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June 16, 2009

Multiple Plastic Surgeries in Mexico: Don't Do It!

I am going to have a tummy tuck, breast lift, and breast augmentation done at the same time with a board-certified doctor in Mexico. He says he can also do minor liposuction and inject the fat in the buttocks to give me a more smooth look.  He says this is included on all tummy tuck patients if they wish to do so, but I am a little nervous. Is it possible to have the three procedures done, along with the lipo and Brazilian butt lift?

- Housewife in San Diego

I am sorry to pick on you "Housewife in San Diego," but your question is very concerning to me. Frankly, I don't think you are being safe.

You're surgery is going to be far too long....

Dual-plane breast augmentations        1 1/2 hours

Wise-pattern (anchor) mastopexies     3-4 hours

Tummy tuck                                      3 hours

My math indicates that you're now up to about 8 hours.  Frankly, that's already pushing it.

I try to avoid operating on a cosmetic patient for longer than 6 hours at a time.  If she is young and very healthy, then maybe I'll do 8 hours. If I think that the case is going to last longer than 8 hours, I never do the operation in an out-patient surgery center.  I do these ultra-long procedures in a real American hospital with all of the safety precautions. The patient stays overnight for close monitoring by an excellent nursing staff.

OK, but now you want to add Brazilian butt lifting.  (Truthfully, I don't think BBL even works. It has never produced long-term success in my hands, and so I don't do this procedure at all anymore.  But anyways...)

Liposuction                                         1/2 hour

Brazilian butt lifting                              1 hour

So, now you've been in the operating room for at least 9 hours. 9 hours is way too long since I bet, Housewife in San Diego, that you will not be having your surgery in a fully accredited hospital.

Sorry. But this plan sounds unsafe.

Practicing in Ventura County, California, I take care of 5-10 patients annually, whose aesthetic surgeries were botched during Mexican plastic surgery adventures. To me, the thought of obtaining medical care—especially surgery—outside of the USA is ridiculous. Many plastic surgery procedures come with significant risks.  For example, most honest American/European/Asian research studies of breast reductions report 30-40% rates of complications!  For tummy tucks, 25-35%!  Many of these complications do not manifest themselves for 2-3 weeks.

So, Housewife in San Diego, what are you going to do if you have a complication?  Drive back to Mexico?  Who is going to take care of your complication at 2 am?

Well, in my community, I do. So, yes, I am bitter. I do resent going to the emergency room in the middle of the night to take care of a patient who had bad surgery done by a foreign doctor who had no intention of looking after her.

And, frequently, my hands are tied because I do not know the details of the surgery. Is the patient supplied with information regarding antibiotic usage? Suture type? Implant size and manufacturer? The answer is always, “No.” Have the patients and I ever been able to obtain this information from the foreign surgeon? Almost never.  Ultimately, my management of the patient’s complications is necessarily suboptimal because I do not have the specifics.

I certainly admit that not every physician in the United States is outstanding. In fact, while there are approximately 60,000 American physicians performing cosmetic procedures, only 6,000 of us are certified by the American Board of Plastic Surgery. Certainly, we need to clean up our own backyard.

Likewise, I am more than happy to refer patients to any number of outstanding Mexican plastic surgeons. Many of the world’s leaders in plastic surgery come from Mexico, particularly Mexico City.

But if you're going to get plastic surgery in Mexico, then do it right. Make sure that the surgeon is truly Board Certified. Which Board? The plastic surgery board or the general surgery board?  Is the facility accredited? What's the policy for complications? Who do you call in the middle of the night?

After you've found a Mexican plastic surgeon who gives you all of the "right" answers, then plan to stay in Mexico near his clinic while you recuperate.  Make sure that you follow-up with the surgeon who did the actual surgery.

Because of the need for prolonged follow-up, even my Mexican colleagues who are fantastic surgeons are not right for my Californian patients.  Follow-up is a crucial part of any surgery.  Surgical care does not end when you leave the operating room!  Patients need to be nursed through complications--some of which don't manifest for 4-8 weeks.  Patients also need reassurance; they must have the opportunity to come to see me, any day of the week and any time of day, to make sure that their experiences are “normal.”  Patients need continued compassion.

And a doctor can’t do any of those old-fashioned duties across the border.

Moreover, a doctor needs to see his/her results. How can I make improvements in my technique if I don’t get to see my results after complete healing?  This might be the biggest flaw of the cross-border surgeons.  They don’t even know that they are continuing to make mistakes, because they never see their own complications.

Some things just shouldn’t be “out-sourced.” Medical care is one of them.

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Comments

fit carey

can you give me the name of the doctor inmexico where your gettigns yours don

cosmetic surgery south africa

Good post. Thank you for informing this lady, as well as all you read this about the risks. I cant believe, 8 hours of surgery. Wow, thats really pushing it!

New York liposuctions

Is something that in most of the cases people don't really need, while health care, in the other hand, is very important. I just wanted to add that I am a huge supporter of people doing what they want to with their money, it's their money after all. So if these people want to spend their money on plastic surgery then so be it and getting their money worth paying for the surgery why should nit they be.

Michael Pickart


I totally agree. A person should be able to spend his money as he wishes. (Thats why I opposed the BoTax.) However, consumers should be smart. Paying for 2 surgeries (the first in Mexico, and the second corrective surgery back homein the USA) is not a good use of scarce monies!

Michael C. Pickart, M.D., F.A.C.S.
Pickart Plastic Surgery, Inc.

428 Poli St.,#2C, Ventura, CA 93001
(805) 648-4567 | fax (805) 641-0811


To: info@pickartplasticsurgery.com

cosmetic surgery in Cancun

Great post!!giving awareness about surgery that makes bad impact is always good.But it doesn't mean that all the surgeons do it just for money!!..All the doctors who are in this field in different hospitals like hospital galenia Wont allowe to make a bad impact on there patients.A good surgeon always care there patients..

Rickson

F1
I really like the fresh & innovative perspective you did on the issue. Frankly speaking I was not expecting it when I started off studying. Your concepts were easy to understand. Glad to know that there’s an individual out there that definitely understand

CAPlastic Surgeon

Stay away from foreign countries when it comes to plastic surgery. It's too complicated when problems crop up. It's also very unfair to expect a general practitioner to clean up your surgeon's mess.

Karen

How about people who can't afford American Doctors, but still want excellent health care... I think most people who go to Mexico or any other foreign country are doing it becxause they have no choice but to...

Michael C. Pickart, M.D., F.A.C.S.

Karen, your point is a good one. American healthcare is, I agree, too expensive. If you are lucky enough to have health insurance, American medical is unquestionably the best in the world. But for th 15-20% of the population without any insurance coverage, the system is a disaster.

However, my practice focuses on cosmetic surgery, which is never covered by health insurance plans anyway. Since patients always pay out of pocket for tummy tucks and breast implants, and since these are luxury services, my point is that you should spend your money wisely. Use high-quality facilities with vetted physicians, who have passed rigorous Board examinations.

While some Mexican facilities are top notch, it's hard for a visiting American to be assured that the OR really is safe. It's much easier to do this at home--in the USA.

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