LA Times Article on Donda West

Yesterday the L.A. Times ran a comprehensive article featuring more information on the tragic death of Donda West after plastic surgery. They cite evidence that she had possible severe atherosclerotic heart disease, hypertension, borderline diabetes, and evidence of pneumonia due to aspiration. These are some very worrysome factors when one considers she underwent 5 1/2 hours of body surgery, which is more traumatic than facial surgery such as a facelift or blepharoplasty. To her surgeon's defense, however, patients sometimes don't inform their plastic surgeon about all their medical history, so as not to be turned down for the procedure. What Donda West told her surgeon and anesthesiologist, however, is not publicly known. The story continues to unfold...

Link to article: here

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Update on the Death of Donda West

The final coroner's report on Kanye West's mom, Donda West, was released Thursday. Although the results are inconclusive, there was no sign that surgery error caused her death. According to CNN.com:

The exact cause of death couldn't be determined but there was no sign of "surgical or anesthetic misadventure" in the death of Donda West, Kanye West's mother, a coroner's report said Thursday...
The report noted that coronary artery disease, the liposuction and mammoplasty, and multiple postoperative factors could have played a role, but said the exact contribution of each factor couldn't be determined...
The investigation found "therapeutic levels of medication" but no unusually high levels....
"The final matter of death could not be determined," the coroner's office said in a statement.
Asked if West would still be alive if she hadn't undergone the surgery, Winter said: "She could, possibly. But she could have also died because of pre-existing cardiac issues."

If one good thing can come out of this tragedy, hopefully it is that prospective patients will ensure their plastic surgeons are board-certified and take all the safety precautions necessary to prevent something like this happening. It has reinforced the rule in my practice that all patients over 40 must get preoperative clearance from their internist of family doctor.

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Breaches of Patient Confidentiality in Donda West Case?

With all the hubbub about Dr. Donda West's plastic surgeon and his background, one important aspect of this whole tragic turn of events has failed to catch the attention of the media: Patient Confidentiality. I've always been taught that government-mandated patient privacy laws prohibit a doctor from giving out a patient's private health information to others without the consent of the patient. Only under certain circumstances are we, as physicians, allowed to release this health information to another person (usually only in emergency situations). So then... Was it lawful for the two plastic surgeons involved with this situation (Dr. Jan Adams and Dr. Andre Aboolian) to discuss Donda West's plastic surgery with the press??? Did Dr. Aboolian break the law by announcing through his publicist that he saw Donda West in consultation for plastic surgery? (click here for link)

As a physician and plastic surgeon, patient confidentiality is of extreme and upmost importance to me and my patients. The fact that these physicians are discussing the tragic details of Dr. Donda West's plastic surgery to the lay media strikes me as self-serving on both counts. With all the horrible accusations being hurled at Dr. Adams, one can see why he would talk with the media as a way to explain and protect himself (who would blame him?). As for Dr. Aboolian, what purpose does it serve (other than self-promotion and publicity) that he release Donda West's personal health information to the public the day after she tragically dies?

These are just some thoughts from an admitted 'non-expert' in patient privacy laws. Any comments would be appreciated.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

More on Donda West's Plastic Surgery-Related Death

More information is coming out regarding the tragic death of Kanye West's mom after plastic surgery. According to CNN.com, Donda West underwent a breast reduction and tummy tuck on Friday, Nov 9th at the surgery center of Beverly Hills plastic surgeon Dr. Jan Adams. The procedure took approximately 8 hours, after which she was sent home to recuperate. On Saturday she was found unresponsive and in respiratory distress. She was later pronounced dead at 8:28 pm at Centinela Freeman Regional Medical Center. An autopsy performed today was inconclusive, pending toxicology tests.

So...what happened??

Obviously I wasn't there and cannot comment exactly on the specifics of this sad case, but there are some points to consider:


1. The plastic surgeon who performed the procedure, to my knowledge, is a bona-fide plastic surgeon who underwent all of the necessary training to perform these surgeries competently. Although the internet is buzzing with reports about his past, his training at the University of Michigan and UCLA earned him board-eligibility to be a plastic surgeon (although he was not board-certified). He is not some kook ER physician posing as a plastic surgeon.

2. An 8 hour "body" procedure is a long surgery to perform on someone who is 58, but is very often performed successfully. I know of no absolute guidelines limiting the length of a surgery, as this is usually a joint decision between the plastic surgeon and the anesthesiologist. In general, a healthy 58 year old should tolerate surgery well. I try to limit my surgeries to 6 hours or less, but this is just my comfort level and cannot necessarily be transferred to another surgeon.

3. Preoperative clearance is important for patients who show signs of heart disease or other illnesses. While this cannot ensure that there will be no complications, it can help prevent unforeseen risks. I routinely require preoperative clearance by a primary care physician prior to most plastic surgery procedures. There is no evidence in this case that preoperative clearance was not obtained by Dr. Adams (although he hasn't commented on this).

4. Plastic surgery is serious business. Death is a possibility with every medical procedure, from colonoscopy to plastic surgery, whether preoperative clearance is obtained or not. This is one of those things that I always pray never happens to a patient of mine, and is always a concern every time a patient undergoes anesthesia. A report in the Plastic and Reconstructive Surgery Journal noted only 1 death in 51,459 plastic surgery procedures. That number is still too high for me not to get gray hairs on my head.

5. What caused her death? I can't tell you for sure, but some possibilities exist. A pulmonary embolism (blood clot to the lungs) is possible, but would usually be a bit more delayed. Excessive bleeding is a possibility, and may have contributed to heart strain resulting in a heart attack. This may also be a result of massive fluid shifts after a lot of plastic surgery. This is something that could occur in this time frame.


I think the lessons for patients to take from this are:


1. Make sure to question your plastic surgeon as to whether the length of your surgery should have you consider splitting it up into two separate operations. I quite often do this with patients who want a breast lift with implants and tummy tuck.
2. Get preoperative clearance by your primary care physician, especially if you are older than 40 and have medical problems.
3. Make sure your surgery is performed in an accredited surgery center with a board-certified plastic surgeon.
4. If you have general anesthesia and go home afterwards, make sure someone is with you at all times during your immediate recovery (first 16-36 hours) so they can call for help if needed.


For more information on choosing a plastic surgeon, click here and here.

For information on safety in plastic surgery, click here for the ASPS FAQ's.


Photo credit: prphotos.com


Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Kanye West's mother dies from plastic surgery-related complications

A very sad story is being reported by several news sources. Apparently Kanye West's mother has died recently likely from complications of plastic surgery. One source is reporting that she underwent a breast reduction and liposuction and stopped breathing while at home recuperating. She was rushed to Centinela Freeman Medical Center, where she was pronounced dead.


A Beverly Hills plastic surgeon has claimed to have seen Mrs. West in consultation and offered surgery after she passed a medical clearance, which was never returned to him. She may have had a thyroid condition or other problem which could affect her heart and predispose her to a heart attack. Reports are still sketchy, and an autopsy is expected to be conducted by Wednesday.

It's always a sad thing to hear of someone dying after having elective surgery. My thoughts go out to Kanye West and the rest of her family.

For more information on the death of Donda West, click here and here and here.

Photo credit: prphotos.com
Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.: