Buttocks Surgery Causes Death of Miss Argentina
December 1st, 2009
My wife, Lindsay, brought this unfortunate case of cosmetic surgery in the news to my attention today. CNN was among the media outlets who ran the story. Gluteoplasty or buttocks enlargement has been popularized by the cultural emphasis on a round, protruding, and firm butt. Both men and women consider this surgery when they want a fuller buttocks. Because of safety issues and concerns, I do not offer this surgery to my patients.
There are two ways to achieve “butt enlargement.†First is by injection. The most popular injectable material has been fat. Fat is first removed using a liposuction technique. The fat is then injected in to the buttocks, after it is purified. Theoretically, this should work, as the buttocks are primarily fat. Unfortunately, there are many reports of sudden death when this technique is used. Extreme caution should be exercised when considering this type of cosmetic surgery, because there appears to be no clear explanation as to why the patients have died. Anytime anything is injected into the body there is a risk of intravascular injection. Antibiotics, anesthesia drugs, and intravenous fluids need to be administered intravenously or into the vein. Immunizations, insulin, local anesthetic, and fat should not. If fat is accidentally injected into a vein in the buttocks, the fat will travel to the heart. The heart pumps the venous blood and fat into the lungs, because this is just how our plumbing works. The lungs filter the fat in its small blood vessels near the aveoli. Small amounts of fat or emboli are usually inconsequential. However, if there is a large amount of fat in the blood or if the blood begins to clot around the injected fat, the resulting pulmonary embolus would most likely be fatal. Sadly, Solange Magnano, Miss Argentina 1994 suffered a fatal pulmonary embolus due to complications from the fat injection into her buttocks.
Another way to enlarge the buttocks is an alternate technique where a solid silicone implant is placed beneath the skin and fat. Solid silicone implants have been around for many years in other shapes. They are used to enlarge the chest in men, calves, and chin. They have been proven to be relatively safe and effective. The surgery to place such implants in the buttocks is not complicated, although the skill of the surgeon is important. The results are generally acceptable to many patients. However, there is a significant risk of a very serious gram negative infection. Because of the posterior location of the surgery and the adjacent location of natural occurring bacteria, risk of infection is considerable.
Some of these bacteria are home to the intestinal tract. Such infections frequently require hospital admission and have a high risk of death. In addition, coloform bacteria can also result in an infection known as synergistic gangrene. In this case, multiple bacteria types infect the tissues together and lead to skin and fat death. Extensive reconstructive surgery, including skin grafts and terrible scars may result. At its worse, synergistic gangrene can lead to death.
I chose not to do either of these surgeries. I do not feel that the risks of these very serious complication are worth the benefits of the surgery for my patients.
Sometimes it’s better to just hit the gym!
Lip Sculpting
October 16th, 2009
I find that a significant part of doing cosmetic surgery is sculpture. Whether I am removing (liposuction), adding (breast enlargement) or rearranging (face lift), the quality of the result and achieving a natural appearance is the direct result of sculpture. Lip enlargement using injectable materials is no different. I first start out with mental image of what normal lips look like. The lips are then sculpted with the injections to look like normal lips. Just this past week, I did three lip injections to minimize wrinkles and give the face a more youthful appearance. All of my patients have a nice improvement in their appearance, no hint of the “sausage lips” look, that seems to be popular in Hollywood.
I have noticed that many injectionists must think lips look like sausages! Jimmy Dean fills cylindrical tubes with meat to create this shape. I do not find this look to be attractive. Nobody’s lips look like sausages except the ones which have been injected! Lips have a subtle curve know as a “Cupid’s Bow.” This complex curve is created by the mirror image of the upper lip meeting the lower lip. The Cupid’s Bow shape is most apparent along the upper lip where the red lip meets the flesh-colored skin also known as the vermillion border.
Lips injected with fat, collagen or hyaluronic acid will look like sausages if they are injected evenly along their length. It is a simple matter of physics. To maintain a normal appearance, they must be injected differentially, maintaining relative fullness of the central upper lip compared to the lateral upper lip. The lower lip should be the mirror image of the upper lip. The lower lip should be fuller lateral to a central relative thinness. You might think of the lips like gears which mesh. Full on top meshes with thin on the bottom and thin on top meshes with full on the bottom.
Three other things to remember. First, the lower lip is almost always fuller than the upper. Julia Robert’s lips are an exception to this rule. In other words, they are not normal. Seeking this appearance will give you unnatural looking lips. Second, lips naturally taper toward the corners of the mouth. Injections here distort this natural shape. Finally, lip enlargement can be accomplished with about 2 ml or cc. This equates to two syringes of most products. Injecting more than 2 ml, increases the risk of getting an unatural appearance (or sausage lips) and more importantly, the risk of terrible scarring from skin necrosis or skin death.
In other words, there is more to creating a naturally pouty lip than most people might appreciate.
Follow Us!
