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Action sought against phony skin doctors

Dermatologists on Wednesday called for a nationwide crackdown on fake physicians who are injecting, burning and maiming people seeking to erase stigmatizing blemishes and the vagaries of age.

Experts at a Manhattan meeting of the American Society of Dermatologic Surgery said state attorneys general need to investigate the growing number of makeshift practices operating in spas, salons and even garages.

The cost of beauty can be permanent scarring and even death as unschooled practitioners attempt to cash in on vanity. The doctors cited recent cases in New York, including one earlier this year in which a Manhattan financial analyst died at the hands of an unlicensed cosmetic surgeon. Police say Dean Faiello gave his victim an overdose of anesthesia.

“There’s a lot of stuff out there that is being used that is not safe, and people need to know,” said Dr. Roy Geronemus, director of the Manhattan-based Laser & Skin Surgery Center of New York. He said the Florida patients hospitalized after injections to treat wrinkles represent a growing public health problem.

Fake doctors, he said, are selling patients on dramatic makeovers at cut-rate prices, and many are using not only devices designed for use by trained physicians but also shady products.

The wares include “fillers” used by cosmetic surgeons; bootlegged compounds, high-powered lasers and smuggled concoctions from abroad, Geronemus said.

Though about 32,500 people die annually in U.S. hospitals due to injuries caused by licensed physicians, no statistics are available on how many die as a result of botched procedures caused by fake doctors.

“They’re flying under the radar and they’re hurting people,” Geronemus said.

Dr. Rhoda Nairns, president of the society and a clinical professor of dermatology at NYU Medical Center, said the victim of a botched facial injection sought her care last week. The patient hoped an injection would erase lines on either side of her mouth, Nairns said. But the filler turned out to be an unlicensed form of silicone and caused disfigurement.

“This is a form of silicone that is not approved by the FDA to be used in humans – or animals,” Nairns said.

Dr. Brett Coldiron, a dermatologic surgeon from Cincinnati, said problematic cosmetic procedures extend to licensed physicians who perform a combined “tummy tuck” and liposuction, which he said can be deadly.

The problem, he said, is the lengthier office procedure that forces patients to remain under general anesthesia for an extended period. Two studies of adverse events associated with the surgeries are to be published by Coldiron and colleagues later this month. His earlier data show that one in every five patients who undergo the cosmetic procedures at the same time die of pulmonary emboli within a few days of the operation. That’s because the heart pumps slower under general anesthesia and blood tends to pool in the extremities, which can lead to clots. Such clots can then migrate to the lungs, causing lethal obstructions.

Patients, nevertheless, like the idea of one-stop surgery in convenient office settings. “Consumers will have to decide what an acceptable number of deaths are,” he said.


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