Deadly cosmetic surgeries in Latin America: A problem of self-esteem?

It’s not the lack of self-love that kills them. Women who die during cosmetic surgeries are killed by medical negligence and a lack of regulation in the face of an issue that seems to be becoming a public health problem in Latin America.

Silvina Luna in Argentina. Arelis Cabeza in Colombia. Jacqueline Román in the Dominican Republic. Liliana Gastélum in Mexico. Liliana Sarasua in Peru. The list of women who have died after undergoing a cosmetic procedure would not fit in this column – not even in the print edition of a newspaper – but their cases perfectly illustrate the problem that the region is facing.

Only in Colombia, one of the main destinations in the world for this type of procedures, mortality associated with cosmetic surgeries increased by 130% between 2015 and 2016, according to the National Institute of Legal Medicine and Forensic Sciences. There is no more official data available after that date. Which is also an important part of the problem: there is no clear view of the situation to guide governments in designing public policies to address this phenomenon.

This information gap is filled by reflections that, although necessary, are not a public problem. “It was the lack of self-love, of self-esteem,” someone always remarks when the fateful consequences of a cosmetic surgery performed by unethical and unregulated doctors go viral.

Women, especially in Latin America, are constantly bombarded with messages that sentence us to fit into a curvaceous mold; to be just another consumer product. However, we can also be independent when deciding how we want to look. Now, a question arises: is it more important to point our morally superior finger at those who decide to alter their appearance than to put a stop to clandestine clinics or surgeons that are questioned for their bad practices?

At the beginning of October, the Colombian justice system sentenced six doctors who performed cosmetic surgeries without the necessary academic training to seven years in prison. The court stated that these doctors provided false information to validate their qualifications before the Colombian Ministry of Education.

Francisco Sales Puccini, his brother Carlos Elías Sales Puccini, Juan Pablo Robles, Ronald Ricardo Ramos, Jorge Nempeque and Óscar Sandoval obtained a degree in plastic surgery at the Veiga de Almeida University, in Brazil. According to the certificate of migratory movements issued by Colombia Migration and provided as evidence in the criminal process, some of these doctors spent less than 30 days “studying” in that country. Regardless, the Colombian Ministry approved their studies as a formal medical specialty.

What is more alarming is that the cloud of suspicion not only hangs over them. Their names were exposed after a journalistic investigation that identified a list of at least 42 doctors with “express degrees” in cosmetic surgery. Of that number, only six have been convicted and another 11 are on trial. But what about the others? Why has justice taken more than seven years to investigate them?

Even worse; those 42 so-called surgeons are just a bunch of amateur, phony quacks, but behind them there are more that still go unnoticed while they keep operating with impunity, believing that justice will never reach them.

Three problems must be addressed here. The first is the lack of government control. People usually report the existence of clandestine establishments where they perform medical or surgical procedures for aesthetic purposes, without this leading to any concrete action; they shut down the place and, within a week, they reopen with a new name and a new facade.

The second is the lack of legislation. Today, the legal vacuum is so vast that a generalist physician can perform liposuction or buttock augmentation procedures without being penalized for this, as there is no law that sanctions it. The third problem is that the patients can be careless. “He had a lot of followers on Instagram” or “an influencer recommended him” are common explanations among the victims of questionable doctors.

Despite this, patients are the weakest link in the chain. I am a journalist; I researched the doctor who performed my breast surgery before going to his operating room. Still, I was deceived by a diploma validated by the Colombian Ministry of Education. Self-care and prevention aside, one cannot expect every person who goes to a health service to have detective skills to be able to trust and come out of a procedure alive. Guaranteeing these minimum conditions, such as certifying the proper academic training of a doctor, is the responsibility of the government, not the patient.

“Better not to have surgery at all” is not an effective response, either. We are free to modify our appearance under safe conditions. For this, political will is urgently needed to address this matter as a public health issue, not through the lens of personal prejudices or opinions about women’s bodily autonomy.

Let this unprecedented sentence in Colombia be an opportunity to remember that this is a phenomenon that transcends borders, and that, while we discuss whether this is a matter of self-esteem or vanity, there are hundreds of people at risk in clandestine operating rooms.

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