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A Face-Lift For Cosmetic Procedures

Posted by Jane Akre
Tuesday, May 27, 2008 9:54 AM EST
Category: Major Medical, Protecting Your Family
Tags: FDA and Prescription Drugs, Cosmetic Procedures, Plastic Surgery, Dr. Jan Adams

Donda West's death is encouraging legislation over plastic surgery outpatient clinics in California.




IMAGE SOURCE: Amazon/ Donda West, Raising Kanye, Amazon.com


Donda West, mother of rapper Kanye West, died six months ago following plastic surgery.

Now her death is influencing legislation among California lawmakers that could make the procedures safer for others.

Legislation has been introduced that pushes for increased oversight of doctors performing cosmetic procedures in an outpatient setting.

West had liposuction and breast implant surgery in an outpatient facility, performed by Dr. Jan Adams. Hours later recovering at home, she had complications and died.

A coroner report found that clogged arteries and heart disease were a factor in her death, not any surgical errors.

Another doctor whom West had previously consulted, declined to operate saying she had risk factors for a heart attack.  

Assembly Bill 2968, requires patients to receive a physical exam before undergoing cosmetic surgery.   Donda West did not have a physical exam by surgeon Jan Adams, says her niece.

Increasingly common are the use of outpatient facilities that are not as strictly reviewed as a hospital.

Senate Bill 1454 would require outpatient facilities, such as the one in which West had her surgery, to undergo inspections every three years. Currently there are no inspection requirements in California.

"These [clinics] are not hospitals. You have to raise the standards," said state Sen. Mark Ridley-Thomas (D-Los Angeles) tells the Los Angeles Times.

Florida tightened some regulations in 2006.   

The “Truth in Medical Education” law required cosmetic surgeons to disclose their background, education and specialty training before treating patients. Increased oversight of non-hospital settings increased after a dozen people died in clinics in 1998.

Outpatient clinics are less likely to have life saving drugs such as the antidote, dantrolene, that may have saved 18-year-old Stephanie Kuleba, who died in March from a rare genetic disorder causing an allergic reaction to anesthesia known as malignant hyperthermia (MH).

During more than five hours of surgery, West had part of her right breast removed and both breasts enlarged. She had abdominal muscles tightened and liposuction.

She went home to recover but was not hooked up to any monitoring equipment.

Experts say that should have been required given her history.

And SB 1454 would disallow the “before” and “after” pictures that often promise startling results after plastic surgery. 

The vice president of the American Society of Plastic Surgeons, Dr. Michael F. McGuire tells the Los Angeles Times, “There’s no way to control surgical judgment.”

McGuire says he backs a law similar to the one in Florida, but also favors only allowing board certified plastic surgeons to perform cosmetic procedures.

Dr. Jan Adams, who made many television appearances and was well known in Hollywood, was not board certified in plastic surgery.

Ontario, Canada doctors are increasing scrutiny after the death of a Toronto woman from liposuction.

Canadian doctors in British Columbia must be certified by the Royal College of Physicians and Surgeons of Canada to perform plastic surgery.

The California Medical Association opposes those restrictions citing that doctors must already be approval by an independent medical staff and insurers before than can perform surgery.

Still largely unregulated are medical spas that offer Botox injections, laser hair removal and photo facials. Lasers can burn and scar patients and currently in California there is no rule requiring a doctor be on the premises.

There were 11.7 million cosmetic procedures in the U.S. in 2007 up 50 percent from 2000.    # 


Posted by Barry L. Friedberg, M.D.
Tuesday, May 27, 2008 1:04 PM EST

It is very hard to read such uniformed information when it comes to the issues of patient safety in office based cosmetic surgery.

Posted by Barry L. Friedberg, M.D.
Tuesday, May 27, 2008 1:05 PM EST

The autopsy of Donna West revealed a 70% narrowing of her right coronary artery.

Posted by Barry L. Friedberg, M.D.
Tuesday, May 27, 2008 1:06 PM EST

There was NO clot withing the artery - meaning her artery was not 'clogged.'

Posted by Barry L. Friedberg, M.D.
Tuesday, May 27, 2008 1:11 PM EST

There was no evidence of muscle damage downstream from her right coronary artery. She did not die from either a through muscle infarction or subendocardial ischemia. AB2968 will not positively affect patient safety. As to the issue of 'inspection' of outpatient facilities - certifying bodies must renew certification every several years, mandating an inspection visit. More information @ LINK - a patient oriented, non-commercial web site.

Anonymous User
Posted by Jan Mannino CRNA, JD
Tuesday, May 27, 2008 7:59 PM EST

Having specialized in plastic surgery office anesthesia for the last 25 years, I am very comfortable in knowing that the same high standards of practice used in hospitals must be used in office surgery. When short cuts are made, standards stretched to fit circumstances and allowing economics to be a prime motivator, complications and bad results will follow.

Anonymous User
Posted by Jane Akre
Tuesday, May 27, 2008 8:12 PM EST

Hello Dr. Friedberg-

Thank you for your feedback. We at IB always welcome readers input although preferably with a little less sharpness to ones criticism.

Let me respond to your first comment. IB follows the Society of Professional Journalists "Code of Ethics" and believes in being responsive to the public and responsible for factually-based reporting.


As to Donda West's condition. The coroners report does indeed say 50-70% occlusion in her right coronary artery. You can read the report below.


For a layman audience, that translates to a clogged artery. The Los Angeles Times apparently feels that way as well. We do that because most of the public does not understand what "occlusion" means. If you can suggest an accurate, yet non-technical term, I'm all ears.

LINK ,0,6020239.story ( sorry you have to paste this one in!)

As to the pending legislation, you can find them at Assembly Bill 2968 below:

And Senate Bill 1454 below:

I'm sorry the link to your site does not work above. Readers can find Dr. Friedberg at:

However you may want to pass on the interview with Dr. Friedberg (the waitress is distracting ):

Again, Dr. Friedberg thank you for your comments. It appears that you have developed an innovation in anesthesiology that minimizes side effects.

If you'd like to talk to us further, IB would love to listen.

Jane Akre- News Editor

Comments for this article are closed.

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