Fred Schulte, KFF Health News
Lenia Watson-Burton, a 37-year-old U.S. Navy administrator, anticipated that beauty surgical procedure would do away with cussed fats shortly and simply — simply because the online advertising promised.
Instead, she died three days after a liposuction-like process referred to as AirSculpt on the San Diego workplace of Elite Body Sculpture, a beauty surgical procedure chain with greater than 30 places of work throughout the U.S. and Canada, courtroom information present.
Cosmetic surgical procedure chains organising store in a number of states rely closely on promoting to draw clients: tv, print, social media influencers, even texts hawking discounted vacation charges. The pitches usually promise sufferers life-changing physique shaping with minimal ache and a fast restoration.
Yet there’s no federal requirement that surgical procedure corporations submit proof supporting the reality and accuracy of those advertising claims. No company tracks how incessantly sufferers persuaded by gross sales pitches maintain painful problems similar to infections, how successfully surgeons and nursing employees comply with up and deal with accidents, or whether or not corporations promoting new aesthetic gadgets and strategies have adequately educated surgeons to make use of them safely.
In 2023, Watson-Burton’s husband and 6 youngsters and stepchildren sued Elite Body Sculpture and plastic surgeon Heidi Regenass for medical malpractice, alleging that the skinny cannula the surgeon used to take away fats perforated Watson-Burton’s bowel, inflicting her demise.
The swimsuit additionally accused Elite Body Sculpture of posting false or deceptive promoting on its web site, similar to describing the clinic’s branded process AirSculpt as “gentle on the body” and stating: “Our patients take the fewest possible risks and get back to their regular routine as soon as 24-48 hours post-operation.”
Watson-Burton was considered one of three sufferers who died after having liposuction and fats switch operations carried out by Regenass from October 2022 to February 2023, courtroom information state. Families of all three ladies sued the surgeon, who denied wrongdoing in authorized filings. The events settled the Watson-Burton household case in 2024. Two different wrongful demise instances are pending, together with a swimsuit by an Ohio lady who alleges her mom relied on guarantees on Regenass’ web site that the operation in California could be secure with a fast restoration.
Neither Regenass nor her attorneys responded to repeated requests for remark. Emails and cellphone calls to Elite Body Sculpture’s Miami headquarters weren’t returned.
State and federal authorities do have the facility to ban false or deceptive medical promoting of all sorts, although enforcement is spotty, significantly when promotions pop up on-line. That means sufferers should do their very own homework in evaluating beauty surgical procedure advertising pitches.
“While consumers should be able to trust that ad claims are substantiated because the law requires them to be, the reality is that it pays for consumers to bring a skeptical eye,” stated Mary Engle, an govt vice chairman at BBB National Programs.
‘Up a Cup’
Founded by beauty surgeon Aaron Rollins, Elite Body Sculpture says in Securities and Exchange Commission filings that it affords a “premium patient experience and luxurious, spa-like atmosphere” at its rising community of facilities. The publicly traded company, based mostly in Miami Beach and backed by private equity investors, markets AirSculpt as being “much less invasive than conventional liposuction” and offering “faster healing with superior results.” The advertisements say that AirSculpt “requires no scalpel, or stitches, and only leaves behind a freckle-sized scar!” and that sufferers “remain awake the whole time and can walk right out of their procedure, enjoying dramatic results!” Some dangers are disclosed.
Rollins, who just lately made headlines for placing his Indian Creek mansion available on the market for $200 million, didn’t reply to repeated requests for remark. A lawyer for Rollins, Robert Peal, responded to an e mail however didn’t remark. On Nov. 4, the company announced that Rollins had resigned as govt chairman of the board of administrators of AirSculpt Technologies and as a member of the board.
Many AirSculpt sufferers decide to have fats that’s faraway from their stomachs or different locations injected into their buttocks, typically referred to as a Brazilian butt elevate. Others use the fats to reinforce their breasts, a process the corporate manufacturers as “Up a Cup.” Since March 2023, at the least seven sufferers have filed lawsuits accusing Elite Body Sculpture of operating deceptive promoting or misrepresenting outcomes, arguing, amongst different issues, that they felt extra ache or healed way more slowly than the advertisements led them to imagine they might, courtroom information present. One of the lawsuits has been dismissed, and the corporate has denied the allegations in others.
