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Posts Tagged ‘plastic surgery’

Celebrating book completion with Carla Luna, co-author Carlos Ochoa, and contributor Joanna Calzada.

Celebrating book completion with Carla Luna, co-author Carlos Ochoa, and contributor Joanna Calzada.

So the free pdf version of the book is complete – and available for download.  (It was hosted on the Smashwords site, but their software reformatted the pdf into a bit of a mess, so I’ve posted the original here.)

I am still working on print versions in both color and black and white for readers who prefer paper versions.  Unfortunately, the cost of printing color photos is outrageous – so please note that this is the direct cost – no profit added.

I would love to have an electronic book available but with the extensive footnotes – it’s quite an endeavor, and since I can not afford to hire someone, a little out of my reach right now.

Mexicali book

mexicali-a-mini-gem-guide-to-surgery-in-mexicali-baja-california:pdf

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It sounds awful to say but it’s a good thing my husband has been out-of-town this week – after all, considering my week in the operating room, he wouldn’t have seen much of me anyway!  But it always drives him a little crazy to see me racing from interviews to operating rooms – stumbling home late, with aching legs and a rumbling tummy, only to climb out of bed and the crack of dawn just to do it again.. then worry that I somehow won’t have time to write it all down – and round and round..  (That being said – he is phenomenal about understanding this driving motivation I have to interview, and to write – even when I’m not quite sure I understand myself.)

So he wouldn’t have complained about my whirlwind tours of the operating rooms this week – or the long days of back-to-back surgery but I would have felt bad about not seeing him all the same..

Instead with my husband thousands of miles away, I hear him smiling in the phone, laughing at my exploits, though I sometimes picture the wrinkle he gets in his brow when he thinks I’m not eating right, or getting enough sleep.. He currently serves as my remote editor for my articles at Examiner.com – calling to give feedback before submission.  He’ll be home soon – and he’ll be patient with me, as always.

Dr. Victor Ramirez, plastic surgeon

Had some great interviews and operating visits this week – including Dr. Victor Ramirez, and most of the plastic surgery community here in Mexicali – but to be fair, I will break it all up into a couple of posts.

Demonstration of techniques for breast reconstruction at Mexicali General

Back in my ‘home’ OR in thoracic surgery – which felt good.  I love meeting and seeing all the different specialties like bariatrics, urology and plastics, but it sure does feel good to come back home again..

back in thoracics (and trying to hang from the rafters)

I could wax some eloquent nonsense about the beauty of a muscle-sparing thoracotomy but then again – the good doc does almost everything minimally invasive, so I never see any.. (and you’ve heard me crow about dual port thoracoscopy.)

with more to come..

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Hundreds of thousands of french made breast implants have been recalled – sending women all over the globe into a panic.  These implants which are no longer in use in France, have been linked to an increased rate of rupture, and possible increased incidence of cancer.

But good news for readers – as you may recall from my interviews with several of the surgeons (as written in the book) – none of the surgeons I interviewed used french implants.  The majority used FDA approved implants (only one brand currently FDA approved.)  Several others use german made implants*.. But this is an example of the details I’ve ferreted out for my readers..

* Brand information and other details are available in the book, “Bogota: a hidden gem guide to surgical tourism.”

More stories about fake docs including this one about a phony performing liposuction while smoking a cigar on AWAKE patients..

This guy was actually a doctor, but that didn’t stop ten of his patients from dying after bariatric procedures..

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While we have discussed plastic surgery safety here at Cartagena Surgery several times, (you can read more here, here and here), it’s time to talk about “less-invasive” and “mini-surgery” techniques such as Botox.

It seems like everyone is offering injectables these days.  In many countries, including the United States – these treatments are offered in multiple places outside the plastic surgeons’ office by a multitude of practitioners including non-specialty physicians, nurses* and high-end salons.  Do you really think that your dentist should be giving you Botox?  Or your hair salon?

These treatments including Botox (botulism toxin), Restylane, juvaderm and other dermal fillers are often used as ‘refresh’ and rejuvenate the face without surgery.  Fillers are used for lip plumping and filling out fine lines and wrinkles. (Note: Botox is also used for several other ‘off-label’ uses.)

However, I’d like to remind everyone to use caution when choosing to use these products.  While less radical than surgery – these treatments are medications and need to be used cautiously (just like any other medical or surgical treatment).   Botox, in particular, when used incorrectly has been linked to several deaths.  Unlicensed practitioners have also been caught using unapproved substances such as construction grade silicone – leading to serious health consequences (this is what happened to Priscilla Presley about fifteen years ago).

The other thing we should talk about beside potential health complications, is the reason injectable and non-surgical treatments are such popular options.  We all want to look good – so shouldn’t you see a specialty trained professional?  When seeking cosmetic results – the results should be cosmetically pleasing – by someone with the experience to perform this properly, not an eye doctor, a dentist or beautician.  A board certified plastic surgeon is the best option to ensure that a person has the best results – without looking artificial or ‘frozen.”  It may cost more (but not always), but aren’t natural, pleasing  and safe results worth it?

