DEATH From COSMETIC SURGERY Is Never Acceptable Claims Dr. Friedberg
CORONA DEL MAR, Calif. -- Olivia Goldsmith, author of The First Wives' Club, died having cosmetic surgery.
With a 446% increase in cosmetic procedures since 1997, the book written by Dr. Barry L. Friedberg, specialist in anesthesia and cosmetic surgery, Anesthesia in Cosmetic Surgery from Cambridge University Press, is a timely arrival. "Minimally invasive anesthesia (MIA) dramatically increases patient safety for cosmetic surgery. Much like the days before fathers were permitted to observe the birth of their children, the public needs to be empowered to ask for safer anesthesia!" says Dr. Friedberg.
"All cosmetic surgery takes place on the superficial layers ('the wrapper') of the body. As such, all cosmetic surgery (even a 'tummy tuck') must be considered minimally invasive. Minimally invasive anesthesia (MIA) is only logical for minimally invasive surgery. Growing numbers of anesthesiologists are beginning to share this view but public safety demands that more need to be asked to provide MIA for cosmetic surgery," says Dr. Friedberg.
According to Friedberg, the use of a level of consciousness monitor like the bispectral index (BIS) is fundamental to the administration of MIA. Prior to BIS monitoring, anesthesiologists were obliged to guess at the correct dosage and, for fear of under-medicating, routinely overmedicated by a factor of at least 20-30%.
Anesthesia was the art of the "controlled overdose." The advent of BIS monitoring has now made that style of anesthesia practice unnecessary and potentially dangerous according to recent research by Monk and Sebel.
BIS provides a number between 0-100 derived from information obtained from the sensor on the patient's forehead. The lower the number, the deeper the level of consciousness, sleep or "hypnosis," as it is known in the anesthesia profession.
General anesthesia sleep levels occur between 45-60. The patient doesn't hear, feel, or remember their surgery with general anesthesia. The same experience can be had with intravenous propofol at BIS between 60-75, a level Friedberg has incorporated as an integral part of MIA.
For greater patient safety, Dr. Friedberg deems BIS monitoring a standard of care, especially for cosmetic surgery.
Disclaimer: Dr. Friedberg is not employed by Aspect Medical Systems, makers of the BIS monitor. He is not a stockholder or a paid consultant. The opinions expressed herein are his professional opinion based on 10 years experience with BIS monitoring for cosmetic surgery.