Do's and don'ts for nips and tucks

WASHINGTON, Aug. 4 (UPI) -- The death of a Massachusetts woman last week from a sham liposuction should raise red flags to consumers about fraudulent cosmetic procedures, experts say.

Fabiola DePaula, 24, died July 30 after a Brazilian couple, unlicensed to practice medicine in the state, gave her liposuction on a massage table in their basement. Although liposuction deaths in licensed clinical settings are not frequent -- the risk ranges from three to 100 deaths per 100,000 procedures -- many in the medical community are concerned about an upward demand for black-market cosmetic treatments.

"The consumer should take a 'buyer beware' (approach)," said Dr. Rhoda Narins, a dermatology professor at New York University and a past president of American Society of Dermatology Surgery.

Because it's a major surgery, lipo hoaxes are relatively rare. But cosmetic procedures such as laser and injection treatments, which often purport to make the skin healthier and younger, attract more scams.

In 2003 survey by the ASDS, nearly 41 percent of ASDS physicians reported an increase in patients who'd gone to cosmetic imposters. These patients often fell victim to scams with lasers, light rejuventation, chemical peels and acne therapy, and in some cases experienced delayed treatment of skin cancer and rosacea.

"A lot of times they get away with it," Narins said, "but you don't want to be the one where they don't."

More than 10.2 million cosmetic plastic-surgery procedures were performed in the United States in 2005, up 11 percent from 2004, according to the American Society of Plastic Surgeons.

In some cases, patients are fooled by a person they trust -- for example, someone who gave them massages or manicures in the past, Narins said. She has seen patients injected with dangerous commercial-grade silicone -- a substance not approved by the U.S. Food and Drug Administration for human use -- which their beauty specialists had recommended to smooth out wrinkles.

However, Narins emphasized spa procedures such as microderm abrasion are acceptable; people should just be wary of injections or surgeries by anyone other than a board-certified doctor. If you're in a hotel room, garage or house, that should be an immediate warning sign, she said.

"It's not enough to get the recommendation of your next-door neighbor -- maybe they were lucky," she said.

The Brazilian couple who performed the fatal liposuction on DePaula ran an underground ring for at least a few years, charging people around $3,000 -- a hefty cut from the average cost of $8,000 -- and relying on word-of-mouth referrals.

"If it sounds too good to be true, it probably is too good to be true," said Dr. Bruce Cunningham, president of the ASPS.

The case of the Brazilian couple is a serious crime and a "frank fraudulent ripoff" of the unsuspecting public, Cunningham said, but it's also fairly unusual. More worrisome, he said, is the phenomenon of trained physicians performing treatments that go beyond their expertise.

For that reason, ASPS recommends these tips for consumers:

-- Require a medical evaluation. Ask a physician to determine what's appropriate for you.

-- Be informed. Speak with friends and family about the procedure, as well as your physician. He or she should explain the risks, benefits and alternatives to your decision.

-- Determine if the physician is certified by a board approved by the American Board of Medical Specialties.

The American Society for Dermatologic Surgery also recommends patients follow these important do's and don'ts when embarking on a cosmetic procedure:

-- Choose a location carefully. Beware of locations outside a physician's office, such as a spa, salon or storefront in a shopping mall.

-- Make sure the doctor is on site. A board-certified physician should perform most cosmetic procedures.

-- Check credentials. Ask about background and training. Is the physician a member of a medical specialty organization?

-- Don't be afraid to walk away. If you get a funny feeling at any point while at an office, leave immediately and do some digging, Narins suggests.

-- Don't be afraid to ask questions. Some examples: What is something goes awry? Have you reviewed my medical history? Who will perform the procedure?

And above all, use common sense, Cunningham and Narins said.

"It's just like everything else in life -- you can't really cut corners," Cunningham said.

For more information:

http://www.plasticsurgery.org/news_room/Patient-Safety-Press-Kit-Index.cfm

http://www.asds-net.org/Media/do-dont/media-do-dont.html

www.quackwatch.org