More on Donda West's Plastic Surgery-Related Death
Posted Oct 18 2008 4:09pm
More information is coming out regarding the tragic death of Kanye West's mom after plastic surgery. According to CNN.com, Donda West underwent a breast reduction and tummy tuck on Friday, Nov 9th at the surgery center of Beverly Hills plastic surgeon Dr. Jan Adams. The procedure took approximately 8 hours, after which she was sent home to recuperate. On Saturday she was found unresponsive and in respiratory distress. She was later pronounced dead at 8:28 pm at Centinela Freeman Regional Medical Center. An autopsy performed today was inconclusive, pending toxicology tests.
Obviously I wasn't there and cannot comment exactly on the specifics of this sad case, but there are some points to consider:
1. The plastic surgeon who performed the procedure, to my knowledge, is a bona-fide plastic surgeon who underwent all of the necessary training to perform these surgeries competently. Although the internet is buzzing with reports about his past, his training at the University of Michigan and UCLA earned him board-eligibility to be a plastic surgeon (although he was not board-certified). He is not some kook ER physician posing as a plastic surgeon.
2. An 8 hour "body" procedure is a long surgery to perform on someone who is 58, but is very often performed successfully. I know of no absolute guidelines limiting the length of a surgery, as this is usually a joint decision between the plastic surgeon and the anesthesiologist. In general, a healthy 58 year old should tolerate surgery well. I try to limit my surgeries to 6 hours or less, but this is just my comfort level and cannot necessarily be transferred to another surgeon.
3. Preoperative clearance is important for patients who show signs of heart disease or other illnesses. While this cannot ensure that there will be no complications, it can help prevent unforeseen risks. I routinely require preoperative clearance by a primary care physician prior to most plastic surgery procedures. There is no evidence in this case that preoperative clearance was not obtained by Dr. Adams (although he hasn't commented on this).
4. Plastic surgery is serious business. Death is a possibility with every medical procedure, from colonoscopy to plastic surgery, whether preoperative clearance is obtained or not. This is one of those things that I always pray never happens to a patient of mine, and is always a concern every time a patient undergoes anesthesia. A report in the Plastic and Reconstructive Surgery Journal noted only 1 death in 51,459 plastic surgery procedures. That number is still too high for me not to get gray hairs on my head.
5. What caused her death? I can't tell you for sure, but some possibilities exist. A pulmonary embolism (blood clot to the lungs) is possible, but would usually be a bit more delayed. Excessive bleeding is a possibility, and may have contributed to heart strain resulting in a heart attack. This may also be a result of massive fluid shifts after a lot of plastic surgery. This is something that could occur in this time frame.
I think the lessons for patients to take from this are:
1. Make sure to question your plastic surgeon as to whether the length of your surgery should have you consider splitting it up into two separate operations. I quite often do this with patients who want a breast lift with implants and tummy tuck. 2. Get preoperative clearance by your primary care physician, especially if you are older than 40 and have medical problems. 3. Make sure your surgery is performed in an accredited surgery center with a board-certified plastic surgeon. 4. If you have general anesthesia and go home afterwards, make sure someone is with you at all times during your immediate recovery (first 16-36 hours) so they can call for help if needed.
For more information on choosing a plastic surgeon, click here and here.
For information on safety in plastic surgery, click here for the ASPS FAQ's.