Nightmare! - Panama City, Panama

I was supposed to see Dr. Crespo based on the...

I was supposed to see Dr. Crespo based on the great results of a facelift that he did for a friend of mine and inquired about him on the website that he shares with Dr. Picard-Ami. Dr. Picard-Ami responded and told me to come for the consultation in Panama City and then they would decide which surgeon would see me. I did that and was very specific in emails before arrival that I was seeking a "minilift", just lower facelift to reduce lines to the sides of my mouth and some slackness in jowl. I am only 50 so it was not major but bothered me (I am a model and youth is everything in this business).

I arrived for the consult and only Dr. Picard-Ami was there. I later learned that Dr. Crespo did not even know that I was attempting to be his patient. Dr. Picard-Ami told me that he advised that he call the surgery a 'necklift' and that he could see my 'platismus' band at top of throat. He said that he would cut and separate that so it wouldn't be visible and then use that incision under my chin to access my lower jowl area for lifting and use incisions in front of my ears to pull back the SMAS (skin plus deeper layers of tissue). He also said that he could do fat grafting which almost all plastic surgeon do now, by harvesting some fat from my belly (I had hardly any) and injecting that into the folds around my mouth. He also suggested a lower blepharoplasty on my left eye.

Before coming to Panama, I said explicitly in my emails that I did not need any work on my neck or eye areas, only the lower face. I agreed to his 'necklift' method of tightening the lower face and initially agreed to the blepharoplasty and paid for both. Then after mentioning it to friends of mine, I canceled the bleph because no one could see why he said I needed it, including me. I was marked by Dr. Picard-Ami in pre-op for the around mouth facial lines and proceeded to have the 'necklift' as he described it although it was not supposed to entail tightening any of the skin on my neck as I did not have even a tiny bit of skin laxity there. 2 days after surgery I realized that I was getting an infection behind my left ear where he had put in the surgical drain. I was still in Panama but not in Panama City and my local doctor began treatment for it.

I sent Dr. Picard-Ami the picture of it (awful looking) and he said that I had no infection! I had to fly to Panama City to have stitches removed a week after surgery which I did even though my local doc said he could not remove the ones near the infection because the incision was not healed which I thought also. Despite how infected the area still was, he removed the stitches but forgot to remove the ones under my chin and I realized it just before leaving his office, then he did it. He still told me that the area wasn't infected but to keep taking the antibiotics my doctor had given me (??). Of course, I was going to. It took 4 weeks for the infection to heal enough to stop putting medication on it. It is still very red and looks awful to a regular person. I also was having trouble with my lymphatic system being very congested (I know the symptoms from my own experience and because I write books on health). My lymph nodes were swollen and painful all over my body and the skin on my neck felt super tight.

In addition to that, once I was not swollen anymore, I realized that I had several very large (2 inches long each) and very hard lumps in my lower face. I went several places for consultations and all of the practitioners said they had never seen anything like it! I was visibly disfigured. I went back to Dr. Picard-Ami one week after stitches were removed and he denied knowing of any reason that could happen or what was wrong except "swelling". I am not stupid nor were the medical practitioners who saw me who were horrified by them and it certainly wasn't normal swelling. The lumps were rock hard. He injected some steroid into it them and he said that 'may help' and advised me to go back to the U.S. and not worry about it because nothing more could be done anyhow. I instead went to the medical director's office of the hospital at Punta Pacifica. I was advised not to go home but to remain for further evaluation by the top plastic surgeon of the practice, which I did.

The end result of multiple examinations was that some material WAS applied somewhere above or under my cheeks and in the jowl area. I demanded by email to know what he had done (despite him telling me nothing was done in that area). He replied that he had surgically grafted fat in those area - a far cry from him injecting my fat into my nasolabial folds! However, the opinion of the most famous dermatologist (MD) in Panama after examination was that she does not think it was fat that was grafted. I am an extremely calm person and I am stressed beyond imagination! I do not know what is in my face, I certainly cannot trust Dr. Picard-Ami to be straight with me AND the hospital told me that they have nothing to do with him, that he is not affiliated in any way with Punta Pacifica and so I have no medical or legal recourse with them! I have had 15 treatments so far with ultrasound and radiofrequency treatments to try to soften and move the lumps which are scar tissue formed over whatever substance he put in my face (encapsulations). One lump has been molded to a slightly less conspicuous size but is still very visible and unnatural looking. The other which runs at an angle in the hollow of my cheek has had no improvement. Even worse, I had to see a doctor on my own for the lymph glands in my neck getting infected which is a medical emergency. He said that the skin around my neck and under my chin was pulled too tight (right, I had no extra skin to pull!) and it is compressing my lymph glands causing some to become hypertrophic. I need to have manual lymph drainage treatments done for an hour each day for an undetermined about of time. I am 100% on my own to pay for the expense of all of these treatments to try to mitigate his errors and they are likely to be permanent!

