When Plastic Surgery Goes Wrong

After four pregnancies, Denise Hendry, wife of ex-Scottish soccer pro Colin Hendry, decided to go under the knife to help flatten her tummy, a decision she regretted for years afterwards, and ultimately, paid for with her life.

During a 2002 liposuction procedure, Hendry suffered nine punctures to her bowels and colon, resulting in blood poisoning, renal failure, cardiac arrest, and a collapsed lung, according to a report published in the U.K. paper The Daily Mail.

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Over the next seven years, she would undergo several more procedures as surgeons attempted to rebuild her abdominal wall and give her a functioning colon, though these surgeries would all prove unsuccessful.

In a recently released excerpt from her diary at the time, Hendry wrote, "I wish I could turn back the clock about six years... this is an awful nightmare. I just want my life back together for my kids' and Colin's sake. This is so unfair."

During a final procedure this past spring, Hendry contracted meningitis from an epidural catheter and after two and a half months in intensive care, the mother of four died from massive brain damage July 10, according to U.K. press reports.

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In her diary, she wrote that she was "angry that those responsible can go home at night and be with their families and I can't; angry that not enough care was taken during the operation," adding that what happened to her was "a risk that was never discussed" and would have made her opt out of the optional procedure had she known, the Daily Mail reports.

Minimizing Plastic and Cosmetic Surgery Risks

Hendry is far from the first to have experienced the risks associated with cosmetic surgery. In 2007, rap star Kanye West's 58-year-old mother, Donda West, died following complications linked to a tummy tuck and breast reduction.

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Despite high-profile cases like those of Hendry and West, deaths related to cosmetic surgery -- at least those performed in accredited centers -- are rare. While surgeons in the United States perform millions of plastic and cosmetic surgery procedures every year, the mortality rate associated with these procedures is only about two deaths for every 100,000 procedures, according to a 2008 study.

But while deadly complications from cosmetic surgeries are uncommon, as with non-cosmetic surgeries, surgeons are quick to point out that there are always risks involved -- risks that anyone going under the knife should be aware of.

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"Any cosmetic surgery has the same basic risk of infections as any surgical procedure would have -- though usually minor, these risks can be life threatening," says Dr. Malcolm Roth, director of plastic surgery at Maimondes Medical Center in Brooklyn, N.Y., and vice president of the American Society for Plastic Surgeons.

"Any time someone is put under anesthesia for a procedure, there's an incredibly small risk of not waking up, [but] if you have other medical problems, that risk can be much higher," he says.

These risks do tend to be "somewhat lower" notes Dr. Garry Brody, professor emeritus at the division of plastic surgery at the Keck School of Medicine, "because it's healthy people electing to have surgery," and generally not those with pre-existing medical concerns.

But the risk can go up dramatically if the facilities or the surgeon is not up to snuff. The complications Hendry experienced are rare and a result of malpractice on the part of her surgeon, Dr. Gustav Aniansson -- who she successfully sued. Hendry became an advocate for better cosmetic surgery safety in the years before her death.

In West's case, her surgeon, Dr. Jan Adams, told the press numerous times that he was not responsible for West's death. However, an Associated Press report at the time revealed that he had two malpractice suits filed against him that ended in payouts. These lawsuits, both settled in 2001, ended in payouts of $217,337 and $250,000. West had reportedly been denied surgery at the hands of a different plastic surgeon, Dr. Andre Aboolian, on the grounds that she had a pre-existing condition.

According to Dr. Michael McGuire, president of the American Society of Plastic Surgeons, the key to minimizing the risks of these procedures is a mantra known as the ABCs of plastic surgery: accreditation of the facility where the procedure is performed, board certification of the surgeon, and checking out the credentials of the surgeon.

"In this country, only 14 states require that the facility where the procedure is performed is licensed or accredited for safety," McGuire says, adding that it's important for the patient to check on this.

When choosing a surgeon, it can be extremely easy to be deceived into believing that a doctor has the proper credentials when they do not, McGuire says.

The primary concern is that they are board certified by the right boards, McGuire, Brody and Roth say.

"There are a number of non-qualified boards that are developed by individuals with the intent of deceiving the public," McGuire points out, noting that just a "board certification" is not sufficient proof of the doctor's merit; it must be the board certification from the American Board of Plastic Surgeons.

You can find a list of board certified surgeons on the ASPS's Web site.

Picking the Right Doctor

"And forget all the advertisements," Brody says. "Anyone who advertises is someone you want to be careful of."

"It's a buyer beware situation, you cannot assume because someone has an MD that they are necessarily ethical, truthful, or appropriately trained," McGuire says.

Next, do your homework and ask the surgeon lots of questions about his or her credentials when you meet, Roth and McGuire say.

Make sure that he or she is qualified in a number of different ways of approaching the issue you bring in, Roth notes, "so that whatever the situation is, whatever the area that patients want improved, the surgeon has the training to offer all the options."

"You might even ask for before and after pictures and ask the doctor how many of that procedure they've performed," Roth says, and above all, "ask questions, have a frank conversation with your surgeon about the risks, and don't be in a hurry."

Also, ask the surgeon if he or she has surgery privileges at a nearby hospital, says McGurie, as this is another way to gauge credentials because hospitals only allow qualified surgeons these privileges.

For Hendry, it was a lack of these ABCs that may have increased her likelihood of complications, McGuire says.

"It was not a board certified surgeon who did the surgery, the facility was not nationally accredited and the doctor did not have local hospital privileges."

Luckily, with the proper consideration, one can find a great plastic surgeon, Roth says, as long as you don't rush through the process.

"There's never an emergency to do an elective cosmetic surgery [so] if you're in doubt, get a second opinion," he says.

"The reality is that major complications grab headlines because they are so rare, but dissatisfied patients are not uncommon. You want to minimize that dissatisfaction by having good communication and a well-trained plastic surgeon."