Medical License on the Line for O.C. Cosmetic Surgeon

The two Andy Warhol originals that decorate his office walls, the personally inscribed photo on his desk of star patient Phyllis Diller, the expensively outfitted women who crowd eagerly into his regal, neoclassical waiting room with hopes of the perfect look--all speak to the success of Michael Elam.

But like wrinkles on the face of an aging subject, Elam’s booming cosmetic surgery practice next to Fashion Island could soon be gone if the Medical Board of California prevails.

The suave, 41-year-old New Orleans native with the movie-star looks is scheduled to be confronted this week in a Los Angeles hearing room by a former Mrs. California from Orange County who charges that Elam drugged her in his office, then gave her a nose job and cheek implants that she never wanted. In addition, state investigators charge that Elam forged insurance documents to try to collect on the operation.

The alleged plot--replete with an aging beauty queen, a wildly successful surgeon who critics say carries a Pygmalion notion of how he wants his subjects to look, a love interest, and an insurance scam--reads like prime-time TV fodder. But it will be up to an administrative law judge to decide whether the charges are fact or fiction and whether, as the state is seeking, Elam’s license should be pulled.

“He changed a Mrs. America runner-up into a recluse who hides in her house,” charged Santa Ana plastic surgeon Robert Miner, who is president-elect of the Orange County Medical Assn. and also the state’s chief medical witness against Elam. “It was irresponsible.”

Underlying the drama is a broader professional feud between nationally accredited members of the American Society of Plastic and Reconstructive Surgeons, such as Miner, and competitors in the “cosmetic surgery” field, such as Elam, who hold different professional affiliations and requirements for performing nose jobs, breast implants, tummy tucks and the like.

As the craving for the latest beauty edge has surged in recent years in Southern California and elsewhere--with cosmetic surgeries growing by 63% nationwide from 1981 to 1988, reaching 620,000 operations--so too has the professional rivalry among practitioners.

Less than five years ago, for instance, Elam and two other local cosmetic surgeons successfully sued the Orange County Medical Assn. to prod it into recognizing cosmetic surgeons from a range of backgrounds and affiliations, instead of limiting its referrals to the nationally accredited American Society, as it had been doing.

“I’m just not one of the boys--that’s the problem,” said Elam, who has parlayed his successful practice into a line of cosmetic applications and video products. “It’s a travesty that the state is wasting so much time and money on something that essentially amounts to a witch hunt, a one-man campaign (by Miner) to get rid of me because I’m successful.”

Elam, who lives in Corona del Mar and had dated Mrs. California’s daughter before their legal run-ins, declined in an interview to give specifics of his defense against state allegations involving two patients, but he did assert that he is not worried about the outcome.

“I will be totally vindicated,” he predicted. “I’m glad that this is all coming out into the open, and I really welcome the opportunity to get this all behind me once and for all.”

He added: “If I was as bad as the state of California says I am, why would I have all these patients, all this success? . . . Who have I hurt? Who have I killed? What have I done except have a couple of unhappy patients? . . . Ever since I did a face lift on Phyllis Diller (in 1983), I’ve been the target of people who are very jealous of my success.”

“I’m on television all the time. I get a lot of publicity. I’m in Vogue, People, all sorts of magazines. And usually when something happens in cosmetic surgery, I get a call. But (the publicity) is a double-edged sword--you get persecuted because of it,” he said.

State officials say it is a sword of Elam’s own making.

And while the doctor acknowledges that he gets more “enthusiastic” about operating on “a really attractive girl” and considers himself “an artist” in his work, his critics charge that what he practices is not art, but rather demagoguery.

“His kind of conduct can’t be tolerated,” said Deputy Atty. Gen. Barry D. Ladendorf, who is prosecuting the case for the medical board. “It’s a black eye on the entire medical profession. It’s one thing to be not too good at what you do, but when you try and cover it up with false conduct and that kind of thing, it’s unconscionable.”

A hearing before a state administrative law judge for Elam, along with former partner Frederick Berkowitz, is set to resume today in Los Angeles and is to continue next week in San Diego. If a judge finds merit to the charges, the two cosmetic surgeons would face suspension or revocation of their licenses, probation or other penalties.

In a part of the case brought in 1988, the Medical Board of California charges that Elam and Berkowitz botched a “tummy tuck” in 1981, leaving Louise Byas of Dana Point with a disfiguring abdominal scar.

A Superior Court jury awarded Byas $84,000 in 1987 in her malpractice claim, but Elam said he wound up settling it for $32,000 after an appeal--one of “three or four” malpractice claims that Elam said he has had to settle.

Elam is named as a defendant in more than two dozen malpractice claims in Orange County Superior Court, a volume that state medical investigators say they consider high even in the sensitive cosmetic surgery field.

