She had responded to an ad from the clinic that promised help for her teenage son's acne. He didn't get the treatment, but Miles made an appointment for herself for laser treatments to remove sunspots on her arms, back and chest.
"They started with the laser on my chest, and when they got to my back, they decided the sunspots were worse, and so they upped the laser, further intensifying the procedure," Miles recalled.
The redness subsided, but each burn drained the pigment from her skin, leaving Miles open to further skin problems should she ever expose the affected areas to the sun.
Miles' experience is hardly unique. In the past few years, reports of fraudulent or shoddy cosmetic and plastic surgery procedures have grabbed headlines:
- In 2003, New York City financial analyst Maria Cruz died after a fatal reaction to lidocaine, delivered by Dean Faiello, a 46-year-old from Newark, N.J., who had been posing as a cosmetic surgeon. Faiello fled to Costa Rica but was apprehended by U.S. authorities in 2006 and is now in prison.
- In 2004, four people in Florida became paralyzed after Bach McComb, an osteopath with a suspended license, administered lab-strength botulism toxin -- not the much weaker Botox -- to himself, his girlfriend and two others. McComb was later sent to prison for three years.
- In 2005, a 46-year-old California woman died of multiple organ failure after receiving a buttock injection of what had been billed as a "French polymer" but was actually cooking oil. The beautician who delivered the shot, 39-year-old Martha Mata Vasquez, was sentenced to 15 years in prison in January.
"I think that, especially in big cities, it's more common than you think, because I see lots of patients with problems who have been treated in hotel rooms, for example," said Dr. Rhoda Narins, past president of the American Society for Dermatologic Surgery (ASDS) and a clinical professor of dermatology at New York University Medical Center.
"Sometimes, when I ask patient what it is that they have had, they really have no idea," she said. In many cases, procedures are performed in non-medical settings -- hotel rooms, private homes, beauty clinics and spas, Narins said. "I've seen several patients who had spa treatments and got comfortable there, and then they were offered non-medical-grade silicone. They ended up having horrendous reactions."
Dr. John W. Canady, vice president of the American Society of Plastic Surgeons (ASPS), said that the underground nature of these sub-par procedures makes them especially hard to track.
He and Narins said consumers should watch out for the following "red flags" when seeking out cosmetic injections or surgeries:
- Check for credentials. It's not enough that your "doctor" is wearing a white lab coat and has a certificate on the wall. A number of organizations -- the ASDS, the ASPS, the American Board of Plastic Surgery and state medical boards -- have online resources that people can check to verify credentials and experience.
- Be wary of cheap deals. "If a procedure has an unbelievable price that nobody else is offering, then you really have to slow down and examine why it's so cheap -- why is it so out of line with the rest of the market?" said Canady, who is also professor of plastic surgery at the University of Iowa.
- Look for nearby medical support. Even procedures conducted by the best-qualified staff can go awry, so make sure your practitioner has equipment and qualified personnel on hand to deal with allergic reactions, clotting and other events. Most reputable clinics will have hospital affiliations. "As a patient, you want to know what things are available if things don't go right," Canady said.
Most of all, the experts said, ask questions.
"It's important to be a responsible consumer, to do your homework, to not be afraid to ask the tough questions," Canady said. "If you ask people legitimate questions in a non-offensive way, and they get angry or hostile with you, then you need to go find somebody else."
Narins agreed that an educated, proactive consumer is the best defense against fraud and abuse in her industry.
"People shouldn't take chances with their health. When you inject something into your body, this is not the same as getting a massage," she said. "This is something that can seriously affect you, and for a long time."
That's a lesson Miles said she learned the hard way, but she's hopeful that her story can at least help others. The clinic she received her laser treatment from has since closed down, and Florida state law was recently toughened to mandate that all laser procedures be done under a doctor's supervision.
But Miles said her scars are a daily reminder that patients remain vulnerable.
"Make no assumptions, and don't be afraid to ask questions," she advised. "The mistake I made was that I never asked these women if they were a nurse practitioner, or if they had any experience doing this before, or how many times they had done it before. All of those were major mistakes."
HealthDay News, 2/26/2007, By E.J. Mundell