DOWNSIDES OF BEAUTY
The risks of cosmetic surgery
There is a price to pay in the strive towards beauty and youth
By Alex Evangelista
February 13, 2019
Downsides of beauty: The risks of cosmetic surgery
AT A GLANCE
- Incidents of cosmetic surgery complications and deaths have been frequently reported over the years, causing concerns about the safety of the procedures
- Complications can vary depending on the procedure, with causes arising from either patient-related, doctor-related, or surgery-related issues
- There is a need for amendments to the law and stronger government support to regulate the cosmetic surgery industry
MANILA, Philippines – All Vinia Bernadez wanted was to be pretty. That is why 9 years ago, she decided to get Botox fillers in hopes of enhancing her facial features.
“Bata pa po ako, gusto [ko na] magpaganda kaya nangarap din ako. May nakikita din kasi ako na mga friends ko din na nagpa-enhance din ng mukha… kaya interested din ako noon,” she said. (When I was young, I wanted to be beautiful so I dreamed too. I also saw my friends get enhancements for the face... that’s why I became interested before.)
What was supposed to boost Bernadez’ confidence turned into a nightmare when her cheeks and chin swelled 6 months after getting the procedure, leaving her previously fine face botched.
It was only later that she found out that she got scammed by a fake doctor. She admitted, too, that back then, she had no idea that her dream of becoming beautiful would have dire consequences.
Cosmetic surgery – just like any other medical procedure – entails risks. Incidents of procedures gone wrong have been reported by the media over the years.
Currently, there is still no available data on cosmetic surgery-related complications and deaths in the Philippines. However, incidents could increase further with the booming industry. (READ: The Internet, beauty, and obscured perceptions)
Complications in the industry can range from minor ones like scarring issues to major, permanently damaging conditions – even death.
Short and long-term risks
“Although, very few people die from cosmetic surgery procedures, there are many who suffer from serious medical complications and disfigurement,” Philippine Board of Plastic and Reconstructive Surgery diplomate Dr Trishalyn Correa said.
The International Society of Aesthetic Plastic Surgery (ISAPS) noted a 5% increase of surgical cosmetic procedures globally in 2017. In the Philippines, there is higher demand now for enhancement procedures due to lower costs, and its position as a medical tourism hub.
The country’s medical tourism index ranked 19th in a study done by the International Healthcare Research Center and the Medical Tourism Association in 2016, with cosmetic surgery as one of the top drivers.
As an elective surgery, doctors and patients have ample time to plan out the procedure. This means that possible complications can be foreseen beforehand. Lack of transparency, thorough preparation and proper skillset, however, can lead to disastrous results.
“The bigger the surgery, the bigger the risks are,” Dr Raynald Torres, chief surgeon of Enhancements Cosmetic Surgery Clinic and fellow of Philippine Society for Cosmetic Surgery, said.
At the very least, patients may develop adverse reaction to prescribed medication and anesthetics which can cause nausea or allergies. Post-surgery infection is also a common defect.
While most times repairable through surgery, some botched works cannot be brought back to normal especially when it entails life-changing surgeries like sexual reassignment. (READ: 'Modern Family' star Reid Ewing on struggles with cosmetic surgery, body dysmorphia)
Doctors warned that too much surgery can also be detrimental.
In 2017, businesswoman Shiryl Saturnino died after undergoing liposuction, breast and butt augmentation in one session, sparking questions on how much surgery the body can handle at once.
According to Torres, blood loss is a common reason for this occurrence. “Hindi ibig sabihin na combined, mas delikado (Just because it’s combined doesn’t mean it’s more risky). But see what kind of surgery is involved.”
Recently, there has been newfound buzz around the safety of implants after they were linked to cancer. The United States Food and Drug Administration (FDA) warned that patients with breast implants have increased risks of developing Anaplastic Large Cell Lymphoma.
Former Philippine Association of Plastic, Reconstructive and Aesthetic Surgeons (PAPRAS) president Dr Carlos Lasa Jr said that while implants have been deemed safe for years now, surgeons have been “shying away from textured implants” after the advisory.
Implants are inert, and more often than not, the human body does not react to them. Some patients, however, experience capsular contracture or hardening of the capsule surrounding the implant. This leads to deformation and may require removal surgery.
There is currently no way to determine how the body will react to implants prior to the surgery, but doctors have attributed capsular contracture to genetics or the presence of bacteria.
Lasa has also advised against the use of non-FDA regulated and fake implants sold in the market as they could have dangerous effects on the body in the long run.
Complications also spring from lack of qualified doctors who take up cosmetic surgery. It takes approximately 16 to 18 years to become a bonafide plastic surgeon, but a number of quack doctors have already been reported while some doctors, although registered general practitioners, tend to take a “shortcut” or detour in practice.
According to Republic Act No. 2382 or the Medical Act of 1959, a doctor can treat patients so long as they complete at least 5 years of medical courses that lead to a Doctor of Medicine degree and finish rounds of internship.
While this law allows doctors to practice their profession in areas with limited medical access, it also opens a loophole for non-specialized doctors to venture into cosmetic surgery.
“Kahit na hindi na sila nag-general surgery (Despite not going into general surgery) [and] specialty training, puwedeng mag-opera (they can operate) because the law allows them to,” Lasa said.
According to Lasa, while doctors often have general knowledge of the body, some procedures in plastics require more thorough understanding and mastery to ensure a successful outcome. An Ear-Nose-Throat (ENT) doctor who decides to go into cosmetic surgery, for example, may perform rhinoplasty, but surgery involving parts below the neck is another story.
“This is where the field becomes murky. You have doctors who are trained in particular specialty pero gumagawa sila ng (yet they do) cosmetic surgery,” he said.
The Philippines also does not have a government-recognized body that regulates the field, and private organizations such as PAPRAS can only do so much to supervise the industry.
“[The] Medical Act of 1959 has to be amended also if they want to put teeth in the law and to really regulate the specialty practice,” Lasa said. “Ang cosmetic surgeons, because they’re basically unregulated, anak nang anak nang anak (continue to multiply)."
Prevention is cure
“A good surgeon should know his limitations as well as the limitations of the patient,” Philippine Academy of Aesthetic Surgery President Dr Francis Decangchon Jr said.
The best way to minimize complications is through careful planning and consultation with credible, well-qualified doctors.
When complications arise, Decangchon advised doctors to “ask for assistance from colleagues” to avoid drastic outcomes.
While complications can be inevitable even in the best hands, Decangchon noted that these can serve as reminders for future operations.
“Every month, we audit our patients. We see interesting cases. Why are they interesting? Kasi may (Because there are) complications,” he said. “We are not there to explore the case and crucify... We want to learn so that in the future we don’t want this to happen to us.” – Rappler.com