Marta Rivera has lived through 12 surgeries in her 49 years, including two for Hodgkin's lymphoma. But Rivera never experienced so many complications as she did when she had cosmetic surgery in Miami five months ago.
The surgery, her first elective procedure, left her with scars, including one below her belly button that opened up three months ago, turned into a penny-sized hole and became infected, oozing a foul-smelling slime.
Rivera, an entrepreneur who makes and sells custom jewelry, spent her life savings for a so-called mommy makeover — a combination breast augmentation, tummy tuck and liposuction procedures. The surgery was performed at Westchester General Hospital by a doctor from CG Cosmetic Surgery, 2601 SW 37th Ave. The cost: $11,000.
The mother of five girls, ages 12 to 33, said she wanted a more attractive body for her 50th birthday. That's why she didn't mind driving the 130 miles from her home in Lehigh Acres, near Fort Myers, to a clinic with affordable prices and a good reputation.
Unlike many CG Cosmetic clients, Rivera had her surgery at Westchester General because her previous operations — including gall bladder removal, two Cesarean sections, carpal tunnel repair and a knee replacement — placed her at higher risk of complications.
The two things Rivera remembers most about the procedures: They were quick, and she did not get the size of breast implants she requested.
Rivera, who worked as an electrician for many years, said she went into the operating room at 8:15 a.m. and opened her eyes at 10 a.m. “I've had many surgeries, and the first thing my mother told me before my first C-section was, 'Look at the time you went in, and the time you woke up,' ” she said.
Rivera said she was fully awake around 10:30 a.m. and asked to see the physician who did her surgery, Dr. Scott Loessin. She was told he was performing another surgery at CG Cosmetic, 4.5 miles away.
Loessin, a board certified plastic surgeon, told the Miami Herald he could not comment about Rivera or other cases where patients have complained.
Following the surgery, Rivera said she immediately realized that even though she had agreed with Loessin on 500cc implants — about the size of a grapefruit — she received 397cc implants, according to hospital records reviewed by el Nuevo Herald.
When Rivera complained that the doctor had not done what he had agreed to do, and what he had been paid to do, Loessin recommended a breast lift, she said. That would be another $2,500. She declined.
For the following months, Rivera said, she has been living through an ordeal. She has had to go to emergency rooms three times, she said, because CG Cosmetic did not provide her with proper post-operative care.
Medical complications such as excessive bleeding, infection and slow-healing wounds are common complications from breast augmentation, tummy tuck and other plastic surgery procedures, said Dr. Alan Matarasso, president-elect of the American Society of Plastic Surgeons (ASPS) and a practicing physician in New York.
Matarasso added that there are "relatively conflicting studies" about whether performing more than one surgical procedure at the same time significantly raises a patient's risk of complications. But he said most physicians agree that four factors have the greatest impact on the risk of complications: the type of facility where the surgery is performed (an office clinic or a hospital), the type of anesthesia that's used, the physician's training and the patient's health.
"Those are what we might call the four pillars of safety," he said.
When it comes to customer service, though, Rivera said CG Cosmetic and Loessin have failed her.
Rivera said the clinic does not reply to her phone calls or emails and that when she manages to get an appointment with the doctor, he always tells her that “everything is all right.” That's what Loessin told her in February, when two of her stitches opened. “They will close by themselves. Leave them open,” he told her, according to Rivera.
One of the wounds did close, but the other did not, and Rivera said she started to feel a strong pain, “like something was poking me from the inside, something that wants to come out.”
The sudden and sharp pain sent her to an emergency room, where a CAT scan and a blood culture showed the presence of the bacteria staphylococcus aureus.
During a five-minute follow-up visit on March 28, at which an el Nuevo Herald reporter was present, Loessin said the wound had to be closed, but that it couldn't be done until after the infection had cleared.
When Rivera asked why he had not closed the wound before the infection set in, Loessin did not respond. He left the room abruptly even though Rivera was almost naked and could have been seen by anyone walking past the door.
“I survived cancer, and now this,” an angry Rivera said as she left her last visit to CG Cosmetic. “I don't want to die like Delma Pineda.”
Pineda, 44, a California resident, died March 6, one day after Loessin performed a breast augmentation and lift, liposuction and tummy tuck on her at CG Cosmetic Surgery. The autopsy report for Pineda has not yet been released.
Danny Simon, an attorney for CG Cosmetic, issued a written statement defending Loessin and the clinic.
"It is our preliminary understanding that the events giving rise to this incident are unrelated to CG Cosmetic's services," Simon said. "We are closely monitoring this case and will facilitate any and all investigation into the cause of this incident."
