Cosmetic surgery gets cheaper, faster, scarier

MIAMI -- Elsie Soto says she couldn't move her legs after she had liposuction and fat-transfer surgery last year at a clinic near here. But instead of sending her to a hospital, a nurse took Soto to her own house. Soto says she has no memory of being taken to the hospital two days later — on her mother's insistence — and needed two blood transfusions when she got there.

A 32-year-old single mother, Soto said she was tired of looking at all the beautifully toned people surrounding her in this popular beach town. She went to three area plastic surgeons before deciding to have her procedures done at Strax Rejuvenation and Aesthetics Institute. It was a simple matter of cost: The other estimates ranged from $10,000 to $12,000; Strax charged $5,000.

But after almost $50,000 in medical bills (including nearly $40,000 for her hospital stay) that insurance won't cover because the procedure was elective, three months out of work and continued pain down her left leg, Soto now says low-cost, high-volume cosmetic surgery clinics are not the way to go.

Strax, which has two locations in South Florida, boasts it is the busiest cosmetic surgery center in the U.S. Soto says that's part of the problem: She thinks she was just another patient whose problems got short shrift in what seemed like an assembly line of patients.

"On Sunday morning, everyone goes to Denny's and comes in and out, in and out, in and out," says Soto, a hospital purchasing aide. "That's how it was." Soto filed a complaint against Strax with The Joint Commission, an independent, not-for-profit organization that accredits most hospitals and many health care facilities, including Strax.

Strax says it is helping consumers by making cosmetic surgery affordable for the masses. Peter Mineo, an outside attorney for Strax, said in an e-mailed statement that Soto "suffered a bruise to her sciatic nerve," which he called a rare but well-known potential complication of fat-transfer surgery to the buttocks. He says Soto was told about the risk. The nurse treating Soto was violating company policy when she took Soto to her home, Mineo says, but called it a "very kind act." And Strax believes Soto's medical problems were quickly resolved, Mineo says. USA TODAY reviewed Soto's medical bills and a statement from her physical therapist.

A booming business

Critics call it the commoditization of cosmetic surgery. Procedures that once included lengthy consultations with plastic surgeons and trips to the hospital, now often involve meetings in office-park surgery centers with salespeople who tell prospective patients what "work" they need and how little it can cost when performed in their offices, say former patients, other plastic surgeons and plaintiff lawyers.

While these clinics typically employ plastic surgeons who are either board-certified or up for certification, lawyers, victims and other plastic surgeons say these new-style surgery clinics are under so much sales pressure they often don't sufficiently screen patients for medical problems, do inadequate follow-up and persuade patients to undergo procedures that are either unnecessary or unlikely to get good results.

Cosmetic procedures ranging from Botox to buttocks lifts performed by plastic surgeons were up 77% last year, as consumers flock to clinics including Strax, the national chain Lifestyle Lift, and other busy cosmetic surgery centers geared to the budget-minded.