Archive for the ‘General Discussion’ Category

Russian Roulette? Strax Rejuvenation

Tuesday, March 27th, 2012

Patients seeking bargain pricing for their plastic surgery have been going to Strax Rejuvenation for years as the cheapest option in town. Strax commonly advertises very low prices to lure patients for their procedures. Recently, patients are learning that the lowest price is often not the best value. There has been another death at Strax Rejuvenation. That makes 5 known deaths in less than three years.

Last Thursday I received information about a patient that died while undergoing a procedure at Strax Rejuvenation. The patient went to Strax for fat transfer to the buttocks. During the procedure her blood oxygen levels began to drop and she could not be resuscitated. She died in the operating room at Strax Rejuvenation.

I have written about the deaths at Strax Rejuvenation in the past:

http://www.dr-rubinstein.com/blog/bargain-price/

In that post I analyzed recent deaths at Strax and calculated their mortality rate. Based upon my review, giving Strax Rejuvenation a huge benefit of the doubt, their mortality rate is alarmingly high. In fact, it was seven times higher than a published acceptable rate from the American Society for Aesthetic Plastic Surgery. When last Thursday’s tragedy is added to the analysis the numbers get much worse.

My original review of the Strax Rejuvenation death rate was based upon 4 deaths in two years time. That was less than one year ago. Let’s look at an analysis that includes this most recent death. Strax Rejuvenation currently has 12 doctors on staff. Only 10 perform aesthetic procedures. We could assume that every one of them operates every day of the week, never takes a vacation, and never sees patients for consultations nor follow up visits. Clearly that is not the case, but let’s give them the benefit of the doubt. Also assume that each doctor performs 4 procedures everyday. That would calculate to  31,200 procedures in a three year period. If that were true the death rate at Strax Rejuvenation would be 1 in 6240 cases. But it’s actually worse than that.

Strax Rejuvenation has six operating rooms. It would not be possible for all 10 surgeons to perform procedures all day, everyday. Only six cases can go on at the same time. So now let’s assume that each of the six operating rooms are fully occupied 12 hours a day, 5 days a week, 52 weeks a year, for three years. That would add up to a total of about 19,000 cases which would make the death rate at Strax Rejuvenation 1 in 3800 cases. That’s more than THIRTEEN TIMES the mortality rate published by the American Society for Aesthetic Plastic Surgery (ASAPS).

If we use Strax Rejuvenation’s own numbers it is even more grave. They boast having performed 29,000 procedures. Strax was founded in 2004 which gives it an eight year history. If the cases are evenly distributed over the eight years that would come out to just under 11,000 cases in three years. That means the death rate at Strax Rejuvenation over the last three years using their own numbers is 1 in 2175 cases. That is shockingly over TWENTY THREE TIMES  the published mortality rate. When compared to having your procedure performed by a board certified plastic surgeon in their own private practice, having surgery at Strax Rejuvenation sure does seem like making a riskier choice to me. Maybe not quite like Russian roulette, but definitely not the bargain most patients think they are getting.

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Smoke OUT! Risks of Smoking and Surgery

Wednesday, January 4th, 2012

Just about everyone knows that smoking is bad for you. But it is easy to ignore just how bad it can be. Particularly for long term smokers who are planning a cosmetic procedure. The truth is, there are very few things that can increase your risk for complications more than smoking. Here’s why.

Healing requires getting lots of oxygen to the healing tissues. Smoking affects your body’s ability to heal in three different ways. First, cigarette smoke has tar in it that gums up the surfaces of your lungs. This reduces the area that your lungs can use to work effectively. Basically it blocks the channels needed to get oxygen into your body and get carbon dioxide out.

Second, while we are talking about the gases you breathe lets discuss carbon monoxide. You may have heard about people committing suicide by starting their car in a closed garage. How that works is the accumulation of carbon monoxide from the exhaust fumes. When you breathe carbon monoxide it gets into your lungs just like oxygen would. In fact it attaches to the same place on your red blood cells that oxygen does. The problem is that it never lets go. Typically every molecule of hemoglobin in your red blood cells is able to carry four molecules of oxygen. Once carbon monoxide attaches to hemoglobin it as there forever, until that red blood cell is replaced by a new healthy one. That can take many weeks. So people breathing in car fumes slowly reduce their ability to carry oxygen to their body until they can’t carry enough to survive. Smokers are doing this very, very slowly, one cigarette at a time.

