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September 15, 2009

Plastic Surgery Nightmares

model with tray of plastic surgery tools

Photo Credit: Liz Von Hoene

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"They don't care," says Boger from Gallerani's office, referring to how easy drug and medical device companies have made it for doctors to perform procedures outside their specialties. "The Vaser salesperson—who is not even a medical rep—comes in and says in six months you can make this much money; he trains the doctor in the afternoon, leaves him with a certificate, and then the doctor's on his own. These companies are out for the profit." (Vaser confirms their sales reps don't have medical training, but says registered nurses perform the actual training once a device is purchased.) Unqualified practitioners need not even jump through those hoops: Internet training services, such as Future Aesthetic Service Training, offer online classes 24 hours a day. (Its $695 two-hour Botox Basics class is "for medical professionals looking for new income streams," according to its website.) Laser devices are easily acquired on the unregulated secondhand market—eBay is rife with them—no training offered.

While most women unwittingly fall prey to unqualified doctors, some actually seek them out. After one Beverly Hills plastic surgeon asked Kanye West's mother, Donda, to undergo a medical clearance test before proceeding with a tummy tuck and breast reduction (standard procedure for patients over 50), she didn't, and found another doctor, Jan Adams. The day after her surgery, West died of heart disease and multiple postsurgical complications. Adams, who was not board-certified, at the time had multiple DUI-related arrests and at least four malpractice suits against him. (In February, he was sentenced to a year in jail for his most recent DUI; in April, he surrendered his medical license.)

A shocking number of women also check their good sense at the door when irresistible convenience is on offer. Board-certified L.A.-based dermatologist Dr. Jessica Wu says she just saw a patient—a young California yoga instructor and mother of four—who couldn't resist her family doctor's drive-by Botox offer when she was in for her kids' checkups. He offered her a discount, and, well, she was there. When she suddenly lost her vision a few weeks later, she rushed to the emergency room, thinking she was having a stroke. Wu says it was a temporary reaction to a faulty procedure. "People do these things because they think Botox is Botox is Botox, filler is filler is filler, no matter where you get it done," Wu says. "But you have to be careful. It's kind of scary out there now."

Watered-down or contaminated Botox, the reuse of liposuction tubing with multiple patients—nothing is off-limits in this tight market. Yet another problem is the infiltration of cheap, non-FDA-approved drugs traded on an oversaturated black market. General practitioner Dr. Jerome Lentini was recently sentenced to 18 months in the Federal Correctional Institution in Sheridan, OR, for injecting patients with research-grade drugs from China that he bought online. "I know that some of my colleagues are purchasing from these companies because it's cheaper than going through legitimate channels," says Wu. "But how do you really know what you're getting? In China, they've counterfeited Botox and made the labels to look identical." In March, Dr. Douglas Halliday, an ear, nose, and throat doctor from East Syracuse, NY, was found by his state's Board of Medical Conduct to have injected 12 patients with an unapproved botulinum neurotoxin labeled "For research purposes only—not for human use" from a company in Arizona. (He was fined and put on probation but is still practicing.) Dr. Gayle Rothenberg, an anesthesiologist highly regarded in the cosmetic field in Houston, was charged with using the same bargain knockoff on more than 170 patients, which allegedly resulted in over $98,000 in profits. Her subsequent conviction was reversed on appeal, and a new trial is scheduled for next month. At least two of her patients claim they now suffer from neurological problems.

One month before 39-year-old Tiffany Barton got remarried, she decided to plump up her lips. There was a "doctor," Mario Nieves Perez, who made frequent visits to the hair salon where she worked as a stylist—the BellaSera Salon in Fresno, CA—offering bargain injections of Restylane for $100. (The national average is $500, according to the American Society for Aesthetic Plastic Surgery.) "I saw the women with Gucci purses coming in to visit him, and it gave me a certain amount of confidence," Barton says. After Perez showed her and her fiancé pictures on a website of what he claimed was his work, she went ahead with the procedure. A month later, on the day of her Las Vegas wedding, she woke up with raised red welts on her throbbing lips (which, thankfully, weren't yet detectable in the photos). When she called Perez, he told her that he had actually injected her with a permanent collagen-based substance called Artecoll, instead of Restylane. "That's when I started getting scared," says Barton. With each passing day, her lips got more swollen and painful; there was no camouflaging the damage a week later. After being turned away by four doctors, she finally found a board-certified dermatologist—Dr. Harry Glassman in Beverly Hills—who would perform three separate surgeries on her lips to remove the unknown chemical (most likely industrial-grade silicone, not Artecoll). "My doctor said it was like chipping into cement—little pieces chunking off," says Barton, who has paid $45,000 out of pocket, the proceeds from a previous divorce settlement, to have a third of her upper lip removed. Her lips, while much thinner and still extremely painful, are finally looking close to normal. Not until she went to the police—four other victims have come forward as well—did she learn that Perez was not actually a doctor. He has since fled to Mexico, and there's a warrant out for his arrest.

The recession has created such a boom in fraudulent doctors that the Florida Department of Health has made more arrests in the first three months of this year than in all of 2003. "I have five investigators," says Bradford Jones, the investigations manager for the Florida DOH's Unlicensed Activities Office, the only office of its kind in the country. "We could double our size, we have so much work."

Sitting next to Jones at a conference table in the concrete bunker of the Intergovernmental Bureau in Miami Gardens, FL, Randy Caballero, a sergeant with the Miami-Dade Police Department's Medical Crimes Unit, says that he has a crushing workload of open cases investigating fake physicians. "A really troubling trend" they have seen lately is licensed doctors knowingly hiring unlicensed doctors. One brought on an unlicensed gynecologist from Cuba, paying her $500 to do vaginal reconstructive surgery on unsuspecting women for which he pocketed $5000 per procedure. "And that's unfortunate, because you, as a customer, think you're doing everything right," says Caballero. "These places are all over TV infomercials, and you think this has got to be legit. Why would they want to jeopardize the business by putting fake doctors in there? But they put them in there. How do you stop a real doctor who is just a bad guy who wants to make money? This isn't something that's going away anytime soon."


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