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Posted Jul 17 2005 12:00am

Comments following my post of the first case on CosmeticSurgeryDisasters.Com were varied. One comment doubted the hazards of surgery in third world countries. He employed the first debating countermeasure:

“This is only one case. It could happen anywhere.”

OK, I need to elaborate:

This case is not my only experience. In fact, this case is not my case, but that of a woman I met on the internet. She lives in Wisconsin.

I see cosmetic surgery complications in my local region. Most of my direct third world country experience is from Mexico. I also see complications that find their way to me from local surgeons. I see some (fortunately much smaller in scope) from my own practice. And I review cases for the California Medical Board, so I see cases statewide.

Complications happen everywhere. It is the scope of those complications that is the main point. This case from Costa Rica is a catastrophe. It is much larger in scope than any other case of which I have even read. The management of the case from that which the patient tells me was peculiar relative to the standard of care we have in California.

Those wanting to make the case that this stuff happens everywhere are generalizing to an enormous extent. Diane’s case is simply not typical of a wound complication seen in the United States. It isn’t even close. It is very likely that the care provided in her case had a great deal to do with this.

You know places without resources, finances and infrastructure. Healthcare is a resource.

Like I have said before, if you want “cheap surgery,” the third world is a good place to look. If you want “safe surgery,” it may not be. It is your risk. You manage it.

Best Regards,

John Di Saia MD

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