The Watson-Burton household argued of their lawsuit that some advertising claims about AirSculpt had been merely not true.
For occasion, Elite Body Sculpture’s web site acknowledged that AirSculpt has “automated technology” set to “turn off” earlier than the cannula penetrates the physique too deeply and probably causes critical harm, in response to the swimsuit. That function didn’t shield Watson-Burton, who paid $12,000 for the operation, hoping for a “quick and timely recovery” earlier than a scheduled U.S. Navy deployment, in response to the lawsuit.
Rather than being mild on the physique, AirSculpt was “extremely painful, highly invasive, unsafe, required more than a short 24-hour recovery period and could and did damage internal organs,” in response to the swimsuit.
Watson-Burton referred to as the San Diego heart on Oct. 27, 2022, a day after the operation, to report “severe pain” in her higher stomach, however staffers took no motion to judge her, in response to the swimsuit. The subsequent morning, an ambulance rushed her to a hospital, the place emergency surgical procedure confirmed the gravity of her accidents. Surgeons famous her accidents included three perforations of the small bowel and sepsis.
Watson-Burton died on Oct. 29, 2022. An post-mortem report cited problems of the beauty surgical procedure, ruling she died after changing into “septic following intraoperative small bowel perforation.” Her demise certificates lists the trigger as “complications of abdominoplasty.”
In courtroom filings, Elite Body Sculpture stated Watson-Burton had “experienced an uncommon surgical complication.” The firm denied that it made any “specific guarantee or representation that injury to organs could not occur.” It denied any legal responsibility or that its advertisements made misrepresentations.
The dispute by no means performed out totally in courtroom. The events settled the case in August 2024, when Elite Body Sculpture agreed to pay Watson-Burton’s household $2 million, the utmost below its insurance coverage coverage. Regenass, the surgeon, who didn’t carry legal responsibility insurance coverage, agreed to pay $100,000 extra, in response to the settlement settlement.
Promises Not Kept
Social media pitches and online advertising additionally led Tamala Smith, 55, of Toledo, Ohio, to Regenass for liposuction and a fats switch, courtroom information state.
Smith was lifeless lower than two weeks later, considered one of two different ladies who died following elective operations Regenass carried out from December 2022 to February 2023, courtroom information present. The surgeon operated on the 2 ladies at Pacific Liposculpture, which runs three surgical procedure facilities in Southern California, courtroom information state.
The households of each ladies are suing Regenass, a board-certified plastic surgeon, and the surgical procedure heart. In each instances, that are pending in California courts, Regenass and the surgical procedure heart have denied the allegations and filed dismissal motions that deny duty for the deaths.
Smith was a touring registered nurse working the in a single day shift at a hospital in Los Angeles. She selected Regenass after viewing the physician’s Instagram page, in response to a lawsuit filed by Smith’s daughter, Ste’Aira Ballard, who lives in Toledo.
The advertisements described the surgeon as an “awake liposuction and fat transfer specialist,” whereas her web site assured sufferers they might really feel minimal ache and be “back to work in 24-48 hours,” in response to the swimsuit.
During the three-hour operation on Feb. 8, 2023, at Pacific Liposculpture’s Newport Beach workplace, Regenass eliminated fats from Smith’s stomach and flanks and redistributed it to her buttocks, in response to the swimsuit. Smith referred to as the workplace at the least twice in subsequent days to report ache and swelling, however a staffer advised her that was regular, in response to the swimsuit. Smith by no means spoke to the surgeon, in response to the swimsuit.
When Ballard couldn’t attain her mom, she referred to as the hospital solely to be taught Smith hadn’t turned up for her in a single day shift for 2 days. The hospital referred to as police and requested for a welfare verify on the extended-stay lodge in Glendale, California, the place Smith had been dwelling.
An officer found her physique on the mattress “surrounded by towels and sheets that are stained with brown and green fluids,” in response to a coroner’s report within the courtroom file. A countertop within the room was “covered in medical paperwork detailing post-operative instructions from a liposuction clinic,” in response to the report. Ballard stated she realized of her mom’s demise when she referred to as Smith’s cellphone; a police officer answered and delivered the devastating information.