Dr. Picard-Ami has taken no responsibility financial or otherwise and I have now paid far more than if I had had my minilift in the U.S with far more stringent standards for plastic surgery and I have been in Panama by myself for 8 weeks missing all of my work back home! I was told that no U.S. doctor is going to want the liability of trying to fix the mistakes of a surgeon in Panama and the therapists here know how to do the ultrasound and "lump" massage treatments recommended by other doctors that I cannot get in the U.S. Dr. Picard-Ami claims to be certified by the American Board of Plastic Surgery but he is not listed on their website. DO NOT have plastic surgery in Panama. You have NO RECOURSE if anything goes wrong!

Panama Surgery Nightmare

I am leaving Panama shortly because I have exhausted every possible and potential remedy here to fix the disaster that I am left with from this surgery. I require an hour of lymphatic drainage treatment every day as prescribed by Dr. Picard-Ami's partner (Dr. Crespo) because my lymphatic system is so disrupted from the surgery. I have seen other plastic surgeons here for consultations to attempt to fix the unauthorized ft grafting that he did but no one wants to touch me or has any suggestions for what can be done now. The places where he grafted fat along my jawline and in left cheek hollow are very hard and lumpy and they hurt. I can feel the material every minute of the day on my face and am still having pain in those areas and several areas of incisions around my ears which the local doctor says is not normal. I have a large ridge of scar tissue that has developed behind my right ear despite daily massages with Cicatrix, the best anti-scar cream on the market.. I am typically a person who heals extremely well with minimal scarring from any surgeries or accidents so that is due to his terrible suturing job. Behind the left ear is still very red and painful to the touch. I don't know how the incisions in front of my ears will heal but right now there are very visible bumps from suturing that are not smoothing out. I don't think I will ever be able to wear my hair pulled back again with this awful result! I have been informed again that the only recourse is the Ministerio de Salud (Health department) in Panama. Unbelievably, these surgeons report to no one who overees the quality of their care! I hope that I can help people to avoid having any experiences like this.

Went for Mini Lift in Panama and Ended Up with Severe and Permanent Injuries

24 Mar 2014

  • 7 months post

I had a devastating experience with what was supposed to be a simple plastic surgery procedure in Panama. The doctor (Dr. Luis Picard-Ami) is advertised as being a very experienced and excellent surgeon but I learned otherwise the hardest way possible. I was transformed from being a beautiful, healthy 50 year old to being consumed with pain every minute of every day and damage to critical body functions. He did the wrong surgery and every single thing about the surgery that he did was done horribly including immediate infection, badly placed incision lines, over 30 deep stitches surfacing and causing infections, all of the skin behind my ears being damaged and turning into scar tissue, a piece of my left ear cut off and severe internal scarring that is literally choking me. WORST OF ALL, he injected me with a toxic liquid silicon substance called biopolymer" or "free silicon". I had terrible burning pain and the sensation of my lower face being heavy and rubbery. He would not admit truthfully to anything that he did including that he injected foreign material into my face (for NO reason and certainly WITHOUT my consent) and refused to produce medical records to me or my doctors so that I could consider how to have the deadly biopolymer removed. My attempt to have a "small" plastic surgery ended up being a fight for my life every day since I had it. Of course, AFTER it happened, I heard from other victims of this same surgeon who also had damaging results and none of them could do anything about it. I have filed criminal charges against the surgeon for attempted homicide. Liquid silicon is extremely toxic and illegal in many countries. In Texas, in February 2014, a woman was convicted of "Depraved Heart Murder" for simply referring a woman to her friend who did silicon butt injections and as a result the young victim died. With liquid silicon, the question is not WHETHER you will have life limiting complications and pain, it is simply a question of WHEN you will. What was done to me was cold-blooded and probably an attempt to cover-up a surgery that was visibly disfiguring but it had the opposite effect of maximizing my injuries immediately. Ladies, who choose to have silicon injections to enhance their butts or anywhere, know that NO vanity is worth having your life compromised or being willing to pay anything to a surgeon later to remove it - and being told they can't. Look up YouTube videos on biopolymer and see what happens to those asses over time! If you are/were considering plastic surgery in Panama, DON'T DO IT! There are no medical malpractice laws and therefore no help if you are injured. That may be true in other counties. 

