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Cosmetic surgery not worth risks
By REBECCA GANZAK
What would you be willing to risk for a slimmer nose? A bustier chest?
Some people will dip into their life savings, spending up to $10,000 on a nose job. Others will go so far as to take a second job or apply for a loan to fund corrective surgery.
You probably won't catch anyone admitting they would risk their life, however. Plastic surgery, like any procedure that uses anesthesia, can be fatal. This proved true for South Florida teenager Stephanie Kuleba, who died on Saturday - 24 hours after her corrective breast augmentation surgery.
Some people will dip into their life savings, spending up to $10,000 on a nose job. Others will go so far as to take a second job or apply for a loan to fund corrective surgery.
You probably won't catch anyone admitting they would risk their life, however. Plastic surgery, like any procedure that uses anesthesia, can be fatal. This proved true for South Florida teenager Stephanie Kuleba, who died on Saturday - 24 hours after her corrective breast augmentation surgery.
It is suspected that she suffered from malignant hyperthermia, which is an increase in the body temperature that can be brought on by anesthesia.
And yet, cosmetic surgeons in Florida say they are seeing more teenagers for plastic surgery than ever before. In 2005, more than 3,500 girls under the age of 18 had breast implants. I attribute this trend to celebrities and pop culture influencing the youth of America and expressing that corrective surgery is acceptable. If no one in Hollywood has a hooked nose, then why should a young girl find hers attractive?
In 2004, more than 326,000 boys and girls under 18 had corrective surgery to fix something that made them self-conscious, according to the American Society of Plastic Surgeons.
But why do these common teenage issues like body image and self-esteem result in the drastic measure of going under the knife? When I am a parent, if my 18-year-old daughter expresses to me that she wants larger breasts or a straighter nose, I plan to kindly inform her that appearance isn't everything. And that I'm not paying for it.
There is plenty more that parents can offer their child than a swipe of a credit card and an introduction to their city's best plastic surgeon. As expensive as it may be, I think parents are using this method of correction as a way to avoid actually being a parent.
Despite the popularity of breast augmentation, it has a high rate of complications and often requires additional surgery within five to 10 years of the original procedure. The same goes for nose jobs.
I don't understand why a parent would want to willingly put their child through such a risk. I guarantee once the teen is done obsessing over one flaw, he or she will move to another. Soon, earlobes protrude too much or calves are too little.
Since I was a freshman in high school, I had wanted a nose job. After breaking my nose several times, the rather large bump that developed was not something I enjoyed seeing in the mirror every day.
But I soon changed my mind after I researched the pain involved, high costs and saw a few graphic episodes of "Dr. 90210."
I have been put under anesthesia before, so that thought did not scare me. However, I did not stop to consider that the chance of death due to anesthesia is pretty common, about 1 in 200,000, according to studies done in 2004. And this doesn't include cases where anesthesia was a secondary factor or contributor to a patient's death.
According to a New York Times article, the agreement among surgeons is that the risk is much higher for elderly or very sick patients, or those with certain medical conditions, which are often easy to miss. Such was the case for 18-year-old Kuleba, who sadly was getting ready to attend UF.
So if anesthesia has the ability to have this effect on anyone, why are people signing up for the unnecessary risk? If you're going to die from a surgical procedure, my thought is that it better be one that is intended to save your life in the first place.
Rebecca Ganzak is a journalism senior. Her column appears on Thursdays.
And yet, cosmetic surgeons in Florida say they are seeing more teenagers for plastic surgery than ever before. In 2005, more than 3,500 girls under the age of 18 had breast implants. I attribute this trend to celebrities and pop culture influencing the youth of America and expressing that corrective surgery is acceptable. If no one in Hollywood has a hooked nose, then why should a young girl find hers attractive?
In 2004, more than 326,000 boys and girls under 18 had corrective surgery to fix something that made them self-conscious, according to the American Society of Plastic Surgeons.
But why do these common teenage issues like body image and self-esteem result in the drastic measure of going under the knife? When I am a parent, if my 18-year-old daughter expresses to me that she wants larger breasts or a straighter nose, I plan to kindly inform her that appearance isn't everything. And that I'm not paying for it.
There is plenty more that parents can offer their child than a swipe of a credit card and an introduction to their city's best plastic surgeon. As expensive as it may be, I think parents are using this method of correction as a way to avoid actually being a parent.
Despite the popularity of breast augmentation, it has a high rate of complications and often requires additional surgery within five to 10 years of the original procedure. The same goes for nose jobs.
I don't understand why a parent would want to willingly put their child through such a risk. I guarantee once the teen is done obsessing over one flaw, he or she will move to another. Soon, earlobes protrude too much or calves are too little.
Since I was a freshman in high school, I had wanted a nose job. After breaking my nose several times, the rather large bump that developed was not something I enjoyed seeing in the mirror every day.
But I soon changed my mind after I researched the pain involved, high costs and saw a few graphic episodes of "Dr. 90210."
I have been put under anesthesia before, so that thought did not scare me. However, I did not stop to consider that the chance of death due to anesthesia is pretty common, about 1 in 200,000, according to studies done in 2004. And this doesn't include cases where anesthesia was a secondary factor or contributor to a patient's death.
