New Delhi: Highly-rated cosmetic procedures can be deadly for you. While the industry for cosmetic surgery is growing worldwide, making thousand-crore business every year, three cases have been reported wherein three people who have undergone cosmetic surgery procedures, died due to life-threatening complications.

All India Institute of Medical Sciences (AIIMS) has witnessed two such cases, i.e. liposuction and breast implant surgeries, that have proved fatal to two young individuals. Another case, according to the Indian Association of Dermatologists Venereologists and Leprologists (IADVL), a case has been reported in Bengaluru where a woman succumbed after a hair transplant procedure at a local beauty salon.
 
In the first case, a 34-year-old man who wanted to have six-pack abs had gone to a cosmetic surgeon in South Delhi for the removal of fat from his abdomen, back and face. Approximately 4.5 litres of fat was removed in the liposuction procedure. At the end of the liposuction operation, the patient started de-saturating and suffered a cardiac arrest, due to which he died.

In the second case, a 30-year-old woman, who was a model, had undergone breast implant procedures a few years back. She faced troubles in her breast due to the filling and when she went to a doctor for its treatment, she died on the operation table. (It is pertinent to note that names of both the patients and clinics are withheld for further investigation as a matter is sub judice.) “Liposuction is a cosmetic surgery which is gaining popularity in the present-day modern world. This procedure is considered to be safe which rarely leads to a fatality. It is considered as a procedure with few clinical side effects, but with the increasing number of liposuction operations, the complications are also being frequently reported which are life-threatening,” said (Prof) Dr Sudhir Gupta, head of forensic medicine department at AIIMS. He added, “With two cases of cosmetic surgery proving deadly to two individuals,  we aim to increase the awareness of public and medical profession regarding the fatal complications of aesthetic procedures.”

It can result from cosmetic surgery such as liposuction and/or fat grafting, cardiopulmonary bypass, pancreatitis, joint repair, severe burns, sickle cell anaemia, diabetes mellitus, and lipid parenteral infusion.

According to an American Society for Aesthetic Plastic Surgery survey, the complication rate in liposuction procedures is 0.25%, while the mortality rate is 0.002%. Fat embolism is one of the most serious complications in liposuction.

While explaining the findings of the autopsy, Dr Abhishek Yadav, Assistant Professor, Department of Forensic Medicine at AIIMS informed, “Dermatology is a vast subject which also includes highly-advanced and expensive cosmetic surgeries like liposuction, breast implant etc. Recently, we witnessed a case of a 34-year-old man who suffered intra-operative death due to fat embolism during liposuction surgery. His autopsy revealed luminal blockade of all coronary vessels. There was widespread haemorrhage in the subcutaneous fat of the thoracic and abdominal area. The examination of lungs and brain revealed fat embolism in lungs and meningeal vessels,” said Dr Yadav, adding that the post-mortem of the woman with the breast implant noted that she died due to anaesthesia complications.

Fat embolism syndrome (FES) is a life-threatening condition which rarely occurs in patients after liposuction. In a surgical procedure such as liposuction, sudden deaths can easily lead to allegations of medical negligence. A thorough autopsy along with histopathological examination can reveal the actual cause of death, as evident in this case, he said. “The surgeons and anesthesiologists should be aware and prepared for early diagnosis and treatment of major complications. The standard infrastructure of the operation theatre and the ICU should be ensured, and surgical aesthetic procedures should be performed in tertiary care hospitals with optimum diagnostic and therapeutic resources in case of such operative complications,” Dr Yadav.

No government body to keep the control on cosmetic surgery

Dr Uma Shankar Nagaraju, Honorary Secretary General at IADVL said, “We have already requested the central government to form a guideline to control the cosmetic surgery industry. As of now, there is not a single authority to keep a watch on their functioning. A case has been reported in Bengaluru where a woman died due to complication in hair transplant at a beauty salon. Basically, in the name of cosmetic surgery, a lot of quacks are running their business.”

Dr Nagaraju said that in India the business turnover for cosmetic surgery is near thousands of crores per year; while Delhi, Mumbai and Bengaluru are the hubs of getting the cosmetic surgeries done.

Situation in Delhi 

Dr Girish Tyagi, Registrar at Delhi Medical Council (DMC) told Mail Today, “These cosmetic surgeries and skin clinics run privately and they are not registered with Delhi Medical Council, so we do not have any control over them. Due to this, the council does not there is no data available that how many such cosmetic surgery clinics are functioning in the city. They do not have the expertise and charge heavy money for it. In most cases, these clinics portray the name of the highly qualified expert, but in reality, they are served by some other unqualified doctor. We have got a few complaints against these cosmetic surgery clinics for which we have asked the Delhi government to take action against them.”

He said that the DMC can only take action if a doctor is practising allopathy and is booked with medical negligence. And cosmetic surgeons claim that laser treatment and liposuction does not fall under allopathy practice, which gives them freedom,’ said Dr Tyagi. “It is very much required that Delhi government should constitute a body or a registration authority to track the functioning of skin clinics provides laser, liposuction etc,” he added.