And last, the nicotine in cigarette smoke has a bad effect on the little arteries that carry oxygen to healing tissue. Nicotine causes them to shrink down in size. Imagine a normal sized artery being the size of rigatoni pasta. When nicotine is around that rigatoni shrinks down to the size of angel hair pasta. As you might imagine, the much smaller artery (capillary) can’t carry enough blood (carrying oxygen) to the healing tissue under the effects of nicotine.

Continuing to smoke leads to lots of big problems including trouble healing, infections, wounds opening up, loss of skin, and lots more. It is particularly dangerous in the case of abdominoplasty (tummy tucks) or facelifts where the skin is really stressed by the procerure and needs lots of oxygen to heal. Patients that have those procedures and continue to smoke can lose big pieces of skin that can turn black and fall off.

No matter what procedure you are planning, smoking is a very bad idea. In my practice I recommend that patients stop smoking two weeks before surgery and refrain from smoking for up to four weeks after surgery. At that point many patients have simply quit forever. If you are planning a cosmetic procedure and are a smoker you need to get the smoke out!

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A Bargain at What Price?

Tuesday, May 31st, 2011

Patients these days often look for the best deal in town. But by searching for the cheapest price some get more than they bargained for. Making the price of your procedure the most important factor in choosing your doctor or facility is not the best way of thinking. In fact, it has cost some people the highest price of all.

In most major cities there are clinics that offer very low prices for procedures that cost more when performed by board certified plastic surgeons in their own private practice. These clinics usually advertise a tremendous amount and make up for the lower profit with volume. One such clinic in south Florida is Strax Rejuvenation. This facility is known for very low prices, but also has a history of significant complications. Just last week a patient having a procedure at Strax Rejuvenation had to be taken to a nearby hospital due to a complication that occurred during surgery. She died three days later. This is the latest of four known deaths in the last two years. That is staggering number. In their defense Strax officials may claim that they perform a very high number of procedures and that the actual mortality rate is not so bad when you account for the number of procedures being done. Well, lets examine that for a moment.

In a study published by the American Society for Aesthetic Plastic Surgery (ASAPS) in 1997, after looking at 400,000 cases the mortality rate was 1 in 51,459 cases. If you look at a two year period that would be an impossible number of cases to perform, even for Strax, to account for four deaths. Strax claims 14 doctors, not all plastic surgeons. Even if we give them the benefit of the doubt and assume all 14 are plastic surgeons, every doctor at Strax would have to perform more than 27 operations every day of the week (Mon-Fri) every week of the month for the entire year to match that mortality rate. In actuality, if we assume that all 14 surgeons perform 4 operations every day (Mon-Fri) every week of the year for the same two year period, the actual mortality rate at Strax would be approximately 1 in 7400 cases – more than SEVEN TIMES the mortality rate published by ASAPS.

So when you are thinking about having a procedure and looking to save money, you would probably be safer to stick with plastic surgeons that are certified by the American Board of Plastic Surgery and in their own private practice. You might have to pay a few dollars more, but if you look for the biggest bargain in town you might end up paying more than you ever thought possible.

To learn more about patient safety, please check out my latest radio show episode.

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Choosing a Plastic Surgeon

Monday, April 4th, 2011

Let’s say you had to get off an island onto the mainland. If you had a choice of taking a small sailboat with someone that didn’t have a captain’s license and had very little experience with sailing, or a more stable sailboat with a fully licensed captain with years of experience, I doubt you would take too long to decide. Now lets say that you could take the smaller boat for five dollars, but the larger boat would cost ten dollars. You probably would still choose the larger boat. This decision is being made everyday by people having cosmetic procedures and the choices that are being made are not always the obvious ones.