“Oh, my God, I fell to the floor,” Ballard stated in an interview with KFF Health News and NBC News. Ballard stated she nonetheless has not gotten over the shock and grief. “It bothers me because how does someone that dedicated their life to save other people’s lives end up deceased in a hotel, as if her life didn’t matter?” she requested.
Ballard stated her mom trusted Regenass based mostly on her web persona. She believes her mom, a registered nurse, wouldn’t have gone to the surgeon had she recognized somebody had died after an operation Regenass carried out on the Pacific Liposculpture San Diego workplace. Terri Bishop, 55, a truck driving teacher who lived in Temecula, California, died on Dec. 24, 2022, about three weeks after present process liposuction and fats switch at Pacific Liposculpture, an organization with a history of run-ins with state regulators.
Pacific Liposculpture didn’t reply to requests for remark. In courtroom filings, the corporate has denied that the operations performed a task in both affected person’s demise and moved to dismiss the instances. The firm additionally argued that Ballard waited too lengthy to file swimsuit.
Bishop, who had a historical past of smoking, diabetes, and hypertension, died from “arteriosclerotic cardiovascular disease aggravated by viral pneumonia (Influenza A H1 2009),” in response to a Riverside County health worker’s report made a part of the courtroom document. The household disagrees and is arguing that Bishop died from blood clots, a recognized complication of surgical procedure. A trial is about for June 2026.
In Smith’s case, the Los Angeles County health worker dominated the nurse died of “renal failure of unknown cause.” The post-mortem report famous: “This is a natural death since an injury directly from the surgery cannot be identified.”
Ballard is demanding additional investigation to unravel what occurred to her mom.
“I don’t think they were straightforward with the risk and complications that could occur,” Ballard stated. “I think they are promising people stuff they can’t deliver.”
Ballard filed a grievance in opposition to Regenass with the California Medical Board, which the board is investigating, in response to paperwork she supplied to KFF Health News and NBC News. She believes regulators should be extra clear in regards to the backgrounds of surgeons who supply providers to the general public. She additionally hopes the investigation will shake unfastened extra particulars of what occurred to her mom.
“I just don’t understand how she came back to me in a body bag,” she stated.
“I think they are promising people stuff they can’t deliver.”
Ste’Aira Ballard
‘Buyer Beware’
Concerns about gross sales pitches for beauty surgical procedure date again many years.
Witnesses testifying at a June 1989 congressional hearing held by a subcommittee of the House Small Business Committee in Washington heard a litany of horror tales of sufferers maimed by surgeons with doubtful coaching and credentials. Subcommittee Chairman Ron Wyden (D-Ore.) stated sufferers had been victimized by misleading and false advertisements that promised a “quick, easy and painless way to change your life — all through the cosmetic surgery miracle.”
Calling for reform, Wyden added: “So, cosmetic surgery consumers are largely on their own. It’s back to a buyer beware market, and it smacks more of used car sales than medicine.” Wyden now represents Oregon within the U.S. Senate.
All these years later, there’s much more territory to police: an onslaught of online advertising, similar to splashy “before and after” images, on-line posts, and podcasts by social media influencers and others courted by surgical procedure corporations in a pricey effort to draw enterprise. Elite Body Sculpture, for example, spent $43.9 million in “selling expenses” in 2024. That got here to $3,130 per “customer acquisition,” in response to the corporate’s SEC filings.
Under Federal Trade Commission guidelines, medical promoting should be “truthful, not deceptive, and backed up by competent and reliable scientific evidence,” in response to Janice Kopec of the company’s Bureau of Consumer Protection.
Any claims which might be “suggested or reasonably implied” by advertisements additionally should be correct. That consists of the “net impression” conveyed by textual content and any charts, graphs, and different photos, in response to the FTC. The company declined to elaborate.
Medical companies are free to determine what documentation, if any, to share with the general public. Most beauty surgical procedure websites supply little or no such assist for particular claims — similar to restoration occasions or ache ranges — on their web sites.
“There is no requirement that the substantiation be made available to consumers, either on a website or upon demand,” Engle, who can also be a former FTC official, stated in an e mail.
