Although it has been over two months since the tragic death of Donda West, mother of hip-hop star Kanye West, it remains fresh in the minds of the public and has raised many questions about the safety of plastic surgery. My own read on the media coverage thus far is that there has been as much rumor as fact, and I would like to set the story straight as best I can.
The facts we know are that Donda West underwent the procedures of breast reduction and abdominoplasty, also known as a tummy tuck, possibly with liposuction on a Friday by Dr. Jan Adams, a "cosmetic surgeon." The following evening, a little over 24 hours after her surgery, she was at home and found unresponsive. Paramedics were called, she was brought to a nearby hospital and she died later that night. An autopsy was performed but the results were inclusive.
We also know that Dr. Jan Adams was a high profile Beverly Hills plastic surgeon who has appeared on Oprah and hosted a show on the Discovery Channel. According to the American Society of Plastic Surgeons, he is not listed as a board certified plastic surgeon. It has also been reported that he was being investigated by the California Medical Board for multiple DUI convictions.
What we don't know is even more important. We don't know if Ms. West had a general medical evaluation prior to surgery by a doctor specializing in Internal Medicine, a routine practice for a 58 year old woman, although reports have surface that this did not occur. We don't know if the surgery was performed in a hospital, a licensed outpatient surgery, or the the surgeon's office operating room. We also don't know whether Ms. West had her surgery as an outpatient or if she was kept overnight for observation, and if so, where this post-operative observation occurred. The issue of post-operative observation is especially important because patients who undergo this combination of procedures are at some risk for post-operative bleeding and dehydration, which is easily treated but if left untreated could lead to cardiac arrest.
This tragedy is a cautionary tale and although all of the facts are not yet available, there is a great deal to be learned from it. First, being a celebrity plastic surgeon has no correlation to either one's skills or credentials. One could easily be a good celebrity plastic surgeon or a bad celebrity plastic surgeon. It has only to do with how well someone plays to the camera.
Board certification does not guarentee that someone is a good plastic surgeon either, but it does provide an independent and fair assessment of a surgeon's knowledge and competence. Why, one might ask, would anyone choose a plastic surgeon who wasn't board certified? Statistics from the American Society of Plastic Surgeons state that there are over 6,000 board certified plastic surgeons in the United States. The problem isn't supply and demand; it's the education of the public about the importance of board certification.
Perhaps the most important point is that while plastic surgery is extremely safe, it is not completely risk-free. There is not enough information to know if the loss of Ms. West could have been prevented. However, a thorough pre-operative medical evaluation by an internal medicine or family practice doctor, and having both the surgery and at least 24 hours of post-operative observation completed in either a hospital or licensed, accredited surgery center, are all steps that normally would have been taken in this case. If all of these precautions are taken in similar situations, then patients and their families can have the peace of mind of knowing that they have taken all of the necessary steps to ensure that their surgery will be as safe as possible.