If you change the details to fit cosmetic procedures you can see the choice that needs to be made. Patients can choose to have a doctor (and sometimes not even a doctor) who has little or no surgical training and is not board certified in plastic surgery, perform a consultation, injections, and even a surgical procedure. Alternatively, they can choose a fully board certified plastic surgeon with years of training and experience in the very same procedures that are being considered. If all things are otherwise equal the choice seems very clear. There are not too many people that would choose the less qualified, less experienced doctor. But when you add the element of cost people suddenly lose sight of that logic. If the unqualified doctor charges $400 and the board certified plastic surgeon charges $600 there are a lot of people that would choose the former based solely on price.

Lets change the details a bit. What if you needed surgery on your brain. What would be more important, the cost or the skill and experience of the surgeon? Most people would not hesitate to pay $200 more for the greater experience and skill of the board certified surgeon. Why should your face and body be any different? There is a reason that board certification exists – the difference matters. Do you really want to place your face, body, or even your life at risk to save a few dollars?

On my radio show, New Reflections we discussed this very issue on a special episode. I invite you to listen to that episode:

http://www.voiceamerica.com/episode/51157/be-safe-be-smart-a-patient-safety-special

Don’t choose the small sailboat with the less qualified captain.

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Why do you want plastic surgery?

Thursday, March 31st, 2011

Patients choose to have plastic surgery and aesthetic procedures for lots of reasons. All of them very personal. Sometimes the significant other doesn’t “get it”. Every now and then I will see a patient in the office who comes in with her spouse who is against the idea of having a procedure. The patients feels strongly about wanting to improve something and her husband doesn’t think she needs it.

It’s hard to understand why the person you love might want to change something about themselves when you look at them and love them just the way they are. Their reasons for wanting to make a change are usually deeply personal and may not make sense to anyone else. The most important reason for having a procedure is that it is very personally important to you, the patient. Once the procedure is done and you feel better about yourself, everyone else will understand how important this has been to you.

On my radio show, New Reflections, we recently did an episode about plastic surgery procedures changing people’s lives. On that show I interviewed a husband and wife about just this type of experience. I invite you to listen to the show and hear their perspective.

http://www.voiceamerica.com/episode/52531/plastic-surgery-changed-my-life

Why do you want to have plastic surgery? To make changes that are really important to you. People that care about you will see that and understand; sometimes it can take time.

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Buy 1 Latisse and Get 1 Free Now Through April 30!

Thursday, March 3rd, 2011

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Check out some of the results:

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If you have questions, just give my office a call – 305-792-7575.

Otherwise, you can order by clicking on the “Order Now” Button Below!

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Plastic Surgery Disaster – Stay Safe, Do Your Homework

Friday, January 28th, 2011

Recently in South Florida there has been a tragedy. Hoping to improve the appearance of her buttocks Lidvian Zelaya, a 35 year old woman from Miami, went to Strax Rejuvenation and Aesthetics Institute for liposuction and fat transfer to the buttocks. She chose the center based upon price, she thought she was getting a bargain. She ended up paying the ultimate price.

On December 27th, 2010 Mrs. Zelaya suffered complications during surgery and was transferred to a hospital where she was pronounced dead. She went to a large center where lots of procedures are done everyday. Her surgeon was board certified in plastic surgery. One would think she had made good choices. Had she done a little homework she might be with us today.

She was quoted a price of $4500 for liposuction and fat transfer. While this is a very good price, one has to be suspicious of pricing that is WAY less than other qualified surgeons are charging. And then there is the surgeon. Strax did not release the name of the surgeon, though the lawyer for Mrs. Zalaya’s husband claims the surgeon was Dr. Roger L. Gordon. While he is, in fact, board certified, a quick perusal of the Florida Board of Medicine might have changed her mind about her choices. Dr. Gordon has multiple complaints and disciplinary charges filed against him. Looking at county records there have also been legal actions involving Dr. Gordon.

A little homework may have helped avert this terrible tragedy. If you are considering have a procedure soon, take time and investigate your options well. Search the American Board of Plastic Surgery website to confirm the doctor is properly certified. Check the state board of medicine website to see if his/her license is clear and if there are any disciplinary actions on record. You can also look up the doctor in your county records website to see if the doctor has been named in legal actions in the past. A little diligence may go a long way in keeping you safe!

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