* For example, as a licensed nurse practitioner – for a 200.00 fee and a one day course, I could (but am not) be ‘certified’ to give Botox and other injectable.  It doesn’t matter whether I have previous experience in plastic surgery, acute care, neonatal, family medicine or even if I have experience giving injections.  Other nurses, doctors, and paraprofessional personnel are eligible to take this and similar ‘short-course’ training seminars for injectable, laser treatments and other ‘minor’ plastic surgery procedures.

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Reno, Nevada

In case you were wondering, licensed plastic surgeons do not make house calls – at least not to perform surgery, that is.  In another story, highlighting the actions of fraudulent medical practitioners – this hack preyed on naive consumers – and was caught after performing a rhinoplasty (aka “nose job”) in someone’s living room.

As we’ve talked about in previous posts – these shysters take advantage of people’s trust, to scam them out of money, (often injuring or killing their unsuspecting patients in the process.)

In many cases, these phony ‘docs’ prey on foreigners (either medical tourists) or immigrants from other countries who are less familiar with the rigidity of the American Health Care system.  Sometimes they use shared culture or language to con their fellow countrymen into trusting them – thus dually victimizing these people, and unfortunately sowing further distrust of the medical system itself.  However, these stories serve as a potent reminder for consumers to stay vigilant and aware..

For all my readers – just remember, if the situation doesn’t seem right (i.e. no clinic, cash-only under the table deals, or “I just don’t have my license here but I am a famous surgeon back in X…” )  WALK AWAY..  then – do the right thing and call the state board, or the police to prevent these people from harming someone else.

Updates on this story

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of a preventable/ unnecessary plastic surgery death in a young woman in Massachusetts.  In this instance – yet again – the ‘surgeon’ performing the breast augmentation wasn’t a surgeon at all – he was a “family practitioner”.

He may be a doctor – but specialty specific training is an absolute must – along with board certification.  Medical doctors (in medicine specialties) as opposed to surgeons spend only a very limited time in the operating room during medical school, primarily as observers.  This is not adequate preparation!

Board certified specialty trained surgeons on the other hand, spend years training in the operating room – performing surgeries under the direct supervision of more experienced surgeons before completing their surgical residencies.

Please do your homework – as we’ve discussed in several previous posts; research your physician and evaluate all health claims.  Your life, health and well-being are a stake.

 

 

 

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Another case of sketchy plastic surgery reported – this time in Myrtle Beach, South Carolina.   Yet again, I would like to caution readers about seeking ‘cheap’ plastic surgery on the internet.  (I’m not saying don’t look – please do!  But look smartly.)  This doesn’t only apply to plastic surgeons, but to all surgeons, physicians, and healthcare professionals.

‘The internet’ is not all the same – the grade of information can vary widely from scientific journals (highly reputable/ reliable) to fiery but heavily opinionated blogs (unreliable/ unscientific) to frankly fraudulent such as in this instance (in the story above).  People need to use caution, due diligence and common sense when researching anything, but particularly medical information on the internet.  You need to do your homework.

There are a few things to consider when researching medical information/ providers on the internet.

1.  Is the information independently verifiable?  (and by what sources?) 

As a medical writer – this is a huge portion of my job – verifying the information obtained during interviews, etc.  But when you are looking to purchase goods or services – you need to do a little investigative work yourself.  Luckily, once again – the internet makes this simple.

The first thing you should investigate is – the person making the claims/ and what their focus is.  Use this website for an example, if you like.  So take the following information (below) – that is easily available on the site..

(If this information isn’t readily available on the site – that should make you suspicious.  “Anonymous” blogs or hidden author websites are NOT reputable.  People with valid, truthful information have nothing to hide, and are not ashamed to stand by their work/ writings.)

so you’ve gathered the following information  from the site:

Author – XXXX   credentials claimed/ authority source:  Physician (MD/ DO etc.)

Product or service advertised on the site:  surgical procedure XX

Use this information to answer the following questions:

1. Who is this person?

2. How do they know this/ what special knowledge do they possess?  (for example – a hairdresser shouldn’t be giving medication advice)

3.  Can I verify this?

– Medical personnel can be verified thru state licensing boards. 

Some states make this easier than others, but ALL states have this information available to consumers.  So go to the website of the licensing board (medical board for doctors, nursing board for nurses) and look the person up.

In this example, I am currently licensed in several states – so pick one, and do an internet search for the board of nursing for that state.  (Tennessee is particularly easy since they post educational information, license violations etc. on-line).  If this licensing information isn’t easy to find on the website, call the board.**

If the website (ie. plastic surgery clinic) lists an address – use that state for your search.

In another example – as seen below – we’ve looked up a surgeon at the Colorado Medical Board.

Looking up a medical license

Looking up a medical license

– All physicians should be licensed in the state of practice (where their clinic is.)  If they aren’t licensed in that state – STOP and find another provider.  Even if the doctor claims to be from another country, he or she is STILL required to have an active license in the state they are working in.**

Here is an example of physicians sanctioned by the Texas medical board (all of this information is freely available on the internet for your safety.)


