News & Features

Awful Plastic Surgery

Avoiding Bad Plastic Surgery

by Staff
Medically Reviewed by Ivan Thomas, M.D.

Even in the best of hands, any cosmetic plastic surgery has a small chance of a bad outcome. But add an untrained or minimally trained surgeon to the mix and those odds leap to Las Vegas house odds against you. Herewith, a handful of highly experienced board certified plastic surgeons recall some remarkable botched cases and where the patient went wrong.

It was one of the most outrageous cases the doctor had ever seen.

While examining a 40-year-old woman who wanted to lighten scars from a previous facelift, the patient told Beverly Hills plastic surgeon Behrooz Torkian, M.D. an amazing story.

About 20 years ago, when she was only 19, the patient had rhinoplasty surgery to repair problem breathing along with a breast augmentation. To save on costs, she went to Mexico. The outrageous part? She was also given a complete face lift -- against her will!

Says Dr. Torkian: "The patient told me she was under sedation during the nose surgery and woke up to a conversation wherein quite a few people where talking about the anatomy of her face while lifting up some of her cheek skin. She asked what was happening and the doctor gave her more anesthesia and told her to go back to sleep."

Bad Plastic Surgery

"When I examined her, I could see the facelift scars were pretty bad," Dr. Torkian told "Because she did not ask for nor authorize a facelift -- who needs one at 19? -- this would be considered assault and battery in the U.S."

"It required four hours and donor cartilage from his ears to repair its appearance and his breathing."

But why would a plastic surgeon give somebody a crude facelift, for no charge and without the patient's permission? The answer is chilling -- for practice!

Either the attending surgeon needed the experience or, the more likely scenario, the first surgeon was teaching on the side and brought in a rookie surgeon who really needed to learn the ropes.

Lesson learned: If you do venture to a foreign surgeon, learn the laws of the land first. In Mexico, one can't report or sue a surgeon for assault or battery.

And there's a not-too-surprising sidebar to the story. The Mexican surgeon botched the rhinoplasty by making that patient's nose too small. Dr. Torkian revised her nose and explained to her that in about one percent of cases, the common general anesthetic she was given -- known as Midazolam -- causes amnesia both before and after waking from a procedure. So she had mostly forgotten about the impromptu face lift.

Awful Plastic Surgery

In another case, Dr. Torkian performed a revision rhinoplasty on a man who suffered a nasal fracture at age 16 and could not breathe properly through his nose. To save on costs, his parents took him to Mexico for a rhinoplasty, which was done badly. At age 31, he could no longer put up with the resulting botched nasal surgery and saw Dr. Torkian for a revision rhinoplasty.

"I found his nose was in terrible shape; it looked like a student, or worse, had done the surgery," Dr. Torkian says. "It required four hours and donor cartilage from his ears to repair its appearance and his breathing."

These were not isolated cases, according to Dr. Torkian, who has consulted this year (2008) on about 20 botched nose jobs done overseas while repairing eight or nine of those surgeries.

Even more alarming: he has also seen other cases of foreign surgery performed on an unwilling or uninformed patient -- presumably for practice or teaching.

Plastic Surgery Gone Wrong

Current botched plastic and cosmetic surgery cases range from the New York City socialite who took her case against her surgeon to the U.S. Supreme court because her eyebrows were too arched, to the cases of Donda West and 18-year-old Florida cheerleader Stephanie Kuleba. West died after several cosmetic surgeries due to a lack of pre-surgical testing, while a rare anesthesia complication caused Kuleba's death. (Read more about the need for pre-surgical testing in plastic surgery.)

Even Priscilla Presley and Tara Reid, two celebrities who could easily afford the best, made headlines with their own botched procedures.

Priscilla Presley After Bad Botox
Priscilla Presley, above, did not check on her
"doctor's" credentials.
(TMZ Photo)

"Even in the best of hands, the rare complication crops up," says Darshan Shah, M.D., a board certified plastic surgeon with offices in Bakersfield and the Los Angeles area. "But the complications or unexpected outcomes are usually less than one percent. However, the qualified surgeon will know how to best deal with unexpected outcomes."

But most bungled surgeries involve ordinary people who muffed a key decision when deciding where, and by whom, to have surgery.

