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General Health : Government Last Updated: Apr 20, 2011 - 9:38:09 AM

California considers more regulation on plastic surgery
By Sue Mueller
May 27, 2008 - 1:17:26 PM

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TUESDAY May 27, 2008 ( -- Lawmakers in California are urging new legislation to enhance the safety of plastic surgery procedures six months after the mother of Kanye West died after liposuction and breast implant surgery, Los Angeles Time reported on May 26.

This is not the first time the state lawmakers attempted to regulate the fast-growing cosmetic surgery business.  The procedures are now commonly performed outside hospital settings in outpatient clinics and many see a necessity to oversee the qualifications of plastic surgeons, accreditation of facilities and readiness of safety measurements.

California pushed to regulate outpatient surgical centers more than a decade ago after high profile patients were reportedly injured or dying during procedures. State law says that such centers should be accredited by an agency recognized by the state government and requires that a clinic should have resuscitation equipment and procedures ready to transfer a patient to a hospital.  But those advocating for greater surveillance say attempts to regulate the industry proved ineffective.

State Sen. Mark Ridley-Thomas (D-Los Angeles) this time proposed a regulation known as SB 1454 to have the cosmetic surgery clinics regularly inspected, for instance, at least once in every three years.

The death of Donda West has also prompted another California lawmaker to push for more patients' safety measures. A bill, AB 2968 by Assemblywoman Wilmer Amina Carter (D-Rialto) requires a patient to receive a physical examination prior to undergoing cosmetic surgery.

Donda West, 58 a retired professor and former chairwoman of the Chicago State University English department, died at a Los Angeles hospital on Nov. 10, 2007 a day after she underwent breast reduction, tummy tuck and liposunction procedures.  

West, who was said to have pre-existent hear condition, did not receive a physical exam by her surgeon, Dr. Jan Adams before surgery, Yolanda Anderson was cited by Los Angeles Times as saying. A spokesman for Adams has early said both Adams and the anesthesiologist thoroughly questioned West prior to the surgery.

Dr. Adams, the plastic surgeon who was reportedly not broad-certified but operated on rapper-producer Kanye West's mother denied any wrongdoings.  Adams said on CNN's Larry King Live that his practice was almost ruined by the bad publicity following West's death, but said he wanted to continue his business, CBS/AP reported on Jan 23, 2008.

It is unknown if the cosmetic surgery West received might play any role in her death.  A corner's report failed to identify the exact cause, but suggesting that she likely died from heart disease coupled with post-surgical complications.

Cosmetic surgery is real surgery to mind those who are willing to risk their lives to beautify their public images.  And no surgery is free of risk.  Many patients may mistakenly view cosmetic surgery as minor procedures and do not realize that some types of plastic surgeries like others are extremely complicated and may carry serious risk including death although rare.  

California is not alone having reported injuries and deaths associated with plastic surgery and seeking more oversight of doctors performing cosmetic surgery.  Two years ago, according to media reports, Florida passed legislation to educate patients about their doctor's credentials.

In Florida, the state took measures to increase oversight over non-hospital surgeries after at least 12 people who underwent surgery in office-based settings died in 1998, Chris Nuland, general counsel to the Florida Society of Plastic Surgeons, was cited by Los Angeles Times as saying.

In Canada, the Council of the College of Physicians and Surgeons of Ontario has passed a series of measures to self-regulate cosmetic surgery in the province two months after Krista Stryland, a Toronto real estate agent, died after undergoing Liposuction at the Toronto Cosmetic Clinic, CBC News reported on Nov. 20, 2007.

The proposed regulations prevent doctors from calling themselves surgeons if they're not trained for surgery and require that doctors report to the College before they change the scope of their practice and begin performing different medical procedures. The council also appointed a panel to identify the high risk cosmetic procedures and clarify what types of training are needed to perform such risky plastic surgeries.

In an effort to strengthen patient safety, Israel also has introduced tight restriction on cosmetic procedures, according to media reports, that can be carried out by plastic surgeons and on who may legally claim to be a plastic surgeon.   In the past, no regulations specify who can claim to be plastic surgeons.

The new Israeli regulations stipulate that breast augmentation, liposuction, body shaping, abdominoplasty and face lifting can be performed only by surgeons certified by the Minister of Health.

Cosmetic surgery has become a good business and almost a public obsession. The demand for the top three procedures in the United States and the UK as well grew by 26% between 1999 and 2000, according to an editorial published on BMJ 2002;324:1229-1230.

The American Society of Plastic Surgery suggests that patients should not focus on the outcome of the surgery they pursue alone. They need to pay attention to the safety of the procedure they are going to undertake. 

One thing patients need to do is make sure that their doctors are plastic surgeons certified by American Board of Plastic Surgery although certification alone does not guarantee that their doctors will definitely perform the procedure perfectly. Certification means only that the surgeon has completed the rigorous requirements for full time practice as a specialist in plastic surgery.

© 2004-2008 by unless otherwise specified

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