By LEDEDRA MARCHE

Senior FN Reporter

For persons considering any type of elective procedure, be it plastic surgery or otherwise, Dr. Kenneth Dickie, a board-certified surgeon, is advising that they research the procedure first.

Bombarded by calls in recent days with queries on the safety of plastic surgery following the death of a young Bahamian wife and mother who reportedly travelled to another country to have a procedure done, Dr. Dickie is clearing the air on the matter.

"Generally, what we like to do is have the patient research the procedure they are interested in getting so that they have some idea about the nature of how its done, who should be doing the procedure and where it should be done – whether it should be done in a doctor's office or in a hospital setting," he said.

The director of Bahamas Institute of Plastic Surgery said that plastic surgeons hope that the research is done before they visit their office and then once a patient goes to see the doctor, before going through with the consultation, find out whether that doctor is certified to perform the type of procedure they want done.

Dr. Dickie specializes in plastic, reconstructive and cosmetic surgery and pointed out that in some rare situations there might be a general practitioner who might being doing breast reduction surgery and has never had proper surgical training.

Stressing the importance of selecting a surgeon who is certified in the specialty area that they are going to have work on, Dr. Dickie said they must ensure that the nature of the procedures are within a safety limit.

Multiple procedures done at the same time such as a breast reduction, tummy tuck and liposuction are, on their own, lengthy in the operating room, he said, revealing that once one is completed, the surgeon has to start over and do another.

"As time goes on in the operating room, you are under general anesthetic for a long period of time, you're laying immobile on an operating room table for a longer period of time and consequently there are certain potential problems that can occur with longer operations," he added.

One of which, he disclosed, are blood clots which form in the legs, infection, a reaction to anesthesia and the amount of blood loss that can occur with multiple surgical operations.

Patients wanting multiple surgeries done usually think its far more convenient to have them done all at once rather than space them out, according to Dr. Dickie, however, certified surgeons generally advise against it.

"We put the patient's safety as number one," he said.

While there are cases where multiple procedures can be done, Dr. Dickie said it means, however, there is a greater responsibility on the physician to ensure that the patient is going to get intravenous fluid, they are going to have pumps on their legs during the procedure and probably be kept over night in the medical centre where they have an intravenous all night, and a nurse checking in on a regular basis.

The physician has a responsibility to advise the patient on the increased risk of the procedure, he said, and while every patient has a different medical history and different problem as far as their body size, the priority is getting the patient through the surgery safely.

Dr. Dickie admits that there are times that he has to turn a would-be patient down, no matter how much they insist that money is no object.

"When I see a patient and I have advised them what my recommendations are for the surgery, if a patient still insists that I go ahead I will usually suggest to them that they probably find another doctor," he said.

The minute the surgeon who has to be the pilot of the plane starts letting the patient, who is not trained to make these decisions, start taking control of even whether the doctor thinks its safe or not to want to do it that's a mistake on the part of the surgeon, said Dickie.

"For me to lose that control because I am the person who's flying the plane and I want to be sure that I am not going to be taking her on a ride that's going to end up in a fatality," he said.

While it does not happen often, Dickie said there are occasions when people do come into his office and their request becomes a concern to him.

Dr. Dickie added that there are also those individuals who are desperate and want to have certain procedures and believe, however, that he will turn them down because of their age.

"I've seen 16-year-old girls who come in with very large breasts and they think I'm going to say 'no' to them because they're only 16. But what they don't know is that a young girl at 16 does not deserve to go through her entire teenage years with breasts that she is totally embarrassed and uncomfortable with," he stated.

"We will do an operation at a young age like that on somebody if they need it and if I feel that they're sensible about what their concerns are and the fact they're going to have surgery."

However, he assures he has no qualms about rejecting someone and points out that a trained plastic surgeon is also trained to be able to know what say to a patient.

"You say to a patient 'I'm sorry but I don't feel that I can fulfill your expectations of surgery. You say it very nicely like that. You don't have to tell them 'you're nuts and get out of my office,'" he said.

There are areas, Dickie noted, where a plastic surgeon has to stand his ground and do what is right and what is best for the patient as well as their business.