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Avoid surgery like Heidi Montag’s, docs say

February 10th, 2010, 6:00 am · 31 Comments · posted by Colin Stewart
Photos: Below, “The Hills” star Heidi Montag before (left) and after (right) the 10 procedures. (Photos by Getty Images and courtesy of ABC). Bottom, Dr. Frank Ryan. (Photo courtesy of Frank Ryan)

Slide show: "Heidi Montag addicted to plastic surgery.".

Related post: This is the second of two posts in which local doctors respond to Heidi Montag’s day-long plastic surgeries. The first was "Heidi Montag surgeries hurt women, docs say."


Beverly Hills plastic surgeon Dr. Frank Ryan went beyond the bounds of routine, safe, appropriate cosmetic medicine during his recent day-long operation on actress Heidi Montag, local doctors say.

They were responding to Ryan’s statement that he performed 10 surgical procedures on the 23-year-old star of “The Hills.” The operation took seven and a half hours, with Montag under anesthesia for nine to 10 hours.

As reported in the blog post "Heidi Montag surgeries help women, doc says," Ryan said, "It is not uncommon in plastic surgery, and especially in Hollywood, to have a procedure take that long."

After newspaper articles suggested that Ryan had done too much, he issued a denial that "Ms. Montag’s procedures were in any way unethical or unsafe." Ryan said that although "viewers might disagree with Ms. Montag’s choices, the safety or propriety of the surgery are not and should not be in question."

But local doctors DO raise questions about such operations’ safety and propriety, at least in general.

"I do not feel it is responsible to promote the idea that nine- to 10-hour-long procedures are safe or routine," said plastic surgeon Dr. John Di Saia of San Clemente and Huntington Beach.

I am conservative," Di Saia said, and "proudly maintain a very low risk-and-complication profile. Nine to 10-hour 10-procedure marathon operations are controversial and certainly do not comprise the bulk of plastic surgery performed today."

Plastic surgeon Dr. Milind Ambe of Newport Beach said he respects Ryan, but in his own practice — for safety’s sake — he limits his patients’ surgeries to six hours under anesthesia.

"I myself have operated on numerous high-profile patients who frequently try to pressure me to do multiple procedures at once," he said. But "I personally have made a choice NOT to exceed more than 5 to 6 hours under anesthesia for my patients.'

"The risks of [blood clots and circulatory blockages] increase with greater lengths of anesthesia," Ambe said. "These can be life-threatening."

He added:

"I’m sure that Heidi Montag is healthy, but other women who are also healthy may be on birth control pills and or smoke and these things increase the likelihood of blood clots and other complications significantly. "

"Additionally, although Dr. Ryan may have an excellent anesthesiologist, not all anesthesiologists are capable of handling the fluid shifts that a patient may experience over 10 hours of anesthesia, especially when there are combinations of procedures that may incur significant blood loss.

Montag underwent these procedures:

  • Mini Browlift
  • Botox for forehead and frown area
  • Nose job revision
  • Fat injections in cheeks, nasolabial fold, and lips
  • Chin reduction
  • Liposuction on neck
  • Ear surgery
  • Breast augmentation revision
  • Liposuction on waist, hips, inner & outer thighs
  • Buttock augmentation

"I don’t do procedures this long myself," said plastic surgeon Dr. Val Lambros of Newport Beach. But he added, "Surgeons operate at different speeds and these procedures could have been done quicker or slower. Anesthesia is very safe and with cosmetic procedures the level of anesthesia is not like bigger operations."

Ambe said:

Combination procedures are certainly appropriate in the right patient, but if the length of the procedures goes over a certain length of time I convince patients to do them in a couple of stages. Even though it may be less convenient, it may be safer in certain patients.

Certainly Dr. Ryan knows what he is doing and I am sure that he considers all of these items discussed. My simple point is that I would not want any patient to think these very lengthy procedures are always safe, especially in patients that are in their 30s or older.

It is difficult for any surgeon, no matter who they are, to expect to be as sharp after six hours of surgery without a break.

The bottom line is that what we as aesthetic plastic surgeons do is elective and, in that regard, we have to do things in the most safe way, operatively-speaking … and we can’t let patients dictate what we do from a safety standpoint, irrespective of who they are.

1441 Avocado Ave. Suite 801
Newport Beach, CA 92660
(949) 759-5539

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