Surgery to die for

Recently, a final-year medical student from the Madras Medical College died a day after undergoing a hair transplant procedure in Chennai. Doctors suspected the cause of death could be anaphylaxis — an allergic reaction to the anaesthesia used. More importantly, the centre was licensed only for cutting and styling hair and not for advanced procedures. The procedure went on for six hours, with plugs of skin with hair from the back of the scalp implanted on the bald patch.

This is the side to cosmetic surgery that society doesn’t talk about — it often involves multiple wounds, anaesthetic risks and infections. “A young medico loses his life after undergoing a virtually harmless procedure like hair transplantation,” says Dr G. Venkatesh Babu, consultant plastic reconstructive and aesthetic surgeon at Care Hospitals, adding, “Deep introspection is required.”

After the medico’s death, plastic reconstructive and aesthetic surgeons warn of the dangers of these procedures without precautions.

Dr N. Jithendran, consultant plastic and reconstructive surgeon, Aware Global Hospitals, points out: “Surgeons with little experience and at times without qualifications, who pass themselves off as licensed professionals, are causing serious harm to patients on operating tables.” He adds, “Cosmetic procedures have a dual edge. They enhance beauty but again do not promise anything. The risk is always with the patients.”

Why are people crazy about needless surgeries “This is a very tricky and important question in today’s world. Any surgery has ethical guidelines and protocols need to be followed. Every patient has to earn his surgery so that it will be complete in its nature. Counselling is lacking in our system and needs to be improved. All these surgeries which are currently done in many hospitals should not be termed as needless or unwanted surgeries without clinical evidence. Few surgeries are gaining popularity because of focused importance by society within ethical guidelines. In today’s practice, the patient’s expectation and outcome of any treatment is very high and to meet this, probably tertiary care centres’ performance has gone up,” argues Dr C.R.K. Prasad, senior laparoscopic and bariatric surgeon, Apollo Hospitals.

Dr Jithendran says, “It doesn’t come as a surprise that these days gynaecologists are doing liposuctions, ENT surgeons are doing hair transplants and even orthopaedics are doing flap surgery and grafting. They are not qualified to do such surgeries. Even though obstetrics and gynecology have combined training, a gynec can’t perform liposuction. It is against the patient’s safety to allow a general surgeon without minimum qualification and proficiency to perform a specialised and risky surgery.”

Leg-lengthening procedures were originally used to treat limb defects or injuries, but recently a growing trend has emerged and patients, especially youngsters, request doctors for the sole purpose of becoming taller. “One should understand that these procedures range from simple to complex and have two sides of the coin — benefit and risk. The risk-benefit ratio has to be assessed before undergoing any procedure. If the risk is more than the benefit then it is better to avoid it,” explains Dr N. Jithendran.

The most popular cosmetic procedures are for making eyes rounder, slimming down jaws, or making noses pointier.

But is the industry out of control “Patients are often brainwashed with the faulty logic of less expensive and less risky surgeries with lower downtime. The result is inadequate and very short lived. An example is that of someone whose facial skin and muscles are very lax. They needed surgery, but were treated by non-surgical methods, bringing a bad reputation to the profession. Most abused is skin lightening treatments.

Injections, lasers and platelet rich plasma. Another example is non-surgical liposuction. Liposuction is surgery, what is non-surgical liposuction Huge billboards everywhere. Both non-medical and some medical personnel are responsible for this,” says Dr V. Sudhakar Prasad, plastic and cosmetic surgeon at Apollo Health City.

Some see the boom in cosmetic surgery as a result of new, more sophisticated procedures and safer anaesthetics. Others credit it as a craving for instant gratification, youth and perfection, and fear of aging and death.

Dr Padmavathi, dermatologist and cosmetologist, adds, “Non-surgical procedures are more popular as they don’t have any downtime. These are delicate procedures which require a lot of technical and anatomical knowledge. It may look easy, but they take care of individual nerves and vessels.

“Now-a-days treatments like Botox, fillers and lasers, etc. are done by unqualified people. That’s why you see so many reports about side effects and disfigurements. Don’t go by ads, check whether the treatment is being done by a qualified person or not.”