When you make the decision to get plastic surgery, what’s the first thing you consider? Do you think about the procedure itself, what technique they’ll use and what products? Do you think about the values and ethics of the surgeon who will be slicing you open?
We have so much trust in doctors these days, we don’t really think about all the ways they could do us wrong. We willingly accept the anaesthetic that knocks us unconscious, excitedly expecting to wake up looking exactly like the women in the brochures.
Sadly, for a shockingly high number of women, this dream fails to become a reality. Women UK spoke to Lisa Doran, founder of the Breast Surgery Advisory, about the dangers of breast surgery today, “Imagine going into surgery, putting yourself through that experience, only to come out looking worse than when you started?”
Lisa recalls her time working as regional manager for one of the UKs leading cosmetic surgeries. “I had patients ringing me in tears from 7 in the morning till 9 at night with issues regarding their surgeries. The management team wouldn’t take any responsibility for their mistakes and the women were powerless because they signed a warranty.”
Appalled by the results, Lisa went on to set up the breast surgery advisory, which focuses on empowering women with the tools, resources and knowledge they need to have breast surgery. “I’m pro surgery, I think everyone should be able to make a choice – but you should have the right information to be able to make the right choice. A lot of women massively benefit from surgery. The only issue is, when it goes wrong, where do you go?”
Unfortunately, cosmetic surgery has become a very profitable industry, being run by businessmen who are predominantly driven by money. Most companies have flashy websites that look very appealing, but it’s almost like they’re trying to sell you something that isn’t real. “So we set something up to stop women from being distracted by the ‘flash’ and instead look at the values and ethics of the surgeon, because that’s the only way you’re going to get a good result”.
A lot of the women who have contacted Lisa were patients to some of the more popular providers. One woman, who has asked not to be named, had her first surgery 5 years ago, and now has one breast that’s a B Cup and the other that’s a double D. When she told the surgeon who operated on her about what happened, he said ‘the reason they are different is because you put on weight’. Lisa comments, “So they fat shamed this young woman, making her think its all her fault. I said to her, are you telling me that clinically you only gain weight in one breast?”
Lisa got onto a London based solicitor, to help look into this woman’s case. After Lisa got her records back, she was appalled at what the Surgeon’s had done. “She stopped breathing 10 minutes after the surgery. I’ve been in surgeries with some of the worlds leading surgeons and I have never seen that happen.”
‘What made this situation even worse, was that the surgeons failed to inform this woman about what happened. This woman went on to have two more surgeries with the company, and no safeguards were put in place to prevent the same thing happening again. “There was also no consent signed for a third procedure, which is illegal. This is happening on a daily basis. There are things that happen that make me so angry and I just need women to wake up and see it.“
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A new report published by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD), presented shocking statistics. This report was specific to purely surgical procedures.
- Routine psychological assessments were carried out in less than 35% of sites
- Nearly three quarters (70%) of clinics in the sector operate effectively unregulated
- 8 out of 10 (79%) of providers offering complex surgeries such as breast reduction, do not perform these anywhere near enough to maintain an appropriate skill set
- Nearly a third (32%) of providers don’t offer a two-stage deferred consent process, i.e., a ‘cooling off period’ after booking surgery
- Less than half (44%) of operating theatres were properly equipped to perform surgery and over one in five (22%) didn’t have a member of resuscitation staff on duty at all time.
One case that was particularly tragic, was the death of Louise Harvey, a single mother of three who went in for breast surgery and a tummy tuck. After the surgery was finished, the surgeons failed to give Louise the anti-coagulant blood thinning drugs to prevent clots. Louise who died on July 5 had revealed her family history of DVT during an assessment she underwent before her surgery.
Evoke reports, “the opening of her inquest revealed her cause of death was a pulmonary embolism following breast augmentation. Pulmonary embolisms occur when a blood clot gets caught in one of the arteries that go from the heart to the lungs.”
Louise tragically died 17 days after her surgeries.
Breast Implant Cancer
When Lisa started working for a breast implant company, she found herself coming up against this massive barrier with some of the breast implant providers.
When women are waiting to have reconstructive surgery, the NHS may defer them to their local private hospital, with whom they have a contra deal with. “Most women think, Oh my God’ I’m going private, this is going to be so much better”, but this might not be the case.
Private providers were using Allergan implants, which have been tied to Anaplastic Large Cell Lymphoma.
A 2019 report by Aaron Sheinin states, “The FDA says the textured surface, unique to Allergan’s implants, are tied to 481 cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a type of non-Hodgkin’s lymphoma. There have been 573 cases of BIA-ALCL worldwide, including 33 deaths. In 13 cases where a patient died and the manufacturer of the breast implant was known, 12 of them involved an Allergan breast implant”.
