed healing.  Sometimes wounds will stay open for a very long period.  When a patient is not healing well this is one of the first things the doctor will look for.

Ultimately you are your own best advocate

  • Take the situation seriously – it may cost you otherwise
  • Take your time
  • Do the research – on the procedure, on the doctor, his experience in the procedure
  • Recognize your motivations along with your expectations – are they reasonable
  • Know your health history and be forthcoming
  • Be sure your decision is yours and not someone else’s
  • Assume nothing and take nothing for granted
  • Watch out for herbal remedies, natural supplements and prescription medications
  • Quit smoking if recommended
  • Be very cautious of having surgery overseas for cut rate discounts  – not the time to bargain shop