Here is another example of a surgeon with multiple medical board actions against her.

licence details

license details

Many of the state medical boards will let you read the complaints, actions and disciplinary measures against physicians licensed in that state.  However, some states allow physicians under investigation to ‘surrender’ or inactive their license to avoid having disciplinary measures recorded.

– All surgeons, or specialty doctors should also be listed with specialty boards – such as the American College of Surgeons, or the American Society of Plastic Surgery(While membership is not mandatory, the vast majority of specialty trained surgeons maintain memberships in their specialty organizations.)  Other things to consider while investigating credentials:

Do the credentials match the procedure?  (Is this the right kind of doctor for this procedure?)

These credentials should match the procedure or treatment you are looking for: such as Plastic surgeons advertising breast augmentation.

This may sound obvious but it isn’t always the case.  (for example:  dermatologists shouldn’t be doing eyelid lifts or plastic surgery, primary care physicians shouldn’t be giving Botox injections, general surgeons shouldn’t be performing lung surgery etc.)
If you aren’t sure what procedures the doctor should be performing, look at the specialty surgery board – it should list the procedure.  i.e plastic surgery and liposuction.

4.  After verifying this information, it is time to do a basic internet search on the individual.  To do this – perform both a Yahoo! and Google search.   This should give you at minimum, 10 to 15 results.

These results should include several non-circular results.  “Circular results” are results that return you to the original website, or affiliated websites.   For example: Using the information from above – both Google and Yahoo! return several results that link directly to this website.  These results also return links for the sister sites.  All these of these are circular results – that return you to the starting point without providing any additional outside information.

However, if you scroll down the results:  outside links should appear.  These should include articles/ publications or scholarly work.  Other search results may include more personal information, social networking sites and other newsworthy articles.  This gives you a more comprehensive picture of the provider.

One of the things we should mention, is patient testimonials.  While many providers include extensive patient testimonials, I disregard these for several reasons:

– There is usually not enough information to verify the authenticity of these patient claims.  “I love my doctor. He’s a great surgeon.” – Gina S.  doesn’t really tell you anything.  In particular, there is no way to verify if there really is a Gina S. or if she is a fictitious creation of the website author.  (There have been several cases where people working for the doctors have created ficticious accounts including before and after photos talking about procedures that they never had).  Don’t be lulled into a false sense of security with patient testimonials.

– Some people use blogs, or message boards for the same purpose, and the same caveats apply.

– Another reason that patient testimonials are not useful in my opinion, is that patients (and their families) are only able to provide subjective information.  Several of the cases in the news recently (of fraudulent individuals posing as doctors) had several “happy patients’ to recommend them.  Patients, for the most part – aren’t awake and able to judge whether the surgery proceeded in a safe, appropriate fashion.  The testimonials are merely a comment on the physician’s charisma, which may give future patients a false sense of security.

I’ve finished my search – Now what?

   Use commonsense:

– Surgical treatments should be performed in an appropriate, sterile environment like a hospital or freestanding clinic.  A reputable surgeon does not operate in the back of a motor home, a motel room or an apartment.  (All of these have been reported in the media.)  If the setting doesn’t seem right – leave.  You can also investigate the clinic.

– Bring a friend.  In fact, most surgeons will require this, if you are having liposuction or another large procedure.  Doctors don’t usually drive their patients around (as was done in several recent cases.)  The exception to this rule is medical tourism packages.  These packages often include limousine transportation services but these services are provided by a professional driver (not the doctor, or ‘his cousin’).  Your friend/ companion is not just your driver – they are also there to help feel out the situation.  If something seems amiss – do not proceed.

– if the price is too cheap – be suspicious.  If every other provider in the same location charges a thousand dollars – why is this doctor only charging a hundred dollars? Chances are, it’s not a sale – and he/ she is not a doctor.

– Use reputable sources to find providers – Craigslist is not an appropriate referral source.

– Are the claims over-the-top?  Is the provider claiming better outcomes, faster healing or an ‘easier fix’ than the competition? (We will talk more about this in a future post on  “miracle cures’ and how to evaluate these claims.

I hope these hints provide you with a good start to your search for a qualified, safe, legitimate provider.  The majority of health care providers are excellent, however the internet has given criminals and frauds with an easy avenue to lure/ and trap unsuspecting consumers.

** The majority of cases that have been recently reported have taken place in the United States (Nevada, New Jersey, Florida and South Carolina.)  Many of the people perpetrating these crimes have posed as Latin American surgeons to capitalize on the international reputation of plastic surgeons from South America.  They also used these claims to try and explain away the lack of credentials.  A legitimate doctor from Brazil,  Argentina, Colombia, Costa Rica or another country, who is practicing in the United States WILL HAVE an American license.

Additional references/ stories on fraudulent surgeons.

(Hopefully this section will not continue to grow)

More on the Myrtle Beach story

Myrtle Beach – a nice article explaining why people should see specialty surgeons

Basement surgery

Article on unlicensed clinics in Asia (medical tourists beware!)

A truly bizarre story about unlicensed dentistry in Oregon

Additional references:

American College of Surgeons – lists doctors distinguished/ recognized as “fellows” in the academic organization, and provides a brief summary of specialties.

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