LOS ANGELES -- Judy Fernandez wanted the looks she had before she
gave
birth to three sons, and it seemed to her like an acceptable
tradeoff:
12 hours of surgery -- at a cost of $20,000 -- for a renewed face
and
body.
She was 47 and in good health, and her sister-in-law, Marilyn
Larsen,
said her motives were obvious: ``As a society, we really are
encouraged
to stay young, to look 40 at 60.''
But Fernandez never woke up from the liposuction and cosmetic
procedures
at ``A New You Plastic Surgery Medical Group'' in Irvine. She
died March
17 of what the Medical Board of California called an overdose of
anesthesia, fluid overload and a fatal dilution of the blood.
The case is one of three liposuction deaths currently under
investigation in California -- just the tip of the iceberg,
experts say,
in a burgeoning, unmonitored field driven by a quest for
perpetual
youth.
It was in just such a setting that Rosemarie Mondeck, 39, of San
Diego,
died June 21, 1994, of cardiac arrest after tummy liposuction at
a La
Jolla dermatologist's office.
Tammaria Cotton, a 43-year-old municipal court clerk from Los
Angeles,
suffered massive blood loss and died of cardiac arrest June 22,
1996,
hours after obstetrician-gynecologist Dr. Patrick Chavis removed
fat
from her stomach, bottom and
thighs.
On its face, tumescent liposuction is simple: a doctor injects a
combination of saline solution, a local anesthetic like
lidocaine, and
epinephrine to reduce bleeding, until the area becomes taut.
Then, the
surgeon makes a small incision and inserts a
tubelike device called a cannula to suction out fat.
The procedure seemed so routine to Tammaria Cotton, who'd heard
about it
from her beautician and church friends, that she did not tell
even her
husband until the night before her surgery.
``It was just liposuction!'' cried Jimmy Cotton, a police
officer, as
his wife died in a hospital emergency room.
But Dr. Richard Ruffalo, past chairman of the department of
anesthesia
at Hoag Memorial Hospital in Newport Beach, said, ``For every
case in
which a death occurs, there's at least 15 to 20 cases where
severe
injury has occurred.''
Dr. Frederick M. Grazer, a Newport Beach plastic surgeon, said
money was
the root problem, especially as doctors' fees are limited by
managed
care.
Under the proper conditions, liposuction -- now the No. 1
cosmetic
operation in the country -- is safe, said Grazer, past president
of both
the California Society of Plastic Surgeons and American Society
for
Aesthetic Plastic Surgery. By various
estimates, anywhere from 100,000 to 300,000 are performed
annually in
the United States.