It’s not ‘just’ a tummy tuck; it’s serious surgery

Bigger breasts, smaller breasts, a different nose -- plastic surgery, these days, is common. But the death of Kanye West’s mother, Donda West, after a tummy tuck and breast-reduction surgery raises questions about how safe the procedures are.

Although West’s death surprised many laypeople, cosmetic surgeons know that plastic surgery is just that -- surgery. “The problem is that we’ve listened to our own PR too much,” says Dr. John Grossman, a cosmetic surgeon who flits between Beverly Hills and Denver. “We assume this form of medicine and surgery is different from other forms in which people can die. To think it is without risk is foolish for the patient.”

“We have all had patients who have had complications,” says Dr. Kimlin Long, a Brooklyn, N.Y., cosmetic surgeon. “What is not a medical issue in everyday life can become an issue in surgery.”

The greatest risk for people undergoing elective surgery derives from the anesthesia, which is estimated to kill 1 in 10,000 to 100,000 people. “Perfectly well patients die under anesthesia for reasons unknown,” Grossman says. Autopsies or examination of surgical records afterward can often pinpoint the problem, be it a small, undetected blood clot in the brain or erratic heartbeats not obvious on an electrocardiogram.

Risks appear to depend upon the type of surgery. One study showed that tummy tucks are associated with a higher risk of lung clots than other kinds of plastic surgery. Also, when patients lie on operating tables for long periods, clots can form in the legs and travel to the heart or brain.

The most common problems for surgery patients, Grossman says, are untreated high blood pressure, a history of chest pain, erratic heartbeats or uncontrolled diabetes. All are associated with greater risk of heart attacks and strokes. Problems arise when people don’t reveal their entire medical history. “Some people are scared that their surgery will be canceled or delayed. That’s a hell of a lot better than ending up in the ICU or ending up dead,” Grossman says. “You should assume that not revealing everything is risking your life.”

Long says some patients are embarrassed about their surgery and so fail to discuss it with their doctor, who might be aware of a condition the patient had forgotten about. She says it’s important to reveal if you’ve had anesthesia before, or allergic reactions to medications. Even taking aspirin or other over-the-counter drugs can thin the blood and cause excessive bleeding if a surgeon isn’t told.

Long says there’s not much risk difference among races. But African Americans are almost twice as likely to have diabetes than non-Latino whites, according to the American Diabetes Assn. And one-third of people with diabetes don’t know they have it.

Grossman says good surgeons take steps to reduce surgery’s risks. For example, doctors can use a machine that simulates the leg-massaging effects of a stroll, cutting down on blood clots there. For tummy tuck surgery, surgeons might thin the patient’s blood because of the higher risk of lung clots.

Patients should not hesitate to call their doctor or go to the emergency room if they start feeling weird after they go home. “If you’re worried, having a lot of pain or bleeding -- go,” Long says.