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Robert M. Freund, MD answers: Plastic surgery gone bad: how common?

ABC News retold the story of Korean plastic surgery addict who used a syringe with cooking oil to inject her own face.  While this is an extreme case, how frequently do you see bad plastic surgery? What are the most common cases and causes?


Robert M. Freund, MD
12 months ago

It is always a touchy subject to discuss bad surgery. Surgery can have a bad outcome for many reasons:

  1. Adverse effects can happen to anyone, regardless of the surgery or doctor. Things like infections, drug reactions, implant rejections or skin necrosis (wound healing problems) can happen to anyone. I always say that if you do not want any risk of complications then don't have surgery.
  2. Adverse effects can happen because of poor patient selection. Many patients actually do not help themselves toward a positive outcome. These type of patients include smokers, drug abusers and patients who are morbidly obese.
  3. The main reason patients love to complain (and lawyers love to sue) is poor outcomes as a result a physicians treatment.

Now, most doctors are brilliant hard-working caring surgeons who try their best. In most circumstances everything turns out great, but sometimes treatment plans are sound but judgement in the amount of skin excised or the angle of pull is off. These are things that can easily be corrected by the attending physician.

Often, patients expect perfection immediately after surgery and then transfer their disappointment into anger towards their doctor. In that case, they will often see another surgeon to perform the minor corrections even though their first doctor is capable of the correction.

Other outcomes may, in a small group, be the result of of the doctor not demonstrating a caring attitude toward the patient. As a result, treatment plans may not reflect that which is most beneficial for the patient. These are the cases that give doctors the worst problems as a group. It is sort of like letting a bad apple spoil the entire bushel.

In my practice, I see many patients that fit into all of these groups. I start my treatment with understanding and compassion. For those that I choose to help (those that have reasonable expectations and are willing to help themselves), I finish with a well-tailored plan for a successful outcome.

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A: not too often

Steven Wallach, MD
12 months ago

Fortunately, most surgeons are very competent and the majority of patients get good to excellent results. On the other hand, patients do seek me out for revisions of many types of aesthetic surgery.  But, the % of patients that fall into this category in my practice is very low.

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A: Plastic surgery gone bad: Don't be fooled

David Shafer, MD
12 months ago

While the patient in your question injected herself, it is still a good question to inquire about bad plastic surgery. My first suggestion if you are considering surgery is to go to someone trained specifically in plastic surgery.

There are many people out there claiming that they are surgeons or cosmetic surgeons who don't even have medical degrees. There is no good regulation about who can do procedures, especially if people are doing it in their private offices. If it seem suspicious, then it probably is. If the price seems to good, then there is probably something wrong. If you are being pressured to sign up for a procedure, then I would worry.

For the most part, I see inferior results from people who tried doing a procedure that they were not trained to do. Additionally, I see many patients returning from plastic surgery vacations where they left the country with the intention of getting a good deal on plastic surgery. Then they return home and now they need everything fixed. I hope this is helpful.

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