The Florida Medical Board marches to the tune of the American Society of Plastic Surgeons (ASPS). This death at the hands of a plastic, not cosmetic, surgeon will be ‘whitewashed’ just like the death of 17-year old, otherwise healthy, Stephanie Kuleba was in 2008 (http://www.nbcnews.com/id/23808301/ns/health-childrens_health/t/teen-dies-after-corrective-breast-surgery/) in a Boca Raton plastic surgeon’s office. Dermatologic cosmetic surgeons performing liposuction in Florida have historically been subject to much greater scrutiny and discipline than their plastic surgery counterparts.
If there was no fat (or blood clot) embolus found in this woman’s lungs at autopsy, one must look to anesthesia for the likely reason for a patient to stop breathing after surgery. Residual opioids and muscle relaxants are likely the guilty culprits for this type of lethal outcome. These agents are far too casually demanded by plastic surgeons who prefer general anesthesia over IV sedation or even more simply dilute local anesthesia (Klein’s solution) for liposuction.
Florida cosmetic surgeons, like dermatologists, more often use dilute local anesthesia and according to a Coldiron study in Florida & Alabama on liposuction deaths (https://www.ncbi.nlm.nih.gov/pubmed/22093178), plastic surgeons had more fatalities than dermatologic surgeons performing liposuction.
As a California based, board certified anesthesiologist involved with office based liposuction cases over the past 25 years and a recognized authority on IV sedation for cosmetic surgery, I am very saddened by yet another avoidable death for a patient without a medical reason to have surgery. Only patients with a medical reason for surgery should be exposed to the risks of general anesthesia. Yet for incomprehensible reasons, my plastic surgeon colleagues continue to dogmatically demand general anesthesia for elective cosmetic surgery patients.
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