Answers to readers' questions

No, I do no not know which has been a huge problem because Dr. Picard-Ami refused to respond to any of my subsequent doctors' requests (and my desperate requests) to know. I may find out soon because I am going to Columbia to see if the most experienced doctor known to remove biopolymer can do it. It has now been almost one entire year that every day I have suffered in excruciating pain and stress that causes severe depression because my 'normal' life is over, all of my savings are gone, I have not been able to work in an entire year or have any kind of relationships, in addition to the obvious aesthetic ugliness. My life for one year has been consumed solely with seeking doctors to find out what was done to me and to treat my serious and painful symptoms. I did finally just get one U.S. plastic surgeon to agree that he would fix the cosmetic damage done by Dr. Picard-Ami to my face, ears and behind ears. The cost is $15,500, on top of the over $70,000 I have spent in this last year on medical treatment and travel to get it. I have no idea yet what the surgeon in Columbia will charge to attempt to remove the biopolymer, if he even agrees to do so after evaluating me in person. I just had another MRI done in the U.S. that clearly shown the foreign material along my jawline which the radiologist states is “consistent with sequel of silicon injections.” I only have time to respond to these postings about once a month so I will address others' questions about why I did the surgery in Panama. I was living in Panama part-time and I wanted to combine the surgery with acquiring the next step in my residency status while I also caught up with friends there and had a brief vacation before I returned to the U.S. to get back into modeling and to run a retreat for women that I was supposed to facilitate in November. I had to cancel EVERYTHING because I was STILL in Panama 3 months after the surgery, being treated and trying to find out what Dr. Picard-Ami put in my face. Hospital Punta Pacifica in Panama City is a John Hopkins accredited hospital and they advertise to American citizens how excellent their doctors are and I had no reason not to believe that until AFTER this horrendous experience. Dr. Picard-Ami chose that I would have my surgery at the Clinica Hospital de Cirugia Plastica when it could as easily have been done at Hospital Punta Pacifica. For those who have posted that they think I am crazy, nothing could be further from the truth. I am a highly educated and extremely successful professional who trusted another professional - with devastating results. That betrayal and the physical, emotional and financial damage that it has caused me is PERMANENT and yet Dr. Picard-Ami and his partner Dr. Crespo (who knew exactly what he did and refused to provide my medical records repeatedly to help me) refuse to take any accountability at all for what was done to me. That is the Ultimate betrayal - zero concern for my life. I am required to take a psychological test for the legal process I have initiated against those doctors and I rated at almost the highest level of post-traumatic stress on multiple dimensions (over 95%) and been diagnosed with Complex Trauma Syndrome. I am an incredibly strong person, ran many businesses for decades and pursued investigations (at serious personal risk) on illegal activities like child abuse and sex trafficking. The VA scandal and CPS problems in Phoenix Arizona are just two of the many issues that I was involved in reporting for years and they both finally made the national news this year, just as medical malpractice in Panama being allowed and covered up will make the news in the U.S. now that I have experienced and reported it publicly. But the depression and hopelessness from my life being destroyed like this (and living with constant pain) has been paralyzing. Anyone who thinks that none of this happened to me must have a personal reason to be protecting Dr. Picard-Ami and from my perspective that is very sick. He is responsible as a surgeon, a doctor and a human being for what he does whether it is a successful surgery or a bad one as is true for any professional. It is very violating to me for others to say that I must be lying when my injuries, expenses and suffering are WELL-DOCUMENTED and I have reports from many doctors and surgeons starting right after my mutilating surgery that clearly state my injuries. Do Dr. Picard-Ami's defenders think that all of these good doctors lied and fabricated their reports? Do they think that the pictures of my injuries taken every week after surgery and MRI reports are fake? What kind of people take pleasure in the suffering of others? It appears that friends of Dr. Picard-Ami do. If the corrupt legal system in Panama does not prosecute him and lets him continue to "practice" as is always the case for doctors there (no matter how many patients have even died), he will still have his judgment day. In the meantime, I have the right and duty to warn others and I am not taking anything away from another person by doing so. If they had or have a surgery with him with good results, then good for them. I would only hope and pray for the best for anyone. But that has nothing to do with what he did (and continues to do by not accepting responsibility) to me!

Updated photos

Both of these photos just taken 11 months after surgery show the permanent pigment discoloration (white stitches marks) in front of ears and I have large visible permanent white patches (that were read for 9 months) now behind both ears. I have to wear my hair in front of my ears to cover them all of the time. The left earlobe is visibly clipped and smaller than the right. The breakouts are from the painful inflammation of the foreign material along my jawline. Even though the surgery records say that a neck lift was done instead of the mini facelift that I went for, there is strange wrinkling of skin under the chin. Plastic surgeons tell me that nothing can be done except a very expensive surgery to pull back and remove the damaged skin in front of the ears. Nothing can be done to repair the distorted ear lobe or the scarring behind the ears. Nothing can be done in the U.S. to remove the biopolymer.

Photos after surgery

Somehow, I did not include these in my first set of post-surgery photos. All doctors tell me that no plastic surgeon did this suturing, especially one with 22 years of experience!
Panama Plastic Surgeon

1 out of 5 stars Overall rating
3 out of 5 stars Doctor's bedside manner
1 out of 5 stars Answered my questions
1 out of 5 stars After care follow-up
2 out of 5 stars Time spent with me
3 out of 5 stars Phone or email responsiveness
4 out of 5 stars Staff professionalism & courtesy
1 out of 5 stars Payment process
3 out of 5 stars Wait times
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