Nonetheless, Elam does not carry malpractice insurance to guard against claims by any of the 400 or so patients he handles a year, the bulk of whom are women who want face lifts, breast augmentations or nose jobs. He says it wouldn’t be worth the $100,000 it would cost him each year. (Although Elam declined to discuss his earnings for this article, he presented tax documents to the Superior Court as part of his recent divorce showing that he reported pretax income in 1989 of $856,015.)

“I don’t believe in (malpractice insurance). I’ll take my chances and challenge every last one of them,” Elam said.

In the Byas case, he took his chances and lost.

Beyond the malpractice charges, Elam and Berkowitz, 67, who met in the early 1970s while Elam was pursuing his medical degree at Louisiana State University, are also accused of insurance fraud. The state asserts that they altered Byas’ medical records to try to collect $3,772 in insurance money by falsely claiming that the woman’s operations were not elective, but rather were needed to fix a medical problem.

But the state’s pursuit of Elam did not end there.

The state began its prosecution of the Byas case late last year, but the administrative hearing was held over until this week because of scheduling difficulties. In the interim, however, the state medical board quietly tacked onto the case a second, potentially more explosive set of accusations.

The second accusation charges that Bonnie Luebke, 55, who won the Mrs. California pageant for married women in 1984 and went on to finish second in the nationwide contest, went to Elam later that year for neck and eyelid tucks. But according to the complaint, Elam “continually attempted to convince” her that she needed more extensive treatment--including cheek implants and a type of nose job that involves surgery on both the inside and the outside of the nose.

Luebke repeatedly refused, the state charges, and went to Elam’s office on Oct. 29, 1985, only for the neck and eyelid procedures. But after sedating his patient with preoperative medications and making her “drowsy and confused,” Elam told her that “he was going to do the kind of surgery that he thought best and that if she disagreed she could leave,” the state complaint alleges. He then performed the cheek implants and nose job without doing the more limited procedures Luebke had requested, the state charges.

The state also charges that Elam and Berkowitz again tried to dupe their insurer by filing a claim for $3,789 and falsely claiming that Luebke suffered from a blocked nasal airway.

“It’s still unbelievable that this could have happened,” Luebke said in an interview. “I just wanted these two little things done--not to change my appearance really, but just to help with the photography I would be doing after the Mrs. California (pageant).”

“But he just kept telling me, ‘I can make you looking 30 again,’ and all this stuff, and I said, ‘Why would I want to be 30 again?’ . . . It was a joke. He told me I had a bump on my nose that he could fix, even though people had always told me I had a nose they’d kill for,” Luebke said.

Added attorney Theodore S. Wentworth, who is representing Luebke in the medical hearing as well as in a separate malpractice suit in Superior Court that is scheduled to go to trial later this year: “He just cut the heck out of her without her consent, left her with a terrific scar that runs seven or eight inches across her forehead.”

“The mentality of this guy is that he thinks he can do practically anything, a kind of God,” Wentworth said. “It’s a power trip.”

Luebke, who lives in Trabuco Canyon, declined to be personally interviewed or photographed for this story but said by telephone that the main effects of the operations for her have been emotional, rather than physical.

“I feel violated. It’s assault and battery--the same as if he’d come up to me on the street and forced foreign objects in my face,” Luebke said.

“The whole things’s been so traumatic; you feel so outraged to know that someone you knew and trusted could deceive you like this,” she added.

Indeed, Elam asserts that his close ties to Luebke and her family helped cause his current legal problems. “I dated Debbie (one of Luebke’s daughters) for a few months and didn’t marry her,” he says.

And Elam is eager to line up clients past and present to contradict his detractors. Perhaps the most famous is Phyllis Diller, who Elam says “put me on the map.”

After another doctor did a face lift on the comedian, Elam did a brow lift and several nose and cheek procedures, and Diller is now the cable-video spokesman for Elam’s line of facial treatment products, known as La Vie.

Says Diller: “What he did for me was absolutely beautiful. . . . I’m a walking billboard for cosmetic surgery. At 73, I look a red-hot 50, so I think it’s great.”

A 46-year-old hair stylist who wants a face lift and went to Elam last week for a first consultation said in an interview arranged by Elam that she too was impressed by the doctor.

“I’m fading fast, and I want to do something about it--to feel fresher,” said the woman who asked not to be identified. “Everyone’s doing it. You almost have to do it these days just to keep up,” she said. “People I know told me about Dr. Elam, and he made me feel really comfortable and set at ease. He’s a good salesman.”

But some patients say that may be the problem--that Elam is too good a salesman.

One young patient of Elam’s, who also asked not to be identified, said she visited the doctor to get stretch marks removed but wound up getting a nose job. The woman said neither she nor anyone she knew had ever had a problem with her nose, but Elam questioned whether it might not be too big for her small face.

The woman indicated that she now sometimes regrets having gone along with his advice. Told by another patient in Elam’s office that her small, turned-up nose looks “so cute!” the woman replied curtly: “Yeah, too cute, I think.”