Once again, it seems that I am typing about the same old story.

Go to the back room of a tile store for your buttock enhancement, and you might very well end up dead!

The story here is that Elena Caro, 42, died according to the Las Vegas medical examiner after some gel substance was injected into her buttocks. The cause of death has been listed as an accident and a possible allergic reaction to local anesthesia.

A husband and wife, Ruben Matallana-Galvas and Carmen Torres-Sanchez are both under arrest after they were apprehended boarding an airplane to leave the country.

There are several lessons here:

– A cheap procedure in the back room of a tile store is not safe! While this seems obvious, I have spoken to patients in my practice who tell me they have had procedures done in apartments, hotels, and other crazy locations.

– Any foreign national who is not even licensed to practice medicine let alone plastic surgery should not be performing your procedure, no matter how simple the procedure may seem. It doesn’t matter how many of your friends have had success with such procedures. Just because they got away with it, doesn’t mean you will. Amercian Board of Plastic Surgery certified physicians undergo years of training, extensive exams both written and oral, and are believed to be safe by their peers. Just because a procedure appears to be simple, that doesn’t mean it is. A physician who knows how to react in a one in a million bad reaction should be the one holding the needle.

– Buttock enhancement with injections of foreign material keeps making press headlines for causing death. Recently a lady from London died from a similar treatment in a Philadelphia hotelroom. I do not personally perform these procedures as I feel the large veins in the buttocks and injecting foreign matter do not mix well. While you may get away with it and have a beautiful backside, you may also not get away with it and end up dead.

– Local anesthesia is not without risk. I see other procedures advertised all of the time as less invasive since they do not involve anesthesia. An anesthetic provided by a board certified anesthesiologist under proper monitoring both intraoperatively and postoperatively is much safer than a large amount of local anesthesia performed in an office procedure without appropriate safeguards. I was involved in often quoted liposuction safety studies while I was a resident that many practitioners fail to understand. Liposuction can be very dangerous in the wrong hands. Be careful what you allow someone to do to you. This “allergic” reaction to local anesthesia which resulted in the death of this woman may very well have been due to lidocaine or epinephrine toxicity and not really an allergy at all. While I have not personally seen the toxicology results, I would be suspicious that it was an overdose of medication as her body reabsorbed medication hours after the procedure rather than an allergy.

Be careful out there! Any surgery has risk. Any surgery can have a poor outcome. Any patient can have an unpredictable unfortunate outcome. Going to a properly trained surgeon who always has safety in his/her thoughts is your best bet.