Friday, November 03, 2006

Liposuction on a 12 Year Old



There is a story out of Texas about a 12 year old girl who is reportedly the youngest person ever to get liposuction. It was performed for weight loss purposes, since she was morbidly obese and was not able to lose weight with more traditional methods like diet and exercise. Her surgeon, Dr. Robert Ersek, who calls himself "the biggest fat sucker in Texas," lived up to his moniker when he liposuctioned 35 pounds of fat from Brooke's arms, back and upper midsection in March and removed another 10 pounds — most of it skin — in May by doing a tummy tuck.
Ersek acknowledged it was "a mega amount" of fat and "off the scale," but he is not alone in doing large-volume liposuction or in doing the procedure for weight loss. He cites other plastic surgeons who agree with him in a 2004 book he co-authored, "Mega Lipo."

I have two main problems with this.
First, liposuction or tummy tucks on a pre-teen are just plain wrong. Children who are 12 years old do not have the mental maturity to be able to make the decision to have elective plastic surgery performed on them. This is a decision that she will have to live with for the rest of her life. Also, if I were to perform cosmetic plastic surgery on a child my wife (a pediatrician) would kill me.
Second, liposuction is not a procedure for weight loss. It is a procedure that is best used for body contouring in order to get rid of areas of fat which are not amenable to diet and exercise. 35 pounds of fat is roughly 15 liters. Any surgeon knows that removal of 15 liters from a person's body will create massive fluid and electrolyte shifts which could make a person very sick. I stop my liposuction amount at approximately 5 liters (or 10 lbs), which is, I believe, the recommendation from the American Society of Plastic Surgeons.

I once had an Asian mom call me up to inquire about cosmetic blepharoplasty on her son. I asked her how old he was. She told me he was 7. Yes, SEVEN! I asked her, "Do you think he has the maturity to make a decision to have plastic surgery?"
She answered, "He tells me he wants the surgery all the time."
I couldn't believe that this mom would even consider plastic surgery for her child. He was not deformed, either, but wanted a "double fold" to look more caucasian. I didn't know who to feel more sorry for: the kid who at age 7 had self-image problems, or his mom who must go through life as a complete tool.

Story credit: statesman.com




31 comments:

  1. Anonymous5:46 AM

    Hi Dr Youn, I was wondering why, instead of lipo a gastric band wasn't tried out? If the child had to have surgery, it seems like that would've been a better option.

    ReplyDelete
  2. I would agree. I guess they were against gastric bypass due to the complication rate (although I would be afraid of the complication rate of taking 35 lbs off someone too!) I get the feeling they didn't look into the other surgical remedies all that closely.

    ReplyDelete
  3. Anonymous10:24 AM

    Tony,

    I think you're being too diplomatic. This case may not be malpractice, but it seems to reflect VERY poor judgement and unconventional advice. As you correctly point out, liposuction is not a weight loss operation. It may be used prior to skin resection to help stage surgery on the massive weight loss group (Dr. Leroy Young from St. Louis wrote an interesting primer about this in Plastic Surgery Products last spring at http://www.plasticsurgeryproductsonline.com/article.php?s=PSP/2006/04&p=7), but even that is not the conventional view on how these should be handled.

    This operation borders on human experimentation when used in the way described on a pediatric patient in the news story. You can expect very unpredictable lipodystrophy deformities as this child ages & continues to be predisposed to morbid obesity.


    There are excellent alternatives to the treatment she recieved, even in the pediatric/adolescent age group. I'll refer readers to this piece I wrote over the summer about this:

    http://plasticsurgery101.blogspot.com/2006/08/bariatric-surgery-in-adolescent.html

    ReplyDelete
  4. I love that you have a blog! Have you seen pics of Pam Anderson lately?

    ReplyDelete
  5. dmarie-
    check out some of the previous posts on Pam Anderson, one which was just a couple weeks ago.
    Thanks!

    ReplyDelete
  6. Dr. Youn--
    I mean her face. She looks kind of strange these days.

    http://nosysnoop.wordpress.com/2006/11/02/what-did-pamela-anderson-do-to-herself/

    ReplyDelete
  7. Anonymous5:37 AM

    this is just about the story: what if she had tried 2 lose waight for like 5 yrs and not succeded? its not easy to b overweight these days people (mainly kids) judge u (mainley other kids) for what they look like not what kind of person they are they dont care thats y all of the popular people are thin nasty people and never ever will b nice or fat think about that

    ReplyDelete
  8. Anonymous11:56 AM

    Although gastric bypass is extreme on someone who is twelve, I doubt it would have the usual complications (which when compared to the 100% chance of complications of morbid obesity isn't such a bad choice). From my readings, most complications come from much older, much heavier and sicker patients. A twelve year old would probably come through that surgery just fine. Plus, the child would continue to lose and could get down to an acceptable weight. Lipo won't do a thing to change her eating habits. I fear this child will gain everything back.

    ReplyDelete
  9. Anonymous1:55 PM

    I read the article in People magazine about this case. The family stated that someone they knew had complications of gastric bypass and that is why they didn't choose that route.
    The dr said he performed the surgery on her, even at her young age, because her dad had been diagnosed with an illness (some form of cancer I believe) and the daughter wanted her daddy to see her skinny before he died. So that is why the dr did the surgery and why he did it so young. The dad is no longer sick.