Recalls Anthony Youn, M.D., a Michigan board certified plastic surgeon: "A patient who had been to Mexico came to me to have the drains removed from her tummy tuck incision. In plastic surgery, the drains we use after that procedure are about the diameter of a pencil. But the drains in this woman were intended for chest drainage and were the size of a garden hose. Plus, she had a bad infection in her incision."

Lesson learned: Aftercare is an essential part of any plastic surgery procedure. If you go abroad for surgery, who will manage post-surgical care in case complications like an infection crops up? And at what cost? (Read the seven top questions you must ask before having surgery in a foreign nation.)

Botched Plastic Surgery

"My problem here in Michigan is that cosmetic surgery businesses hire very young or very old surgeons who may not be trained properly and then heavily advertise popular procedures at bargain basement prices," Dr. Youn says. "On your first visit, you discuss surgery with a sales staff member, not the performing surgeon."

"Some surgeon may advertise that he or she is board certified but you must hone in and inquire, 'certified in what?'"

Lesson learned: A red warning flag should go up if -- for any reason -- you can not first meet the doctor who is to perform your surgery.

"Botched cases also put qualified plastic surgeons in binds," Dr. Youn says. "If a patient comes to me for care but has no more money, do I turn him away or do I perform the surgery pro bono…which basically supports bargain basement surgeons?"

Each surgeon deals with that conundrum according to his or her own conscience. For Dr. Youn, if the bungled surgery only looks bad, the doctor regrettably declines most patients' pro bono reparative surgery. But if the botched surgery is causing a threat to life or health, like any moral physician he feels the obligation to treat them, without considering their ability to pay.

Lesson learned: Patients can be blinded by prices that are unrealistically low -- like $3,000 -- when compared to the prices charged by other qualified plastic surgeons in their area. For instance, in Dr. Youn's neighborhood, saline breast implant surgery done by a qualified plastic surgeon costs between $5,000 and $6,500.

If you happen to be price conscious, consider this: patients who bit on the bargain basement $3,000 breast augmentation must shell out about another $7,500 to $9,750 to correct a bungled job. Thus, seeing a fully qualified plastic surgeon can be like having an insurance policy for both your health and your pocketbook.

Patrick Hudson, M.D., F.A.C.S., a New Mexico board certified plastic surgeon, reports seeing one botched face lift in which the skin was pulled so tight, the patient had vision trouble.

"It required two operations, costing three to five times as much as the original surgeon was paid to repair the damage," Dr. Hudson says. "I had to take donor tissue from the patient's temple and other locations to repair it.

Post-Breast Augmentation Symastia
This 23-year-old patient's breast implants rolled
together into a condition known as Symastia.
Moreover, the surgeon did not know how to correct
it. More research would have revealed the surgeon
had little experience with breast implants.
(Cannon photo)

Other methods for more fully protecting yourself against botched plastic surgery include:

  • Reading surgeons' credentials online

While there are many medical boards that certify various specialties, the two that test cosmetic plastic surgeons are the American Board of Plastic Surgery and The American Board of Otolargyngaology. Moreover, your surgeon's certification should be listed at The American Board of Medical Specialties (ABMS).

Any cosmetic plastic surgery practice is largely a cash-up-front business and that attracts many types of physicians. So even when a doctor has a board certification, experts say the consumer should make sure the practitioner has not crossed over from another medical discipline -- like gynecology -- to perform a popular but unrelated procedure like liposuction or eyelid surgery.

"Some surgeon may advertise that he or she is board certified but you must hone in and inquire, 'certified in what?'" says Robert Kotler, M.D., a Beverly Hills cosmetic surgeon. "Some boards, like the Board of Laser Surgery, do not really mean anything."

  • Use a super specialist

"Nose surgery is very, very difficult," says Andrew Jacono, M.D., a New York City board-certified plastic surgeon. "It requires operating on about 2,000 noses to get a good understanding of the anatomy and how a nose heals after surgery. So use a super-specialist, a surgeon who performs the procedure you want two to three times each and every week."

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About our medical reviewer: Beverly Hills Plastic Surgeon Ivan Thomas, M.D., F.A.C.S. specializes in all breast procedures and a newer type of abdominoplasty known as the Beverly Hills Tummy Tuck which provides patients with dramatically flatter abdomens, along with a significantly better-defined waistlines.

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