Sheinin continues, “Most cases of this particular cancer, which attacks the immune system, are not diagnosed for years after the original implantation.”
For further information of BIA-ALCL, visit: http://breastsurgeryadvisory.com/bia-alcl/
When Lisa enquired about why they were using such products, while knowing the dangers associated and how they give a secondary form of cancer, she was shocked by the response, “because they’re cheaper ”. Lisa protests, “You can’t base decisions on somebodies health because of a £300 difference in price.”
You would assume health care providers look to care for patients, but it seems in cases such as these, earning a bigger profit is more important. Lisa continues, “how another woman could sit in front of me and say ‘we’ll use a product that could potentially give a woman cancer after they have had cancer, just because it’s cheaper’.”
Speaking to the Guardian, Mark Clemens, an associate professor of plastic surgery at MD Anderson Cancer Center in Houston, says, “I have never seen a case of ALCL that isn’t related to textured implants.”
Mark warns women to be aware of the risks, “It is an uncommon disease so when women are deciding on breast implants they need to be aware of the risks and benefits of textured and smooth; they need to be told that it can exist, what the symptoms are and what to do about it.”
The MHRA is calling for medical professionals to report suspected or confirmed cases of BIA-ALCL. Symptoms include an onset of fluid build up or swelling around the breast. The surgeons have been asked to remove the fluid and send it off for a fluid aspiration test, where they take the fluid out with a needle and send it off for testing.
“But they’re not doing it”, explains Lisa, “Because they’re worried women will become afraid of having implants”.
Lisa spent years trying to educate the surgeons to do the right thing by the patient, “but then I thought, actually the people who need to be educated are the patients. They need to not be sold glossy advertising, they don’t need to look at ‘body beautiful’ and expect that’s going to happen because the reality is it doesn’t always work out like that”.
Lisa acts as a first point of contact for women looking to get breast surgery, or to advise women on what to do if their surgery went wrong. This service is completely free the only thing they need to pay for is associated surgery costs, if applicable. “But we also help women get their money back if they have had surgeries that have gone wrong”.
The breast advisory clinic gets their income from the surgeons. “I have a register of surgeons who specialise in breast surgery”. Lisa then refers patients to the surgeons on her register.
I ask Lisa about the surgeons on her register, to which she replies “all the surgeons on our register are world class, with excellent results and outcomes for patients. I audit each surgeon twice a year and ensure they follow the 14 points set out as a government safety”.
Lisa continues, “we make sure to spot-check everything – if they don’t do one of those 14 points we take them off the register”.
The 14-point plan, which ensures all surgeries are safe and successful, is outlined here: http://breastsurgeryadvisory.com/how-we-choose-our-surgeons/
“Some of it sounds standard, like changing gloves, or using a nipple shield, but it’s not being done”, explains Lisa. “During breast surgery you’re supposed to use a nipple shield, which is a plaster that goes over your nipple. Your nipple carries a lot of bacteria, so you must cover them to avoid getting any contamination into the incision”. Lisa goes on to explain that most surgeons fail to adhere to the standard hygiene practices, such as those on her 14 point plan, in order to save time and money.
“A patient wouldn’t know to ask for these things, like will he use nipple shields, will he change his gloves? So it’s up to the Doctor to know them. But they skip these steps because it costs money. Like most things in life you need to be part of an inner circle of people who can inform you about what you need to look out for.”
The issue with surgery today is that there is no one to monitor whether the surgeries are being correctly carried out. “After each surgery I request a copy of the patients notes to ensure everything went ok and to see exactly what happened in theatre”.
When talking about the products used, “We’ll only use products with the lowest possible risk. Every surgery caries risk, we can’t escape that, but if we can negate the risk and say to a woman that we’re going to use a product that has never given anyone any side effects, wouldn’t you rather that? Rather than a surgeon that says well I’m going to use these breast implants because I’m getting them at a discounted rate from the supplier. And that’s honestly what happens!”
Women are not given the information they need to say no. We look to surgeons as the experts, hoping they will give us the right advice for our bodies. But in reality, there are many surgeons who base their decisions on where they can get the cheapest product.
Lisa enforces a code of conduct on all her surgeons, which states that no doctor is aloud to take incentives. “It’s still a business, doesn’t matter how we look at it, it’s still a business. But what we can do is make that business safer and push surgeons to put the patient’s health before the bank balance of that particular practice or clinic.”
“We’re there to give women a voice, to give them the information they need. If I could prevent one more woman going through what I’ve seen, I know I’ve done something right.”
Lisa’s website can be found here: http://breastsurgeryadvisory.com/
By Ciara Glover, Features Editor