In some cases the patient, who is most often an otherwise intelligent and careful human being, did not know they were not being treated by someone with appropriate training.
How does this happen? You'd be amazed how easy it is to advertise yourself as a qualified provider of aesthetic care- you just take out an ad and do it. You would think that there are powers at large that would aggressively prevent this kind of thing, but the powers don't actually exist and/or they are overwhelmed. No one will stop you if you fraudulently call yourself a plastic surgeon (even if you are really an eye doctor, a family doctor, or in some cases, not a doctor at all). Patients almost always assume that if a doctor (or not) is offering a service, that he or she is trained to perform this service, and has been qualified to do so in the same way doctors have always been forced to achieve high levels of training and certification before practicing.
And that's where I believe our government is failing doctors and patients alike. In the United States, we are accustomed to believing that physicians (in order to practice) have completed medical school and a years-long and rigorous training program that specifically prepares them for the type of medicine they wish to practice. This means that if you took your child to a pediatrician, you felt you could be confident that the doctor had completed training in pediatrics- or the government wouldn't be allowing him/her to practice pediatrics. This is not the case in aesthetic care, where doctors (and others) are injecting and cutting patients after a ridiculously short and cursory training program most often administered not by expert surgeons, but by the company that sells the product!
Unfortunately, we are experiencing a perfect storm of sorts, with declining insurance reimbursements to doctors, an increased interest in aesthetic care, and some unscrupulous behavior on the part of manufacturer's of aesthetic products and equipment.
Because family doctors (or urologists, gynecologists, etc..) have seen their incomes go down as a result of insurance companies maneuvering, being able to improve the bottom line by offering a bit of Botox or liposuction becomes very attractive. Consider that the manufacturer of the liposuction machine assures you that the machine does all the work and they can train you to perform liposuction in a weekend at a resort course, and it's not hard to understand how these doctors suddenly become "liposuction experts".
Except that every so often someone dies. The recent case in south Florida of a woman who died at the end of a liposuction procedure being performed by a doctor whose training had been in Rehabilitation Medicine is just the most recent and most dramatic of many examples.
Thankfully, most of these interactions do not result in the patient's death. Most often, the patient experiences only disfigurement and embarrassment as a result of their poor decision making.
Amazingly, in many cases it is only AFTER the poor outcome that they find out the person who performed the procedure was not a Board Certified Plastic Surgeon.
In some, they entrust their safety to the provider understanding ahead of time that they are not in the hands of a plastic surgeon because they believe the doctor would not offer something they weren't adequately trained to do. In others, they want to save some money, or come to that doctor because his/her advertising said they are "the best"- and doctors don't lie, right? (I would submit that when enough money is at stake, some doctors are amazingly dishonest). In some cases a combination of these factors is at work.
In many cases, the corrective procedure is more extensive and expensive than the initial procedure would have been if performed by a qualified plastic surgeon- a classic case of the patient being "penny wise and pound foolish". Often, complete correction is not possible.
This is the second part of the tragedy. Because most of these people consider themselves to be intelligent and responsible citizens, and because they are already traumatized by the developing understanding that their poor decision making has caused them permanent disfigurement, they almost never complain to the organizations charged with protecting the public from this kind of activity. It's embarrassing enough to have made the poor decisions that resulted in allowing someone poorly trained to do so do liposuction on you- most people are loath to add to that embarrassment by making it a matter of public record.
And so it goes on.... With a death from time to time to bring it to the public's mind.....for a few days..... then we're back to business as usual....
So- how do you protect yourself???
I always tell my patients- Even if you don't come to me, please see a surgeon certified by The American Board of Plastic Surgery. The certifying board is very important. Make sure the facility is accredited, and that the anesthesia provider is also well-qualified. Situations in which your health may suffer are not those in which it might be in your best interests to cut corners and try to save a couple bucks.