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September 15, 2009

Plastic Surgery Nightmares

model holding breast implant

Photo Credit: Liz Von Hoene

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Last May, Carla Mainella, a 47-year-old Hollywood, FL, woman with stubborn post-baby fat congealed around her waist and upper thighs, had no reason to suspect that the doctor she picked to administer SmartLipo with Vaser—a procedure that combines two laser techniques to melt adipose tissue (which is then suctioned out with thin cannulas) and sculpt the skin—was anything but highly trained. The website for his wife's medi-spa, out of which he operates, was very enticing, brimming with pictures of the doctor surrounded by beaming, buxom Miami Dolphins cheerleaders; furthermore, Sound Surgical Technologies, the company that manufactures the Vaser Lipo machine, had listed him on their site. Mainella thought it was curious that her three afternoon appointments were delayed until late evening—one session lasted until 4 a.m.—but she was so delirious from the Valium they gave her when she walked through the door (and which she was still feeling the buzz from when she drove herself home), she stayed. "I call it the Horror Clinic," she says today, recovering in Italy from third-degree burns on her inner thighs, stomach, and back; the nerve and muscle damage in her legs may well be permanent. "I was only a little bit fat—I'd worked out my whole life. Now my body is destroyed," she says. Mainella, who runs a high-end Italian import-export business and owns a real estate company, is devastated that she let herself be victimized by someone with no expertise. It was only after she contacted a lawyer that she found out the doctor was certified solely in internal medicine with a specialty in pulmonary disease, and had settled a wrongful-death suit for $240,000 just one month before her procedure.

"Any medical doctor can practice cosmetic surgery—they don't have to specialize in it," says attorney Aronfeld. "We see gynecologists and pediatricians doing plastic surgery. An EMT or cardiologist could do Botox injections." Because Florida (as well as several other states) does not require doctors to carry malpractice insurance—and the Homestead Exemption protects their homes from collection on liability settlements—"it's really the perfect place for the less scrupulous medical provider to come and take advantage." And it's not just unlicensed foreign doctors crossing the border. "It's nice Jewish guys you'd want to introduce to your daughter who are taking advantage of the situation. They're in it for the money, thinking, Hey, it's legal. Why not? The danger now is the crossover—when your friendly neighborhood orthopedic surgeon decides he's going to do face-lifts."

Even dentists are getting in on the action. Board-certified dermatologist Dr. Roy Geronemus, director of the Laser & Skin Surgery Center of New York, was shocked to receive a notice from his own dentist saying that he offers Botox. "I found a new dentist," says Geronemus. "He ought to stick to what he's trained in."

"It's becoming very popular with them right now," says Dr. Louis Malcmacher, a general dentist from Ohio who travels the country training others to inject the substances, citing that it's now legal in at least 22 states for dentists to inject wrinkle-treating neurotoxin and dermal fillers. Calling from the Courtyard by Marriott at LaGuardia Airport, where he's just taught a course in Botox to 20 of his colleagues, he dismisses the polemic as a mere turf war, with core practitioners trying to keep all the money in their own pockets. Dentists are born injectors, he says. And anyway, "15 percent of Allergan's sales of Botox are going to OB/GYNs—now what the heck are they doing in the facial area?" he adds with a laugh. (Allergan says that it does not track sales by specialty.) Malcmacher markets his sold-out classes on his website ("Learn to produce up to $3000 per hour with these nonsurgical techniques") and admits he started injecting to satisfy his wife's penchant for the services. "Why should I send her to someone else, for crying out loud?" he says. It was easy not to: Allergan will teach even nonphysicians how to shoot its intramuscular toxin. (A spokeswoman for Allergan stresses that although they teach physician assistants and nurses, the company sells its products only to physicians.)


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