According to a New York Times article, the agreement among surgeons is that the risk is much higher for elderly or very sick patients, or those with certain medical conditions, which are often easy to miss. Such was the case for 18-year-old Kuleba, who sadly was getting ready to attend UF.
So if anesthesia has the ability to have this effect on anyone, why are people signing up for the unnecessary risk? If you're going to die from a surgical procedure, my thought is that it better be one that is intended to save your life in the first place.
Rebecca Ganzak is a journalism senior. Her column appears on Thursdays.
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July 2nd, 2009 CorrectionThe UF-Georgia football game is held annually at the Jacksonville Municipal Stadium. The contract for the game is between UF and the city of Jacksonville. An article in Tuesday’s paper stated otherwise. |
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The following are comments from the readers.
anguaa wrote on Mar 27, 2008 2:37 PM:
" Not everyone has malignant hyperthermia, so comparing Kuleba's situation to everyone else is a poor comparison. "
narkose wrote on Nov 17, 2008 6:17 PM:
" For anguaa -
You have missed the essential point -
the mere risk of malignant hyperthermia is unacceptable and avoidable for elective cosmetic surgery
General anesthesia(GA) for cosmetic surgery is a massive 'overkill' of trespass on the patient
perhaps an analogy you might understand is one can eliminate a housefly with a shotgun (GA) or a flyswatter ('Goldilocks' anesthesia) - both will do the job but the shotgun leaves a much bigger mess to clean up. "
You have missed the essential point -
the mere risk of malignant hyperthermia is unacceptable and avoidable for elective cosmetic surgery
General anesthesia(GA) for cosmetic surgery is a massive 'overkill' of trespass on the patient
perhaps an analogy you might understand is one can eliminate a housefly with a shotgun (GA) or a flyswatter ('Goldilocks' anesthesia) - both will do the job but the shotgun leaves a much bigger mess to clean up. "
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narkose wrote on Mar 27, 2008 8:15 AM:
Corona del Mar, CA
She wasn’t as famous as Olivia Goldsmith, author of The First Wives Club, but Stephanie Kubela’s death was just as avoidable, says Dr. Barry Friedberg, a globally recognized leader in cosmetic surgery anesthesia.
Complications from rare genetic disorder, malignant hyperthermia (MH), appear to be the cause of the Florida teenager’s needless death.
Triggering agents for MH are inhaled general anesthetic (GA) agents (i.e. halothane, desflurane and sevoflurane) and the muscle relaxant, succinycholine (SCH), used to intubate the airway.
GA is the predominant choice of anesthesia cosmetic surgery, so her surgeon was within the ‘standard of practice’ in that choice – expedience over outcomes.
Unfortunately, GA or the ‘standard of practice’ includes many unnecessary, avoidable and potentially fatal risks to patients choosing to have surgery that has no medical reason or indication.
Among those avoidable risks are MH, blood clots to the lungs, airway mishaps leading to lack of oxygen to the patient’s brain, postoperative nausea and vomiting (PONV), and postoperative cognitive disorder (POCD).
All of these risks can and should be avoided by having surgeons and patients choose a kinder, gentler anesthetic technique – propofol ketamine or minimally invasive anesthesia (MIA)® pioneered by Friedberg.
Neither propofol nor ketamine are triggering agents for MH. Had Ms. Kubela received MIA, she would likely be alive today. BIS monitoring of the patient’s brain gives a numerical value of propofol sedation at which ketamine can be given without negative side effects.
In 2005, The Doctors’ Company (TDC) Newsletter extolled the safety of propofol ketamine over general anesthesia for prevention of blood clots to the lungs. TDC is a medical malpractice carrier with a high percentage of plastic surgeons as insured.
No airway mishaps have been reported with MIA. With minimal trespass, patients tend to breathe normally and require little assistance or intervention to keep their airways open. No lack-of-oxygen accidents have been reported with MIA.
MIA has the lowest published rate of PONV, highly desirable, especially for facelift and tummy tuck patients.
Sometimes MIA is called ‘Goldilocks’ anesthesia. BIS monitoring eliminates the common anesthesia practice of giving too much for fear of giving too little. The opportunity for POCD is thereby greatly minimized.
More anesthesia providers are recognizing the advantages of MIA. Both surgeons and anesthesia providers need to be asked to provide it to optimize patient safety for cosmetic surgery.
Barry L. Friedberg, M.D. has been in active practice exclusively in office-based anesthesia for cosmetic surgery since 1992. He has published 30 letters to the editor, 14 articles and 6 book chapters including 3 in Anesthesia in Cosmetic Surgery recently published by Cambridge University Press.
More information can be found @ www.cosmeticsurgeryanesthesia.com, a patient oriented, non-commercial web site.
Disclaimer: Dr. Friedberg is not employed by Aspect Medical Systems, makers of the BIS monitor. He is not a stockholder or a paid consultant. The opinions expressed herein are his professional opinion based on 11 years experience with BIS monitoring.
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