Be careful who sucks your fat; unqualified suckers proliferate as liposuction balloons in popularity.

Be careful who sucks your fat

Unqualified suckers proliferate as liposuction balloons in popularity

Could some doctors be so greedy they'd market themselves as strenuously as a used car dealer? That they'd step on the toes of board certified practitioners by claiming that they too are board certified, but by the wrong board?

And could this uniquely Southern California debate be swirling around suction-assisted lipectomy, better known as liposuction?

It is. With up to 2,500 Angelenos subjecting themselves to liposuction surgery each month, competition is squeezing the plastic surgeons who once had a handle on the procedure.

Dr. William Shaw, chairman of plastic surgery at UCLA Medical Center, says "it's being done in virtually every hospital every day."

The average cost of a liposuction procedure ranges from roughly $1,000 to $2,500. And that translates to nearly $50 million a year that Angelenos are plunking down to go under the hose.

No wonder, with that kind of serious money on the table, L.A. plastic surgeons are becoming increasingly aggressive with their marketing efforts.

One has but to leaf through the pages of almost any Southland publication to find liposuction ads featuring scantily clad models, who, it seems, never were fat in the first place.

The last 50 pages of the May Los Angeles magazine are filled with them.

Apparently many of those ads are being taken out by doctors who don't have the eight years of specialized training required to become a certified plastic surgeon. Most aren't certified by the American Board of Plastic Surgery, the only legitimate certifying board, reports Dr. Dennis Thompson, president of the Los Angeles Society of Plastic Surgeons.

It's caused one fat mess.

"You see these ads where a surgeon is surrounded by beautiful women, implying he's done surgery on them all," Thompson says. "But often they're just hired models."

Dubious ads

Another dubious advertising practice now in wide use is stating that a surgeon is "board certified" without specifying which board did the certifying.

While there are only about 200 plastic surgeons in Los Angeles County certified by the American Society of Plastic and Reconstructive Surgeons, there are between four and five times that many performing liposuction surgeries here.

And there are now more than 100 self-designated "boards" across the country, reports Cathy Coyne of the American Society of Plastic and Reconstructive Surgeons.

"You have a few doctors getting together and saying, `Hey, let's certify ourselves.' And there's no watchdog around to prevent it," Coyne laments.

Dr. Jeffrey I. Resnick, a Santa Monica plastic surgeon, is equally disconcerted.

"You've got ear, nose and throat guys doing liposuctions of the buttocks," he complains. "Gynecologists are doing them (liposuctions); dermatologists are doing them."

Sen. Dan McCorquodale (D-San Jose) is trying to stop the indiscriminate fat sucking with his bill, SB2036, which is currently before the California Senate Appropriations Committee. The bill would crack down on quacks by making it a crime to fraudulently claim to be certified by the American Board of Plastic Surgery, or to advertise bait-and-switch prices.

But for the time being, any medical doctor can legally perform liposuction surgeries, or any other kinds of surgeries for that matter. The results are sometimes alarming, liposuction experts say.

"I saw one unfortunate lady who looked like one of those topography maps, with lumps and dimples all over the place," recounts Myra Staresina, a medical malpractice defense attorney with the firm Bonne, Jones, Bridges, Mueller & O'Keefe. "Sometimes an accordian-type occurrence takes place when too much fat is taken out."

Other complications are more than skin deep.

Infections, bowel perforations and other internal injuries, while rare, sometimes result from liposuction surgeries. Some have even caused death.

Most serious problems result from an overly demanding patient teaming with an overly aggressive surgeon, reports UCLA's Shaw.

"The common denominator in serious problem cases is a doctor trying to take out too much (fat) at one time," he says. "Sucking off fat is like hitting the patient with a baseball bat. It's quite safe if you do it a limited number of times. But if you're batting the patient all over the body, and doing that to hundreds of patients, you're going to have some serious injuries and maybe even deaths."

The process

Most patients can safely have four or five pounds of fat removed in a single session, Shaw says. But the acceptable limit varies from patient to patient and depends on how many sites are being sucked.

The actual procedure, which usually lasts between 60 and 90 minutes, involves having a small incision cut just below each fat protrusion to be excised.

A blunt metallic instrument called a cannula, which can be up to a foot long and three inches wide or as small as a few centimeters in width and length, is then slipped through the incision and under the skin.

It is stroked back and forth through the fatty deposit with a motion that resembles the arm action of a cellist.

The extracted fat, liquified and yellowish at first and then brownish-red as the procedure progresses, is put into sealed bags. Those bags are picked up at week's end by biological waste disposal companies, which incinerate the sludge.

On average, Angelenos are contributing more than 100 pounds of fat each day to those companies' incinerators.

Liposuction veterans contacted for this article said they'd do it again.

"I just bought a new bathing suit yesterday and I'm going sunbathing in Phoenix this weekend," gushes a 28-year-old office worker who had fat sucked from her thighs, abdomen and knees six weeks ago. "It was very painful, but not worse than I thought it would be."

UCLA's Shaw, however, stresses that liposuction is a contouring procedure for those with localized collections of fat; it's not a weight-reducing technique.

Those with overall weight problems must strive for ideal beauty the old-fashioned way, through diet and exercise, Shaw indicates.