Surgery of choice - 2

Last week I wrote (or rather copied) information that is not being imparted to "consumers" regarding cosmetic eye surgery. During the week, I received several comments, including one from an anaesthetist who works in London and is currently on holiday in Malta.

It seems that the Health Department and Medical Council should roll up their sleeves, while the Broadcasting Authority has a duty to restrict subtle advertising in a very delicate area. This is also consumer protection.

In Italy there was the pitiable death of a 40-year-old lady after undergoing cosmetic surgery to remove fat from her abdomen and thighs. Liposuction is not a simple procedure, after all. It is not the same as changing the engine oil in your car.

FDA on the risks

I shall be taking up this matter in Parliament. For the time being, during the recess, I have only one option. The information that follows comes from the Website of the Food and Drug Administration of the United States. There should be no doubt that this is competent independent advice, from a source which is above suspicion.

The FDA warns that a person intending to undergo liposuction should make a very informed decision, and not to depend on information given by friends or advertising.

The FDA lists the following risks:

Infections. Infections may happen after any surgery and may occur after liposuction. Some physicians prescribe an antibiotic to all patients undergoing liposuction but other physicians do not. It is important to keep the wound(s) clean but even if you do, infections may sometimes occur from the surgery. Sometimes, infections may be serious or life threatening such as in cases of necrotising fasciitis (bacteria eat away at the tissue) or with toxic shock syndrome, a serious, sometimes fatal infection caused by a bacteria, that is associated with surgery (you may have heard of toxic shock syndrome occurring in women using tampons, also).

Embolism. Embolism may occur when fat is loosened and enters the blood through blood vessels ruptured (broken) during liposuction. Pieces of fat get trapped in the blood vessels, gather in the lungs, or travel to the brain. The signs of pulmonary emboli (fat clots in the lungs) may be shortness of breath or difficulty breathing. If you have the signs or symptoms of fat emboli after liposuction, it is important for you to seek emergency medical care at once. Fat emboli may cause permanent disability or, in some cases, be fatal.

Visceral perforations (puncture wounds in the organs). During liposuction, the physician is unable to see where the canula or probe is. It is possible to puncture or damage internal organs during liposuction.

This may happen, for instance, if the intestines are punctured during abdominal liposuction.

When organs are damaged, surgery may be required to repair them. Visceral perforations may also be fatal.

Seroma. After liposuction, there may be a pooling of serum, the straw coloured liquid from your blood, in areas where tissue has been removed.

Nerve compression and changes in sensation. You may experience "paresthesias", which is an altered sensation at the site of the liposuction. This may either be in the form of an increased sensitivity (pain) in the area, or the loss of any feeling (numbness) in the area.

If these changes in sensation persist for a long period of time (weeks or months) you should inform your physician. In some cases, these changes in sensation may be permanent.

Swelling. Swelling or edema may occur after liposuction. In some cases, swelling may persist for weeks or months after liposuction.

Skin necrosis (skin death). The skin above the liposuction site may become necrotic or "die.". When this happens, skin may change colour and be sloughed (fall) off. Large areas of skin necrosis may become infected with bacteria or micro-organisms.

Fluid imbalance. Fat tissue, which contains a lot of liquid, is removed during liposuction. Also, physicians may inject large amounts of fluids during liposuction. This may result in a fluid imbalance. While you are in the physician's office, surgical centre or hospital, the staff will be watching you for signs of fluid imbalance.

However, this may happen after you go home and can result in serious conditions such as heart problems, excess fluid collecting in the lungs, or kidney problems as your kidneys try to maintain fluid balance.

Fatalities related to liposuction. There are numerous reports of deaths related to the liposuction procedure. Although it is difficult to be sure how often death from liposuction happens, there are several studies that estimate how often patients undergoing liposuction die during the procedure or as a result of it.

For space reasons, I have skipped the risk of toxicity from anaesthesia and burns. My question remains: Are consumers being informed, or is it good business to show a popular personality happy with her liposuction? Is this fair?