‘My boob job nearly killed me’

WITHIN minutes of being admitted to a Sydney hospital with a severe infection in her left breast implant, Michelle* was told it needed to be removed immediately, or she could die.

Just days earlier, the Sydney woman had undergone a breast augmentation procedure.

The operation was performed by a man who called himself a cosmetic surgeon, but Michelle now knows he is only qualified as a GP.

The doctor performed the surgery in his clinic in western Sydney, not in a hospital, using "twilight sedation", an anaesthetic technique involving a mild dose of general anaesthesia. where the patient is sedated, but not unconscious.

Michelle had asked for "natural-looking" breasts and was concerned her chest would look out of proportion.

"All I remember is waking up out of twilight sedation and I had these enormous watermelon breasts," Michelle, 54, told news.com.au.

"I said, 'I told you I didn't want porn star boobs,' and he said, 'You're overreacting, they're swollen.' But my blood sugar wouldn't come down, I felt unwell and all he did was say, 'You're overreacting,' and shove a needle with antibiotics in my arm.

"He would not help me and I knew I had a bad infection, so my partner drove me to hospital and the doctors told me, 'You've got a severe staph infection, you probably got that from this surgery'.

"The doctors said, 'Michelle, this is really, really serious. You're high risk - we need to go into surgery and remove the implant now. Have you got all of your stuff in order?' I said, 'What do you mean?' It was terrifying," she said.

"They'd seen this sort of work before from this doctor and they said, 'Did you know he was not a surgeon?' and I didn't."

Her surgeons drained 250ml of puss from her breast and took out the implant.

"I was left with one implant on one side of my chest that was huge, that caused me back aches, and nothing on the other side. I was so ashamed. I wouldn't leave the house because I was in so much pain."

Michelle was about to make another frightening discovery - the cost of fixing the botched procedure would be massive and force her into financial hell.

Australia's plastic surgeons say the problem is on the rise. Women are spending thousands on revisionary surgery after an unqualified clinician has damaged their bodies.

News.com.au has been investigating why anyone with a standard medical degree is legally allowed to perform cosmetic surgical procedures in Australia.

These should be performed by a plastic surgeon or a medical practitioner who has undergone proper cosmetic surgery training, the industry's top bodies say.

But a lack of industry regulation and confusion about the term "cosmetic surgeon" means patients are handing over their bodies and cash to dodgy doctors, with devastating and often lethal consequences.

Breast augmentations are the most at-risk procedure, said Australasian Society of Aesthetic Plastic Surgeons President Mark Magnusson.

Breast implants should last for around 10-12 years before they need replacing.

"All breast implants will eventually need re-operation, but I'm seeing people coming in after having their implants for 12 months because they've had a complication like bleeding or infection," Dr Magnusson said.

"Things like that should be very low in a well-run practice, but this is happening too often," he said.

THE FIXER

Sydney plastic surgeon Dr Rohit Kumar spends a lot of his time fixing other people's mistakes.

"About 10 per cent of my practice is doing revisionary breast or body surgeries, which is far more than I would like it to be," Dr Kumar said.

"Every single procedure has been performed by a non-registered, non ASPS [Australian Society of Plastic Surgeons] clinician. They've been done by someone calling themselves a cosmetic surgeon."

One of the worst cases he has taken on was of a patient whose unqualified surgeon had put asymmetric implants inside her chest.

"When I did her surgery, I found she not only had two different sized implants, but they were from two different companies and two different shapes. They didn't even use the same brand, same shape or same size," Dr Kumar said.

"It was almost as though what was left in the boxes in the operating theatre was what they put inside her. She walked out with clearly asymmetric breasts."

Dr Kumar performed Michelle's revisionary breast augmentation surgery last year.

Her superannuation fund allowed her to withdraw $24,000 from her super to pay for the procedure.

"I'm lucky they allowed me to do that but it's not great for me long-term and I had to pay $6000 tax on top of that for withdrawing money early from my fund," Michelle said.

