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Questions about the care of Donda West

Posted Monday, November 19, 2007 to GOSSIP > Celebrities

Posted by James Romanelli, MD, FACS

A number of patients this week have asked me about the sad, sudden death of Donda West, mother of Kenya West, shortly after cosmetic surgery in California.  Donda West was 58 years of age and reportedly underwent a 6-8 hour breast reduction and abdominoplasty by Dr. Jan Adams, who is not a board certified plastic surgery.  She apparently went home the same day.

My patients are mothers of young children, single men and women, retired or working people.  They all have responsibilities, and many tell me that they want to havet cosmetic surgery, but they don't want to have complications or die from anesthesia "just to look better."  Those are rational concerns.  And the tragedy of Donda West raises many questions about her care, but also offers insight into safety in plastic surgery.

Board Certification.  Kenya West mother was apparently operated upon by Dr. Jan Adams, a Beverly Hills plastic surgeon.  Dr. Adams is NOT board certified in plastic surgery.  He is NOT a member of the American Society of Plastic Surgery or the American Society for Aesthetic Plastic Surgery, the internationally respected societies of Plastic Surgery.  Searching the American Board of Medical Specialties today you will find that the only board certified "Jan Adams" in the United States is a family practitioner.  Board certification as a Plastic Surgeon is not immediate upon completion of Plastic Surgery residency.  A young plastic surgeon first practices for a year or two as a "Board Eligible" plastic surgeon before he or she can complete the rigorous examination process leading to Board Certification.  Dr. Jan Adams has practiced for many years.  Why not choose a board certified plastic surgeon?

Medical Condition.  Dr. Andre Aboolian, a board certified plastic surgeon practicing in California was quoted as saying that he consulted on Donda West, but would not operate on her without medical clearance.  He was quoted as saying that she had a significant medical condition.  The impression given is that Donda West needed more evaluation prior to surgery.

Length of Surgery and Extreme Makeovers.  6 to 8 hours of surgery is a long time for cosmetic surgery.  Most plastic surgeons I know and respect limit cosmetic surgey time to 5 or 6 hours.  The risk of complications from surgery and anesthesia rises dramatically as surgery time increases beyond that point.  Prudence dictates that cosmetic surgery makeovers can be broken up into separate surgeries, so that surgery time is not excessive.

Post-Operative Recovery Setting.  Some surgeries are routinely outpatient:  breast augmentation, breast reduction, anterior facelifts, rhinoplasties, most liposuctions.  Even these surgeries, taking, on average, 1 to 3 hours to compelte, may be best performed at a hospital, with an overnight stay, for individuals whose medical status is less than ideal.  Personally, I perform most full abdominoplasties, and full face and neck lifts with arrangments for an overnight stay, either with a private duty nurse at the office surgical facility, or at Huntington Hospital.  Some surgeries are best monitored by professionals the first 24-48 hours.  I know some colleagues will perform a full tummy tuck as an outpatient. But I just don't get it.  What is the advantage? Save a few dollars?  But risk a hematoma occuring while the patient is at home, only hours after surgery?

Now I certainly don't know why Kanye West's mother died.  I have no contact with her family or her doctors.  I am very sorry that this tragedy occured.  It may or may not be related to her surgery.

 It is a federal violation of patient privacy for a doctor to talk about their patient's condition without the permission of the patient or her authorized representatives.  So I don't know how Dr. Adams or Dr. Aboolian are going to deal with that issue.

Reality TV Factor.  Patients ask about extreme makeovers and f Dr. 90210 all the time.  Some of the antics on that show are a bit strange.  Always check on the board certification of your plastic surgeon.  I am afraid that in the mindset of Hollywood and Beverly Hills celebrity is more important than simple substance and reality. 

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