PANEL RECOMMENDS LIPOSUCTION RESTRICTION; HIGH-VOLUME SURGERIES RISKY, BOARD SAYS.

Byline: Susan Kelleher The Orange County Register

Liposuction surgery killed between 60 and 100 people in the United States last year, so California should ban large-scale liposuctions performed outside of hospitals until safety issues are sorted out, a state medical board committee said Saturday.

The six-member plastic surgery committee unanimously endorsed a moratorium on so-called large or mega-volume liposuction - surgeries involving the removal of more than 4 or 5 liters of fat - after questioning doctors who perform and regulate cosmetic surgery through professional organizations.

Committee chairman Dr. Robert del Junco said the number of deaths from 110,000 procedures performed last year was unacceptable for a procedure widely described as the most popular cosmetic surgery in the country.

Orange County had at least one liposuction death last year, a high-profile case involving a La Habra woman who bled to death after undergoing 10-1/2 hours of surgery that included liposuction to remove 14 pounds of fat.

At least two dozen other Orange County patients contracted a rare bacterial infection from smaller liposuction surgeries at one doctor's office last year. The outbreak is still under investigation by the county health department.

``After looking at what little data is available, it is my opinion . . . that mega-volume liposuction is experimental and can be extremely risky,'' del Junco said at a public hearing on the topic.

``Liposuction has no health benefit to outweigh the considerable risk, and it is my opinion that it is simply too risky to be performed in free-standing, unregulated offices until there is greater scientific data, (until) it is adequately regulated or the profession can demonstrate that it has taken great strides to ensure patient safety.''

Medical Board of California spokeswoman Candis Cohen said any new regulations or restrictions approved by the board would require legislation. The committee already is plugged in with Assemblyman Martin Gallegos, D-Irwindale, who is interested in exploring new regulations.

Doctors attending Saturday's meeting said it was impossible to legislate good surgical judgment and urged the committee to steer its efforts toward public education.

``The public needs to spend time doing its own self-education,'' said Dr. James Wells, a member of the board of directors for the American Society of Plastic and Reconstructive Surgery. ``They're in too big a hurry to get things done.''

Other doctors urged the medical board to crack down on doctors whose advertising contained exaggerated claims or inflated credentials. It's a popular strategy, they said, used by ``weekend wonders'' who begin performing procedures after taking a weekend course.

Most liposuction surgeries involve the removal of relatively small volumes of fat in areas such as the thighs. But in recent years doctors have reported taking out more than 15 liters of fat and fluid - about 30 pounds - over larger areas of the body in a single operation. It's those larger procedures that have generated the most controversy.

The definition of large or mega-volume liposuction - one doctor in Texas calls his 10-plus-liter surgeries ``giganto liposuction'' - differs from doctor to doctor. Del Junco said the committee picked the 8- to 10-pound cutoff because it was the number generally considered to be large volume by professional societies and some insurance companies that provide malpractice coverage to doctors who perform the procedure.

Dr. Mark Gorney, representing one of the largest medical malpractice insurance companies in the state, said California and Nevada doctors covered by the Doctors' Co. lost nine patients to liposuction complications in the last 18 months.