Despite the reconstruction, her breasts still aren't what they should be.

"They are disproportionate in size and I have a lot of scarring from the reconstruction. I'm going to require up to two more surgeries on top of that. My recovery is probably going to be another couple of years," she said.

"The affect that it's had on me mentally … it's affected my home and work relationships."

THE LONG TERM IMPACT ON PATIENTS

Dr Magnusson said it can be "absolutely devastating" for patients.

"It impacts everything about your life. Even if it's not visible to other people, you feel like it's there ... like a great bit banner across your chest," he said.

"There's a lot of cliches about cosmetic surgery, but the majority of patients who have surgery want to feel unnoticeable. Girls with large breasts want to have normal-sized breasts. None of them want to keep their large breasts. Girls with small breasts want to feel feminine, as though they're part of the crowd."

Dr Magnusson says patients are often made to feel like they "messed up" their recovery, when really the mistakes were made during surgery.

"When patients find out what went wrong, they sometimes feel silly and say, 'How did I even let myself, get myself into this?'

"They're blaming themselves and are made to feel like they did something wrong in the recovery and that's why the problem keeps happening."

It gets depressing for the surgeons too.

"We have patients sitting across the table from us in tears," Dr Kumar said.

"Many women don't come forward because they feel uncomfortable and they feel guilty. They don't want to admit and say, 'I actually have this problem.'

"It's very disheartening to speak to patients and say the damage is significant or the result is so poor that no matter what you do, you can improve things but you'll never bring it back to normal. If you had gone to a properly qualified plastic surgeon instead, you probably wouldn't have this problem."

HOW YOU END UP SPENDING DOUBLE

Many patients who wish to go under the knife choose their clinician based on cost, not quality or expertise.

The decision to "save" money and choose an unqualified surgeon can actually end up costing patients more, because they have to undergo expensive revisionary surgery to fix their mistakes.

"I call it a bait and switch," Dr Kumar said. "Because realistically, you think you're paying a low price and you will be, but when you then add the cost of revision and complications, you end up paying double or triple what you'd pay if you'd done it with a proper surgeon the first time.

"For example, you might pay $10,000-$15,000 for the original surgery and $10,000-$15,000 on revisionary. So you're spending $25,000-$30,000 on an operation that should have cost half of that."

The reason why plastic surgeons cost more is because of their increased level of training, as well as the facilities and staff required to conduct a safe procedure.

"You need the right number of staff in the operating room and in recovery room. Of course all these things add costs," Dr Magnusson said.

"Many people are having these procedures done in facilities that aren't fully equipped, as a way to try and save cash," he said.

But Dr Kumar said coughing up the extra money in the first place is the key to patients getting the results they want.

"I always find it surprising when people are willing to cut corners. It's your body. You get one shot at it," he said.

"If you had to get heart or brain surgery, would you get the cheapest person or would you get the best person? If you're willing to do that for your heart or your brain, why wouldn't you do that for your breasts?"

WHAT NEEDS TO BE DONE TO FIX THE PROBLEM

Michelle wants the federal government and the Medical Board of Australia to address the issue with the term "cosmetic surgeon".

Technically, there is no such thing as a cosmetic surgeon. You're either a plastic surgeon or a cosmetic medicine practitioner.

"You can say that you perform cosmetic surgery, but you can't actually use the title 'cosmetic surgeon'. I'm not a surgeon, I only perform non-surgical procedures so I call myself a cosmetic medicine practitioner," said the Cosmetic Physicians College of Australasia spokeswoman Dr Mary Dingley.

"Give the authorities the power to shut people down," Michelle said.

"We need a regulator with some very strict guidelines about what people can and can't be called and for them to take action. If we had that, my doctor would not have operated on hundreds of women, including me."

 

*Last name has been withheld for privacy reasons

 

So how do you avoid dodgy doctors? Read our explainer about how to choose a qualified surgeon.

 

Do you have a story you'd like to share? Email rebecca.sullivan@news.com.au.


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