USATODAY.COM
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.
Joyce Wooten, left, says her surgery four years ago left her with lopsided ears and hanging skin. Michelle Cordi, right, sued because of wounds that didn't heal around her ears.
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.
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By Jayne O'Donnell, USA TODAY
MIAMI – Her husband says he loved her the way she was, but Kellee Lee-Howard wanted a trimmer body. So she went to a clinic for "minimally invasive" liposuction.
Maria Shortall (left) and Kellee Lee-Howard.
James Howard woke up on Valentine's Day 2010 to find his wife lying dead on the living room couch.
Along with her husband, Lee-Howard, 32, left behind six children — ages 3 to 14 — and a trail of questions about the doctor here who isn't board certified in any medical specialty but performed a type of liposuction he trademarked and has been teaching other non-plastic-surgeons across the country.
Alberto Sant Antonio, whose office wasn't registered as a surgery center, had done the liposuction a day earlier. According to the autopsy report, Lee-Howard died of an overdose of the painkiller lidocaine from complications after "elective cosmetic surgery."
Lee-Howard told her husband she had learned of the Alyne Medical Rejuvenation Institute through an ad and that she'd found a "safe" way to lose weight by surgery.
After the procedure, she didn't feel well and went to sleep on the couch. The next morning, when their then-10-year-old son tried to ask her if he could play a video game, Howard noticed she wasn't breathing and "started screaming her name," trying to wake her.
There was so much lidocaine in Lee-Howard's body that it showed "a basic misunderstanding of the principles of pharmacology and patient safety," says Alberto Gallerani, a plastic surgeon here who is an expert witness in the Howard family's lawsuit against Sant Antonio. "It was just outrageous."
Reached at his office, Sant Antonio said he was "not at liberty to talk about the case." His attorneys did not return phone calls, but in July they filed a motion seeking to dismiss the case or require the Howard family's attorney to specify how Sant Antonio was negligent.
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By: Dr. Leonik Ahumada, representing the group of (Dr. Asokan, Dr. Rogers, and Dr.Nijher)
 Thirty years ago virtually all surgery was performed in hospitals with lengthy in hospital stays. Today many procedures can be performed safely and efficiently in an outpatient setting. Outpatient services are provided by ambulatory surgical centers. These centers were first opened in the 1970's and since that time have developed into high quality, costeffective alternatives to inpatient hospital care. These centers can be within a hospital (performing inpatient and outpatient procedures) or free standing facilities that concentrate on outpatient procedures only.
Ambulatory surgery centers can be multi-specialty centers that perform procedures ranging from cataract surgery to colonoscopies in the same building or they can be highly specialized centers such as cardiac catheterization centers or outpatient plastic surgical facilities. Although there are several settings where surgery can be performed such as hospitals, office-based, clinic or minor procedure rooms, the ambulatory surgical center is highly regulated by federal and state entities. Physician offices in contrast generally are not required to meet similar standards.
The safety and quality of care offered at ambulatory surgical facilities is regulated by state licensure, Medicare certification and voluntary accreditation. This consists of rigorous initial and ongoing inspections and reporting by these centers. Ambulatory surgery centers that serve Medicare beneficiaries must be certified by the Medicare program and must comply with federal government standards for the purpose of ensuring the quality of the facility, infection control and patient safety. Part of these guidelines includes staff registered nurses for patient care, strict protocols for patient recovery and discharge, emergency planning, and written guidelines for transferring patients to hospitals if needed.
At the Aesthetic Center for Cosmetic & Reconstructive Surgery we offer the safety and comfort of an on-site ambulatory surgical center for our patients. Our center is certified by Medicare which translates to certification that meets federal and state standards for safety, infection control and outcomes evaluation. We perform outpatient cosmetic and insurance covered plastic surgery procedures. Our entire center specializes in plastic surgery. From our staff of Board Certified Plastic Surgeons, anesthesia staff, registered nurses and certified surgical technicians the entire center is dedicated to providing high quality, safety and comfort to the plastic surgical patient.
By CATHERINE SAINT LOUIS
NY Times Published: June 3, 2009
IT used to be that a cosmetic surgery patient who was tired of sagging jowls would discreetly ask for names of reputable doctors who did face-lifts. A surgeon, building a practice as word of mouth about his skills spread, became, in effect, his own brand.
But now face-lifts themselves are being branded. Certain minimally invasive procedures are marketed directly to patients in a one-size-fits-most approach. Patients pick an operation — usually after seeing it touted online, on TV or in magazines — and are referred by a national organization to a doctor.
Two procedures sold this way are the Lifestyle Lift, which an ad in Family Circle describes as “revolutionary” and a way to “remove wrinkles, frown lines and sagging skin” in about an hour; and the QuickLift, which also benefits from nationwide marketing that promotes a short recovery and only local anesthesia.
Because these procedures, priced at $4,000 and $5,900, contrast with more extensive face-lifts requiring general anesthesia and usually costing more, they have become popular: More than 100,000 patients have received the Lifestyle Lift alone since 2001, according to the company.
But some surgeons think branded face-lifts are problematic. It is not the procedures themselves that disturb critics — many plastic surgeons and otolaryngologists (head and neck surgeons) offer their own quick-recovery face-lifts. But some doctors are concerned that patients may be so persuaded by advertising that they don’t seek a second opinion or investigate the full range of options. Consumers may pick a minimally invasive procedure when the results they seek may require more complex — and expensive — intervention.
“What’s new is this is plastic surgery being marketed to the public as a widget,” said Dr. Brian Reagan, a plastic surgeon in San Diego. “People are buying, so buyer beware.”
In this new landscape, patients are encouraged to seek an advertised procedure rather than work with a surgeon to select from a menu of options. What’s more, some patients are now “looking not for the best doctor, but the one who has the magic wand,” said Dr. Reagan, who has given a lecture titled “Invasion of the Mini-Lifts ... Coming to a Clinic Near You.”
Dr. David M. Kent, an osteopath and facial plastic surgeon who founded Lifestyle Lift, said he employs nearly 100 doctors in 31 offices who are trained to do Lifestyle Lifts. (The company also has 10 doctors in private practice who license its brand.) “Every single patient gets the same basic face-lift,” he said, explaining that it consists of lifting underlying layers of muscle and connective tissue, and trimming skin. Patients also receive custom nips and tucks as needed.
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