    ReplyDelete
  10. Anonymous11:16 AM

    Plastic surgery on a child is really sick, and as for people who blame the "thin is good, fat is bad" culture, well, this isn't going to help that change, is it? Taking such drastic and dangerous weight loss measures on a child just validates the anti-fat culture. This is really not okay.

    ReplyDelete
  11. Anonymous11:49 AM

    I also read this article in people, children do not become obsese overnight. we as a nation need to wake up and change our eating habits drastically! Parents need to cook healthy organic meals for their children rather buy them mcdonalds and lipo a baby

    ReplyDelete
  12. Anonymous9:29 AM

    You know that show the biggest loser? Why dont they have a biggest loser for kids?? Having plastic surgury at age 12 is just plain wrong. In about two years she will probably be back to the weight she was.

    ReplyDelete
  13. Anonymous9:08 AM

    I recently read about a new gastric band that was removable and the procedure did not include the re-routing of the small intestine. Wouldn't this type of procedure be safer for such a young individual?

    ReplyDelete
  14. Anonymous1:38 PM

    hi dr youn i weigh 220 pounds and i am 13 i am 5 2 for my height and i am considering liposuction but i dont know if it is safe what should i do???

    ReplyDelete
  15. Anon-
    I recommend that you talk with your pediatrician about options other than liposuction. Good luck to you.

    ReplyDelete
  16. Anonymous12:42 AM

    Dr. Youn - This story is disgusting! Have you seen what they have done to that poor innocent girl? Plastered her in a little pink bikini all over the internet. Mother signing "mother of pink bikini Brooke Bates. It makes me sick. The biggest fat sucker in Austin, Texas did the operation (OH PLEASE!) Someone wrote thank god for all of the plastic surgerons that do the right thing and won't operate on little girls. The mom wrote back, thank god for that plastic surgeon that wasn't afraid to do something different. HELLO? It's called no the other plastic surgeons were thinking about HER SAFETY! ABOUT DOING WHAT WAS RIGHT! She was a little girl who was still growing!Oh this story makes me so hot! My question to you is this:
    The mother wrote on a site that Brooke is now going to possibly get lapband surgery done. That sickens so many people. The child is only 13yrs old. She is not very obese now. Why are they doing this to this little girl? Now that she lost all of that weight, had the lipo and tummy tuck... her mom STILL wants her now to undergo lapband surgery?
    Another question: What TYPE of man (doctor) in your eyes would perform plastic surgery on a little 12yr old girl?
    And be SO PROUD of his work doing that to a child? It is disgusting to sooooooo many people!
    Have you looked at her before and after pictures? Went from innocent into some sort of adult overnight.
    And the kid was only 12yrs old.
    Why would the mother even talk about lapband surgery for the innocent girl Dr. Youn?
    She is ONLY person that is going to suffer the most later in life.
    And she is the ONLY innocent person in this thing! I live in Austin, TX where all this occured... and it DISGUSTS sooooooo many people here!!!!!!!
    Please explain about the lapband surgery. She is not super obese, and only 13yr old. How can they all get away doing this to this innocent child? This story makes so many disgusted, it is nice to hear doctors disagree with it! Many doctors and plastic surgeons have said how wrong it was!!!!!!
    Would love to hear your thoughts. Thanks.

    ReplyDelete
  17. I agree that cosmetic surgery on children is not the right thing to do.

    ReplyDelete
  18. Anonymous6:31 AM

    Aloha Dr. Youn,

    So why was this child unable to loose weight the natural way? Isin't it easier for children? I blame child obesity on the parents who allows fast food as part of their complete diet. Now, the child is suffering for all those chips that was placed in front of her for dinner, all the ice cream and cookies that was allowed to quiet her as a young girl. This is a sad case and I do categorize it as child abuse.
    May God bless this child.

    ReplyDelete
  19. Anonymous6:40 AM

    One more thing...

    I read that she was 5'5 at 220 pounds, a size womens 22...

    35 pounds sucked brings her at 175 pounds, which is still obese at her age and height.

    What is the usual procedure after this? MORE LIPO!! Poor child...


    Quoting you Doc, "Lipo is not used for weight lost, only trouble spots". Okay, so I have a trouble spot around my belly button. Like a little pooch *sigh*. I can never get rid of it no matter how many sit ups i do, diets i go on, and tans i get!! What would a procedure COST to get about 3 pounds sucked out of me...???

    THANKS!!!

