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Journalism of Courage
Some celebrity events end up demonising plastic and cosmetic surgery as life-threatening. That’s why the death of reality star Kim Kardashian’s lookalike and model Christina Ashten Gourkani has again raised anxieties about cosmetic surgeries. She reportedly suffered from a cardiac arrest following a plastic surgery procedure. Her family claims that her sudden passing is a homicide as a result of a medical procedure gone bad.
Assessing the facts of this case, top south Delhi-based plastic and cosmetic surgeon, Dr Anup Dhir, says, “People forget that she pushed herself to the extreme end of the spectrum with obscene implants because she wanted to look and live like Kim Kardashian. She had a very imbalanced lifestyle, and no right-thinking surgeon would agree to this form of body correction. Any cosmetic surgeon would pass their patient through a rigorous psychological assessment, look for underlying mental health triggers, address them, act like a counsellor and then decide whether the surgery is indeed warranted in the first place.”
Dr Dhir has played counsellor in many of his own patients with body imitation and celebrity avatar issues. “You have to build body confidence in your patient first and then see whether that requires enhancement or correction within practical limits. I have personally refused such unjustified demands to look like a celebrity. Only crazy doctors can operate on crazy patients,” he adds.
Having said that, Dr Dhir says that a cardiac arrest during any surgery is possible when a proper pre-operative health assessment and testing are not done. “We insist upon a detailed history of health conditions, tests to see if we have missed any underlying conditions and even check for substance abuse. We never go for successive procedures before the body heals fully,” he explains. “But the biggest problem is many seeking to correct their looks through surgeries do not go to established plastic surgeons but choose to go for fly by night operators who will do anything for money. These procedures by untrained hands are what give cosmetic surgery a bad name,” he says.
For example, it could be something as basic as administering anaesthesia. The margins of safety for sedation and local anaesthesia being very narrow, toxic amounts may trigger cardiac arrest. Sometimes over sedation impairs breathing. A trained hand would know how to control the dosage, have the skills, equipment and facilities to provide airway and breathing support to patients. Sometimes fat particles or prosthetic filler can enter the blood system and cause embolism, leading to cardiac arrest. “These things do not happen with trained hands. Besides, even with protocol compliance and extreme care, all surgeries can have adverse events like cardiac arrests. The type of preparation before a surgery, therefore, becomes important,” says Dr Dhir.
The Stanford Medicine guidelines for plastic surgery may help you ask the right questions of your surgeon. Following are its pointers:
*Ask the surgeon to explain the benefits, risks, and expectations of the procedure.
*Discuss what type of anaesthesia will be administered and what recovery time is expected.
*Inform your physician of any medications (over-the-counter or prescription) you are currently taking, as well as any prior procedures, history of chronic illnesses, and/or allergies you may have.
*Be sure to stop drinking and eating for the recommended time period before and/or after surgery.
*Be sure to follow any specific pre-operative bathing, shaving, or cleaning instructions.
*Be sure to discuss any post-operative instructions that need to be followed (i.e., changing dressings, post-op medications, follow-up appointments).
*Do not wear makeup the day of surgery, including nail polish.
*Do not wear eye contacts the day of surgery.
*Leave valuables and jewellery at home.
*Advise the medical staff of dentures or other prosthetic devices you may be wearing.
*Be sure to arrange all insurance coverage prior to surgery, as many insurance carriers do not cover many types of plastic surgery procedures (particularly cosmetic procedures).”
