List date(s) this work was published or aired.
Jan-11
Provide a brief synopsis of the story or stories, including any significant findings.
“Awake” surgery is a new and aggressively marketed cosmetic surgery, performed under local anesthesia, touted as the cheaper, smarter alternative to traditional surgery–a procedure that not only puts the patient in control but also saves money. Sounds like a great deal, right? Except in reality, as Erdely’s investigative article found, Awake procedures are a way for minimally trained surgeons to profit from dangerous operations that no hospital would allow them to do. Erdely explores this new frontier of cheap liposuction and breast implants–taking readers into a seedy medical realm of unlicensed practitioners, screaming patients, and unsterile operating rooms–and examines the surgeries’ true costs to patients. She reveals some startling major findings for the first time, including:
– Most Awake surgeons are not plastic surgeons, but rather are family physicians, OBs, ophthalmologists, pathologists, or any doctor willing to pay up to $7,000 for a two-day training course.
– Though the Awake procedure is advertised as having the patients’ needs in mind, it was actually designed to meet the doctors’ needs: General anesthesia needs to be performed in hospitals or clinics with high safety standards. By cutting anesthesiologists out of the equation, Awake practitioners–generally doctors who lack hospital privileges for plastic surgery–can exploit a legal loophole by performing the operation in the privacy of their own offices.
– Because only local anesthesia is used, doctors see little reason to be accredited by safety organizations like AAASF; as a result, many Awake practitioners operate in facilities with few safety standards and no oversight.
– Erdely’s reporting revealed that the five official-sounding organizations that offer the Awake training courses–American Academy of Cosmetic Gynecologists; the National Society of Cosmetic Physicians; the American Academy of Cosmetic Family Medicine; the American Academy of Cosmetic Dermatologists; and the National Society of Cosmetic Plastic Surgeons–are actually the same organization. In addition, these organizations have few, if any, membership requirements (unlike more prestigious, long-standing medical organizations, which demand board-certification in that specialty, continuing education, and sponsorship by current members).
– Though a big selling point of Awake surgery is avoiding the risks of general anesthesia, the large volume of lidocaine used during an Awake breast implant surgery (sometimes more than 50 mg per kilo) can pose a considerable threat to patients. • Some state medical boards are concerned enough about the growing problem of amateurism in plastic surgery–what they call “scope drift”–that they’re beginning to figure out how to stem the tide.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
Documents: Numerous medical journal articles about cosmetic surgery outcomes; complication rates; lidocaine safety; and articles studying doctors’ scope drift into cosmetic surgery Numerous legal complaints against Awake practitioners, across several states Data from several state medical boards and state health departments, detailing complaints against Awake practitioners FDA report on breast implant re-operation rates and ruptures Data from the American Board of Plastic Surgery and from the American Society of Aesthetic Plastic Surgery Postings on online message boards from Awake patients Awake doctors’ websites promoting their work; websites from the various Awake training organizations promoting their workshops State medical boards’ “scope of practice” guidelines
Explain types of human sources used.
Awake surgery patients Awake surgery doctors Several plastic surgeons, as well as the Presidents of the American Board of Plastic Surgery and the American Society of Aesthetic Plastic Surgery President of the American Society of Anesthesiologists President of the American Association for the Accreditation of Ambulatory Surgery Facilities State medical board personnel in Nevada, California, Arizona, Florida and North Carolina Women’s’ health policy advocate Lawyers representing Awake surgery patients
Results:
This was the first major article to shed light on–and call into question–this new, fast-growing surgery, and it was hugely reposted and discussed in the blogosphere. Before the article was published, Googling the words “Awake surgery” would merely bring up Awake practitioners’ gushing websites; now the top search results are serious discussions about the surgery’s hazards, which (one would hope) is giving otherwise-prone patients pause about undergoing this problematic procedure.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
No corrections, clarifications or challenges to accuracy.
Advice to other journalists planning a similar story or project.
As difficult as it can be to get people to open up about having had cosmetic surgery in the first place, it’s that much harder to get them talking about their cosmetic surgery gone awry. Many of these women are dealing with a good deal of guilt and shame for what happened to them, feeling as though society will condemn them as having gotten what they deserved for their vanity, frugality, and lack of due diligence. But having personal stories is essential for a reader to understand the human aspect of a story like this–so to draw the subjects out, patience and good listening skills are key. Perseverance is also needed in tracking down elusive statistics and studies in a field for which there is precious little data.