TALLAHASSEE - Members of state medical boards this week will consider restrictions on procedures known as "Brazilian butt lifts," with some surgeons taking aim at a temporary rule that limited the number of procedures they could perform each day and required the use of ultrasound.
A joint committee of the Florida Board of Medicine and the Florida Board of Osteopathic Medicine will take up the issue Thursday during a meeting in Broward County, with the full Board of Medicine expected to discuss it Friday.
The Board of Medicine in June approved an emergency rule that limited surgeons to performing three Brazilian butt lifts a day and required that they use ultrasound. The procedures, more technically called gluteal fat grafting, involve injecting fat to enlarge or reshape patients’ buttocks.
Emergency rules generally last only 90 days. As a result, medical-board members will discuss more-permanent rules.
A group known as Surgeons for Safety and individual doctors have challenged the emergency rule in a state appeals court. The group this week will ask medical-board members to scrap the restrictions in the emergency rule and look at other ways to regulate the procedures.
Steve Menton, an attorney for the group, said surgeons are trying to help produce a "meaningful solution that really addresses patient safety."
"Certainly, there are a number of items that we believe can really further the board’s goal of patient safety," he told The News Service of Florida.
Brazilian butt lifts have drawn widespread attention in recent years, with Board of Medicine member Kevin Cairns saying during a June meeting that Florida has become "ground zero" for the procedures. The emergency rule pointed to 10 verified deaths during the past three years of patients who underwent Brazilian butt lifts.
Also, information prepared for Thursday’s meeting included an order signed last week by state Surgeon General Joseph Ladapo restricting the license of a Miami-Dade County physician after an Indiana woman died in April following a Brazilian butt lift. The emergency order barred physician Oliver Pope Simmons from performing the procedures and also pointed to the possibility of additional disciplinary action.
In the procedures, surgeons remove fat from areas of patients’ bodies such as abdomens or thighs and inject it into the buttocks, according to an explanation that is part of the emergency rule. Deaths have occurred because of pulmonary fat embolisms, which involve fat getting into the patients’ bloodstreams.
The emergency rule indicated that limiting doctors to performing three Brazilian butt lifts a day could decrease surgeon fatigue and distractions. Also, it required the use of ultrasound to help guide cannulas, which are instruments used in injecting fat.
But the Surgeons for Safety group contends that the measures do not effectively address issues with the procedures and, in the case of ultrasound, could cause problems for doctors who have not been required to use the technology in the past. In written comments submitted for Thursday’s meeting, the group called the limit of three procedures a day "arbitrary."
"In our opinion, as surgeons who have been performing these surgeries for years with a focus on safety and quality outcomes, these restrictions will do nothing to address the underlying problems we know exist in our industry," the written comments said. "These (problems) include, but are not limited to, surgeons running too many operating rooms at once, falsifying or hiding medical records and a disregard for what amounts to ineffective enforcement. In fact, the policies contained in the emergency rule and the rule being workshopped will likely make the situation worse for patients, as high-quality, law-abiding surgeons will comply with the new restrictions, resulting in a reduction in supply of safe procedures. This will drive the patient demand to the bad actors."
The group called the ultrasound requirement "unsafe."
"Many high-quality surgeons have been trained to safely perform this procedure with both hands," the written comments said. "The introduction of an ultrasound requirement without proper education, training, and appropriate technology takes away one of the surgeon’s hands, forces the surgeon to take eyes off the patient to monitor a screen, and interrupts the cadence of the surgery. Requiring surgeons to completely change the way they perform an operation without investing in training and technological innovation first is dangerous."
As alternatives, the group suggested establishing a doctor-to-patient ratio. It said safety problems occur when doctors have more than one patient under anesthesia in different operating rooms at the same time.
Also it called for making clear that injections must be performed by the surgeons conducting the procedures and not be delegated to other people.