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Low-cost Dominican surgeries spark warnings by US

Low-Cost Dominican Surgeries Spark Warnings By US

SANTO DOMINGO, Dominican Republic (AP) - Beverly Brignoni was a young New Yorker seeking a less expensive way to enhance her appearance and she did what many other people are now doing: travel to the Dominican Republic for cosmetic surgery.

It went horribly wrong. The 28-year-old died Feb. 20 from what the doctor told her family was a massive pulmonary embolism while getting a tummy tuck and liposuction at a clinic in the Dominican capital recommended by friends. Family members have serious questions about her death and want local authorities to investigate.

"We want to know exactly what happened," said Bernadette Lamboy, Brignoni's godmother. "We want to know if there was negligence."

The district attorney's office for Santo Domingo says it has not yet begun an investigation because it has not received a formal complaint from Brignoni's relatives. Family members say they plan to make one.

Shortly after Brignoni's death, the Health Ministry inspected the Vista del Jardin Medical Center where she was treated and ordered the operating room temporarily closed, citing the presence of bacteria and violations of bio-sanitary regulations. The doctor who performed the procedure and the clinic have not responded to requests for comment.

Brignoni's death is unusual, but it is not isolated. Concerns about the booming cosmetic surgery business in the Dominican Republic are enough of an issue that the State Department has posted a warning on its page for travel to that country, noting that in several cases U.S. citizens have suffered serious complications or died.

The U.S. Centers for Disease Control issued an alert March 7 after health authorities in the United States reported that at least 19 women in five states had developed serious mycobacterial wound infections over the previous 12 months following cosmetic procedures in the Dominican Republic such as liposuction, tummy tucks and breast implants.

There were no reported deaths in those cases, but treatment for these types of infections, which have been caused in the past by contaminated medical equipment, tend to involve long courses of antibiotics and can require new surgery to remove infected tissue and drain fluid, said Dr. Douglas Esposito, a CDC medical officer.

"Some of these patients end up going through one or more surgeries and various travels through the medical system," Esposito said. "They take a long time typically to get better."

The Dominican Republic, like countries such as Mexico, Costa Rica and Thailand, has promoted itself as a destination for medical tourism, so-called because people will often tack on a few days at a resort after undergoing surgery. The main allure is much lower costs along with the promise that conditions will be on par with what a patient would encounter at home.

In 2013, there were more than 1,000 cosmetic procedures performed in the Dominican Republic, 60 percent of them on foreigners, according to the country's Plastic Surgery Society.

The Internet is flooded with advertisements and testimonials from people who say they have had successful procedures in the Dominican Republic, and an industry of "recovery houses" has sprung up to serve clients, along with promoters who canvass for clients in the United States. The price is often about a third of the cost in the United States.

Dr. Braun Graham, a plastic surgeon in Sarasota, Florida, says he done corrective surgery on people for what he says were inferior procedures abroad. He warns that even if a foreign doctor is talented, nurses and support staff may lack adequate training.

"Clearly, the cost savings is certainly not worth the increased risk of a fatal complication," said Graham, past president for Florida Society of Plastic Surgeons.

Brignoni was referred to the Vista del Jardin Medical Center by several acquaintances in the New York borough of The Bronx where she lived, said Lamboy and Lenny Ulloa, the father of the 4-year-old daughter she left behind.

"Supposedly, it was a high-end clinic, one of the best in the city," Ulloa said.

The doctor who performed Brignoni's procedure, Guillermo Lorenzo, is certified by the Plastic Surgery Society, but there are at least 300 surgeons performing cosmetic procedures who are not, said Dr. Severo Mercedes, the organization's director. He said the government knows about the problem but has not taken any action. "We complain but we can't go after anyone because we're not law enforcement," Mercedes said.

The number of people pursuing treatment in the Dominican Republic doesn't seem to have been affected by negative reports, including a previous CDC warning about a cluster of 12 infections in 2003-04.

In one recent case, the Dominican government in February closed a widely advertised clinic known as "Efecto Brush," for operating without a license. Prosecutors opened a criminal case after at least six women accused the clinic of fraud and negligence. The director, Franklin Polanco, is free while awaiting trial. He denies wrongdoing.

There was also the case of Dr. Hector Cabral. New York prosecutors accused him of conducting examinations of women in health spas and beauty parlors in that state in 2006-09 without a license, then operating on them in the Dominican Republic, leaving some disfigured. Cabral pleaded guilty to one count of unauthorized practice of medicine in October 2011 and returned to the Dominican Republic, where he still practices.

In 2009, Dominican authorities charged Dr. Johan Tapia Bueno with illegally practicing plastic surgery at his apartment after several women, including a local television personality, accused him of malpractice that left them with infections. Awaiting trial, he has pleaded innocent to charges that include fraud.

Juan Linares, a lawyer hired by Brignoni's boyfriend, said he is still awaiting an autopsy report.

Because she arrived in the country late at night on a delayed flight and was on the operating table early the next morning, a main concern is whether she received an adequate medical evaluation before the procedure. Graham, the Florida surgeon, said sitting on a plane for several hours can cause blood to stagnate in the legs and increase the risk of an embolism.

Brignoni paid the Dominican clinic $6,300 for a combination of liposuction, tummy tuck and breast surgery. Lamboy said she had decided not to have the work done on her breasts and was expecting a partial refund. The woman, who worked as a property manager, had lost about 80 pounds about a year earlier after gastric bypass surgery.

Brignoni was clearly excited about the procedure. Her final post on Facebook was a photo she took of her hands holding her passport and boarding pass for the flight from New York to Santo Domingo.

"She wanted it so bad," her godmother said. "It felt like she was going to have a better outlook on life, getting this done."


Associated Press writer Ben Fox reported this story from Miami and Ezequiel Abiu Lopez reported in Santo Domingo.

Join the discussion

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Bodacious Beauty March 31 2014 at 10:52 AM

If it's not broken, don't fix it.

Flag Reply +2 rate up
MURIELCP3 March 31 2014 at 12:08 PM

The real issue is that women feel the need to get cosmetic surgery in the first place. We live in a society that places way too much empahsis on what people look like. It is a shame that this pretty young woman felt the need to go under the knife because she was obviously not satisified with the way she looked. She needed a psychiatrist not a plastic surgeon.

Flag Reply +7 rate up
3 replies
jvmcfla@aim.com March 31 2014 at 3:21 PM

It is tragic that people are losing their lives, but at the same time you cannot just hop on a plane to a foreign country to save money on plastic surgery without realizing the risks! Did these people ignore the warnings, did they want surgery so badly that they were willing to possibly risk their own lives?! It seems the answer is yes! You couldn't pay me to have plastic surgery in the U.S. or the Dominican! To each their own, but it is risky as it is let alone going away and having it done when there is no way you can really research the doctors, the facility etc. I hope that people will wake up and put their vanity far, far behind them as living a life with the face and body you are born with is much better than possibly dying from plastic surgery!

Flag Reply +2 rate up
Cathy March 31 2014 at 6:06 PM

Women just cannot leave well alone. Vicious media campaign and starved " celebrities " that are plastic put so much pressure. Most of those celebrities without make-up look horrible. Be who you are. Have faith and confidence in yourself. You want to loose a few pounds? Fine. Do it the right way. Thery will come off. Do not go under the knife in no country. It is dangerous.

Flag Reply +1 rate up
jaaltobelli March 31 2014 at 6:05 PM

if it sound too good to be true it usually is.

Flag Reply +3 rate up
mateya5 March 31 2014 at 12:27 PM

sscott5145.. you're post just goes to show how ignorant people in this country are about "socialized medicine" facts. As a matter of fact Canada has excellent state of the art health care with excellent and regulated health care professionals.. I have been employed in Canada as well as the U.S. as a health care professional critical care provider... Actually you need to check the facts and you will see that Canadians are healthier than Americans because EVERYBODY has access to health care..Even though there is a longer wait for tests( except for emergency situations of course) they still come out on top of the US.. There is much less unnecessary testing and exposure to radiation and care and treatment is evidence based .. The treatment you get is not dependent on how much you can afford ,therefore everyone is treated based on their health needs not their wallet contents..

Flag Reply +1 rate up
3 replies
mateya5 March 31 2014 at 12:37 PM

Ps Do you know how many people considered" healthy " by all standards have died or have been disfigured here in the US. from plastic surgery ? Plenty ! I live in a very "upscale area " where the "best " plastic surgeons have their clinics and I know of at least 4 people who have died during or post procedures such as a breast Aug. lipo and face lift to name a few in the last 6 yrs. in this area alone.. bottom line is all major surgery comes with risks... pick your battles..

Flag Reply +3 rate up
bh1929 March 31 2014 at 12:47 PM

That is what happens when you use the low bidder.

Flag Reply +3 rate up
1 reply
slackwarerobert bh1929 March 31 2014 at 1:51 PM

Where does it say she took the low bid in the dominican republic?
maybe she took the highest one.

Flag Reply 0 rate up
debnaert March 31 2014 at 12:56 PM

"WE want to know if we can GET SOME BIG MONEY from her death" That's the REAL question from her family members.

Flag Reply +1 rate up
1 reply
slackwarerobert debnaert March 31 2014 at 1:49 PM

Not if she used the return ticket to fly back in a casket.
If she stayed there, then a refund on the flight sounds resonable.

Flag Reply 0 rate up
weeeally March 31 2014 at 6:04 PM

Vanity is a beach. Back in the 80s and 90s, basically if you have a big behind, you are black. Some hispanics as well. Now, white women are buying big butts, full lips, and strong facial bone structures like they were born that way. The only thing white women didn't copy from black women is their hair. But I guess that's okay, because black women seem to want to copy hair from white women. The difference is that a wig or weave can be removed daily. But when you start surgically enhancing your lips, butt, and bone structure, I personally think that you are insecure, totally

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