Pineda's family has contacted a law firm in South Florida to investigate her death. No lawsuits have been filed.
Rivera said she has filed complaints with the Florida Department of Health, the Florida Medical Board and the Better Business Bureau.
Her infection is gone but the wound is still open, although it's gotten smaller. “It's better, thanks not to CG Cosmetic but to the people in the emergency room,” she said.
Her bills for the emergency room visits now top $10,000, she said, and she has no health insurance. She has decided to try to recover on her own.
“I don't want more bills,” she said.
After surgery, she wound up in a hospital
Another cosmetic surgery patient who had the same procedure with the same doctor also wound up in an emergency room.
From her room at the Grant Medical Center in Columbus, Ohio, Stephanie O'Brien told el Nuevo Herald by phone, her voice breaking, that she could have died.
The 43-year-old O'Brien came to Florida in March for a mommy makeover at CG Cosmetic.
The surgeries were performed at the clinic on March 19 by Loessin, whom O'Brien said she hardly met prior to the procedure.
You don't deal with the doctor except for two or three minutes,” she said. “When I went into the surgery room I never saw him, when they were giving me anesthesia or after the surgery.”
The surgeries cost $13,000 and there were no immediate complications, said O'Brien, who is in the real estate business.
But when she returned to CG Cosmetic a week later for a follow-up visit, O'Brien said she complained about feeling dizzy and that one breast was more swollen than the other. She said she was told that was normal, that there were no problems and she could go home.
Days after returning to Ohio, O'Brien felt worse.
“I had a lot of pain, and the skin around my stomach was turning black,” said O'Brien, adding that one of her breasts remained more swollen.
She called CG Cosmetic and emailed photographs of her breasts, she said. A nurse practitioner replied that O'Brien was having an allergic reaction to a dressing tape and recommended that she stop using it.
When the pain became unbearable, O'Brien said she went to an emergency room and was told that there was bleeding behind the breast implants. “I had to have emergency surgery,” she said. “They drained a liter of blood from behind my left breast.”
Excessive bleeding injuries, such as the hematoma that O’Brien had behind her breast implant, is the most frequent complication of any surgery, said Dr. Matarasso, the president-elect of the ASPS.
“By and large we consider bleeding probably the number one risk factor,” he said.
Doctors in Ohio also had to drain areas around O'Brien's abdominal area “because the stitches were too tight and the skin had died,” she said. She was drained three times a week for two weeks.
O'Brien stayed three days in the hospital. Her medical insurance will cover the costs after she meets her $7,350 deductible. But her story did not end there.
She later underwent a skin graft. Surgeons removed skin from her hip and grafted it to her stomach area, which was infected. She'll have to go back for two more procedures to expand the graft.
“It will cost me about $40,000 to fix what they did to me,” she said.
O'Brien told el Nuevo Herald that CG Cosmetic offered to perform her two last procedures at its clinic, but she declined the offer. “They've done enough damage to my body,” she said.
She's demanding that CG Cosmetic Surgery pay for the hospital bills generated by its “sloppy work.”
O'Brien said she has advice for anyone considering cosmetic surgery: Make sure the surgeon is qualified, that the clinic has an emergency contact number and that the doctor is available to answer concerns after the procedures, "not just a nurse practitioner."
It's unclear what advice Loessin provided to O'Brien prior to surgery. But Matarasso emphasized that while a physician has a duty to recognize the risks and to take steps to reduce them, the patient also has a responsibility to follow their doctor’s orders.
For instance, Matarasso said, physicians often instruct patients to stop taking certain medications and supplements known to raise the risks of excessive bleeding — such as aspirin and vitamin E supplements — at least two weeks prior to surgery. Patients who smoke also run a higher risk of complications, such as wounds that are slow to heal, and doctors often advise patients to stop smoking at least one month before surgery, he said.
Matarasso, who said he has extensive experience with makeover surgeries, said the number of procedures performed at one time can also increase the risks of bleeding, infection and slow-healing wounds.
The U.S. Food and Drug Administration has its own advice for anyone considering breast implants:
▪ Be aware that breast implants are not forever. That means anyone with breast implants will face additional surgery, although no one knows when.
▪ Read the product labels. They provide information about the indications for use, risks, warnings, precautions and studies related to the FDA's approval of the materials.
▪ Consult with a surgeon. The surgeon should evaluate the form, size, texture and location of implants as well as the placement of the incisions, for each individual person.
▪ Be aware of the long-term risks. The FDA has identified a link between breast implants and Large Cell Anaplastic Lymphoma, a type of non-Hodgkin lymphoma.
▪ Be aware that supervision is important. If you notice any uncommon signs or symptoms, immediately notify you health care provider.