The legislation permits “puffery,” or boastful statements that no particular person would doubtless take at face worth, or that may’t be proved, similar to, “‘You’ve tried all the rest, now try the best,’” Engle stated.
Where to attract the road between acceptable boasts and unverified claims may be contentious.
Athēnix, a personal equity-backed beauty surgical procedure chain with areas in six cities, defended its use of phrases similar to “safer” and “better results” as puffery in response to a false promoting lawsuit filed in opposition to the corporate by Orange County District Attorney Todd Spitzer in California in August 2022.
Spitzer argued that Athēnix touted its “micro-body-contouring” approach as “safer” than conventional liposuction and supplied “outstanding results with less pain and downtime” with out backing that up, in response to the swimsuit.
“There is no study or evidence to support these statements and no scientific consensus about the use of these new techniques,” Spitzer argued.
The events settled the case in July 2023 when Athēnix agreed to pay $25,000 with out admitting wrongdoing, courtroom information present. Before the settlement, Athēnix argued that its use of phrases similar to “safer” and “better results” was “subjective” and “puffery” — and never false promoting.
While there’s little indication that native or state authorities are stepping up scrutiny of beauty surgical procedure promoting, federal authorities have signaled they intend to crack down on doubtful promoting claims made by drug producers.
In a letter sent to drug companies in September, FDA Commissioner Marty Makary wrote that “deceptive advertising is sadly the current norm” on social media platforms and that the company would not tolerate these violations.
‘Bad Advice’
To show medical negligence, injured sufferers typically should present that their care fell under what a “reasonably prudent” doctor with similar training would have supplied. In their protection, surgeons could argue that problems are a threat of any operation and {that a} poor consequence doesn’t imply the physician was negligent.
Some lawsuits filed by injured sufferers add allegations that ads by surgical procedure chains misled them, or that surgeons failed to completely clarify attainable dangers of accidents, a requirement recognized in medical circles as informed consent.
Caitlin Meehan had such a case. She underwent a $15,000 AirSculpt process at Elite Body Sculpture’s clinic in Wayne, Pennsylvania, exterior Philadelphia. She agreed to the surgical procedure in March 2023, she stated, as a result of the corporate’s web site described it as “Lunch Time Lipo,” in response to a lawsuit she filed in late August. The swimsuit alleges that the physician she mentioned the process with “maintained that there are no serious, life-threatening, lasting and/or permanent complications,” in response to the swimsuit.
During the process, nonetheless, gases grew to become trapped beneath her pores and skin, inflicting a widespread swelling referred to as subcutaneous emphysema, in response to the swimsuit. Meehan was shocked to see her face, neck, and higher physique severely swollen, inflicting her shortness of breath.
A buddy who drove her to the appointment requested the employees to name an ambulance, however employees members stated that wasn’t crucial, in response to the swimsuit. After an hour’s drive dwelling, Meehan stated her pores and skin felt prefer it was burning and he or she referred to as 911. She spent 4 days within the hospital recovering and stays scarred, in response to the swimsuit. The swimsuit is pending, and the corporate has but to file a solution in courtroom.
Scott Hollenbeck, rapid previous president of the American Society of Plastic Surgeons, stated recovering from liposuction in a day “seems unrealistic” given the bruising and swelling that may happen.
“The idea that you could return to work 24 hours after effective liposuction seems like extremely bad advice,” Hollenbeck stated.
‘I Felt Horrible’
Ads that promised sufferers minimal discomfort even have come below assault in affected person lawsuits.
More than 20 different medical malpractice instances reviewed by KFF Health News made comparable allegations of surprising ache throughout operations at beauty surgical procedure chains utilizing lidocaine for ache reduction in “awake liposuction.”
One affected person suing Elite Body Sculpture in Cook County, Illinois, alleged she “was crying due to [the] severe pain” of an operation in September 2023. She alleged the physician stated he couldn’t give her any extra native anesthetic and pressed on with the process. The defendants haven’t filed a solution in courtroom. The apply didn’t reply to a request for remark.
Engle, the previous FTC official, stated that whereas claims of discomfort are considerably subjective, they nonetheless should be “truthful and substantiated,” similar to supported by a “valid, reliable clinical study of patients’ experience.”
NBC News producer Jason Kane contributed to this report.
