Between 1984 and 1986, the number of liposuction operations rose 78 percent—but the procedure barely worked. Liposuction removed only one to two pounds of fat, had no mitigating effect on the unseemly "dimpling" effect of cellulite, and, in fact, often made it worse. The procedure also could produce permanent bagginess in the skin and edema, just two of the "variations from the ideal" that the plastic surgery society cataloged in its own report. Another "variation" on the list: "pain."
Furthermore, the plastic surgery society's survey of its members turned up several other unfortunate incidents. A liposuction patient lay down to have stomach fat removed and woke up with a perforated bowel and fecal matter leaking through the abdominal cavity. Three patients developed pulmonary infections and two had massive infections. Three suffered pulmonary fat embolism syndrome, a life-threatening condition in which fat can lodge in the heart, lungs, and eyes. And "numerous patients" required, as the survey delicately put it, "unplanned transfusions." On March 30, 1987, Patsy Howell died of massive infections three days after a liposuction operation performed by Dr. Hugo Ramirez, a gynecologist who ran a plastic surgery clinic in Pasadena, Texas. The same day Howell had her operation, Ramirez performed liposuction on Patricia Rogers; she also developed massive infections, was hospitalized in critical condition, and eventually had to have all her skin from below her chest to the top of her thighs removed.
Howell, a thirty-nine-year-old floral shop manager and the mother of two sons, submitted to liposuction to remove a small paunch on her five-foot-one frame. She weighed only 120 pounds. “This literature she got at a shopping mall said the procedure was so simple,” her friend Rheba Downey told a reporter. “She said, ‘Why not?’” She made up her mind after reading Ramirez's newspaper ad, calling the surgery "the revolutionary technique for reduction of fat without dieting." No one told her about the dangers. Ramirez operated on more than two hundred women, causing numerous injuries and two deaths before his license was finally revoked.
By 1987, only five years after the fat-scraping technique was introduced in the United States, the plastic surgery society had counted eleven deaths from liposuction. A 1988 congressional subcommittee placed the death toll at twenty. And the figure is probably higher, because patients' families are often reluctant to report that the cause of death is this "vanity" procedure. A woman in San Francisco, for example, who was not on the surgery society's or Congress's list, died in 1989 from an infection caused by liposuction to her stomach; the infection spread to her brain, her lungs collapsed, and she finally had a massive stroke. But her family was too ashamed about the procedure to bring it to public attention.
The society's 1987 report on liposuction, however, seemed less concerned with safety than with "the reputation of suction lipectomy," which its authors feared had been "marred by avoidable deaths and preventable complications." It concluded that all problems with liposuction could be easily solved with "guidelines governing who is permitted to perform and advertise surgical procedures." In other words, just get rid of the gynecologists and dermatologists and leave the surgery to them.
Yet some of the liposuction patients had died at the hands of plastic surgeons. And the most common cause of death was the release of fat emboli into the heart, lungs, and brain—a risk whenever inner layers of epidermis are scraped, no matter how proficient the scraper. As even the report acknowledged: "[Liposuction] is by its nature a tissue-crush phenomenon. Therefore, fat embolism is a realistic possibility."
Surgeons also marketed the injection of liquid silicone straight into the face. Vogue described it this way: "Plastic surgery used to be a dramatic process, but new techniques now allow doctors to make smaller, sculptural facial changes." This "new" technique was actually an old practice that had been used by doctors in the last backlash era to expand breasts—and abandoned as too dangerous. It was no better the second time around; thousands of women who tried it developed severe facial pain, numbing, ulcerations, and hideous deformities. One Los Angeles plastic surgeon, Dr. Jack Startz, devastated the faces of hundreds of the two thousand women he injected with liquid silicone. He later committed suicide.
For the most part, these doctors were not operating on women who might actually benefit from plastic surgery. In fact, the number of reconstructive operations to aid burn victims and breast cancer patients declined in the late '80s. For many plastic surgeons, helping to boost women's self-esteem wasn't the main appeal of their profession. Despite the ads, the doctors were less interested in improving their patients' sense of "control" than they were in improving their own control over their patients. "To me," said plastic surgeon Kurt Wagner, who operated on his wife's physique nine times, "surgery is like being in the arena where decisions are made and no one can tell me what to do." Women under anesthesia don't talk back.
-Susan Faludi, Backlash: the Undeclared War Against American Women