    ReplyDelete
  20. Usually a couple thousand dollars for liposuction

    ReplyDelete
  21. Usually a couple thousand dollars for liposuction

    ReplyDelete
  22. Anonymous11:48 PM

    The reason that her mother called her "pink bikini Brooke" was because of all of the negative comments about her swim suit. I think she looks very Beautiful and most importantly, "CONFIDENT".
    Thanks
    Judy

    ReplyDelete
  23. Anonymous12:03 AM

    I am a very close friend of the family and the reason that Cindy Bates didnt let Brooke have lap band surgery is because she lost one of her dearest friends the previous year and the second reason is she didnt want anyone cutting and re-routing intestines. Risk is much to Great. She has mentioned the lap band for her daughter at a later time and this would be for Brooke's Peace of Mind. Nobody wants to have to worry about eating too much! This lap band prevents over eating and makes it more possible to mantain weight. Her son is probably getting the lap band early in June. Brooke's parents are good people and they just want whats best for their kids. This family isnt the only family with overweight kids. Its an epidemic. Lack of Exercise for children in our schools have a major impact on the growing obesity problem! Two days a week at P.E. Just isnt enough and its a very dangerous world that we live in and parents cant let their children go out and play and run like in the past without parental supervision. I think if you are the parent of a child who is struggling with their weight, its only fair to do something immediately to further damage the childs health. Please try and understand why this family made the wonderful decision that they did. Brooke is so very happy and says that she never wants to go back there again!! She feels great and she is in excellent health! GOD BLESS.
    A Good Friend of the Family.

    ReplyDelete
  24. Anonymous12:23 AM

    For the person that said that she is still obese after her surgery is off base. She has continued to lose weight and is now down to 155. Another comment was how terrible it is for mom to think about the lap band for Brooke and I think its sounds more like a very
    Caring Mother who wants to help her MAINTAIN HER WEIGHT!!! MOST EVERYONE THATS EVER LOST WEIGHT HAS PUT IT BACK ON OVER TIME AND SHE THINKS THAT THERE IS NOTHING WRONG FOR USING THE LAP BAND AS PREVENTATIVE MAINTANCE. I HAVE TO AGREE WITH HER. HER MOTHER IS VERY VERY BIG OF PREVENTATIVE MAINTANANCE AND ALOT OF PEOPLE THINK ITS GREAT. I BET AT LEAST ONE PERSON THAT READS THIS ATE TO MUCH TODAY???! Well, for some people this is a problem because they gain weight and for others its not a problem at all TO eat too much. Lucky folks!! Wouldnt it be nice to never ever hear the word "DIET" Again? Thinking about being on a "DIET" 24/7 or Oh gosh I ate too Much is something that people dont have to live with any longer. Alot of people are just plain hungry all the time and we all know how this hurts in the gut. Ouch!!Not a good feeling at all, but alot of us have to deal with this hunger feeling alot more than we want to. It must be very hard at 13 years old to have the worry on your mind all of the time about what and what not to eat and how much etc. The lap band prevents the OVER EATING AND ITS ADJUSTABLE AND VERY LOW RISK INVOLVED. PLEASE RESEARCH IT. ITS NOT AS DANGEROUS AS THE GASTRIC BYPASS. Modern technology can be our Friend if we let it. Dont be scared to step "OUTSIDE OF THE BOX" ITS OKAY. GOOD FRIEND OF THE FAMILY

    ReplyDelete
  25. Anonymous7:01 PM

    What is the BIG DEAL About "Pink Bikini Brooke" or "Mother Of"? She is a beautiful young lady in a pretty PINK BIKINI! I guess you also think the dallas cowboy cheerleaders are awful too.?. Look at the teenage IDOLS! Brittany Spears, Jessica Simpson (Dukes of Hazard-SHORT SHORTS!!) Cheerleaders with short skirts, And so on. A person can still look sexy and be a CHRISTIAN!! I think Brooke is a Beautiful Girl Big or Little and as long as she's happy with herself and Continues to watch her diet and get plenty of exercise she is on the right track! Keep Up the Good Work Brooke!!! We are proud of you!

    ReplyDelete
  26. Wow what a story, poor kiddo. I was wondering why lap band wasnt considered first. Not that I even think a 12 yo should have that but its got to be better than 'mega lipo'

    Anyways great blog
    Cheers

    ReplyDelete
  27. This poor child most likely has an undiagnosed endocrine disease. This is horrifyingly sad to me.

    ReplyDelete
  28. I just saw this story on CNN. Her mother twice mentioned that the girl was a 'compulsive eater' and since the surgery, she has gained back about 50% of the sixty pounds she lost.


    This girl needs psychiatric help. The surgery was not only life threatening, it was pointless and useless.

    Why did no one on CNN ask WHY this girl is compulsively eating? Why does her mother mention it as a throwaway and never consider that she's the one providing this child with food?

    ReplyDelete
  29. Anonymous4:25 PM

    if u want surgery u should get
    from someone that will do it

    ReplyDelete
  30. Anonymous2:44 AM

    I agree with the person who mentioned the lack of exercise "epidemic" among kids, etc. but even with that being the case, it is not enough to make a young person so morbidly obese. Overweight, maybe, but this individual is just off the charts. Especially at that age, when you are growing and your metabolism is at an all-time high!
    Do whatever it takes: get an in-home exercise machine, sign the kid up for afterschool sports, whatever, and give them a healthy diet!! Duh!

    ReplyDelete
  31. Anonymous3:06 PM

    Im 13 and weigh 18 stone now if you are skinny you wouldnt understand how it is so not 'easy' to go for a run so shut up i would die for a band

    ReplyDelete