On January 19 this year, Lauren James had liposuction on her thighs and buttocks at the Centre of Cosmetic and Plastic Surgery in Melbourne. Three days later, after suffering intense pain and bleeding, the blonde-haired, vivacious 26-year-old property valuer was dead.

"She was extraordinarily beautiful, both inside and out," said her shocked brother, Collie James Jr, after the tragedy. "If there is a connection found between the treatment and her death, it would be in honour of her and her great capacity for love that we would want to make sure this did not happen to anyone else."
Cosmetic surgery is booming. Last year, we spent an estimated $1.3 billion on liposuction, breast enhancement and other procedures featured on wildly popular shows like Extreme Makeover and Dr. 90210. But what women like Lauren don't realise is that plastic surgery isn't always as risk-free as it seems. Here's what you need to know ... Liposuction $8500 gets you treatment on your thighs and bottom

"There are no restrictions or guidelines in Australia on who can perform [liposuction] and where or how it is performed," according to The Cosmetic Surgery Report to the NSW Minister for Health, 1999. Furthermore, in every state apart from Queensland, anyone with a medical degree can call themselves a cosmetic surgeon (as distinct from a plastic surgeon), even though they may not have had any specialist surgical training.

Death rates from liposuction are higher than for car accidents, according to a recent study reported by the US Food and Drug Administration (FDA). The rate of death was estimated at between 20 and 100 deaths per 100,000 for liposuction, compared with 16 deaths per 100,000 car accidents. "A lot of the liposuction in the UK and US is done in less satisfactory circumstances than here," reassures Dr Dan Kennedy, spokesperson for the Australian Society of Plastic Surgeons. "The Australian experience is much safer."

Complications from liposuction can include loss of sensation, skin dimplinG and (very rarely) flesh-eating infections, says Sydney plastic surgeon Dr Anand Deva. Fat loosened during liposuction can also travel to the lungs or brain, which can be fatal .

Breasts
40,000 boob jobs are estimated to have been performed in Australia last year (exact figures are not recorded), making it the most popular surgical procedure, claims Dr Kennedy.

Risks include infection, reduced sensitivity, scarring, breakage and necrosis (skin death). According to an FDA study in 2003, 46 per cent of women with silicon gel implants and 21 per cent with saline implants underwent at least one re-operation within three years.

In Australia, most cosmetic surgery is carried out under general anaesthetic.

"There is a remote possibility - one in 100,000 patients - that you could die under general anaesthetic, either due to allergy or heart attack," warns Associate Professor Kate Leslie of the Australian and New Zealand College of Anaesthetists. "Awareness, or waking up during an operation, affects less than one in 1000 patients, while the same number suffer damage to their teeth caused by tubes being placed in their mouth."

Even local anaesthetic can be risky. "If too much local anaesthetic is injected, or it is injected into a blood vessel rather than tissue, it can cause local anaesthetic toxicity," reports Dr Leslie. "You can have a fit, or it can stop your heart. It's rare, but the people who have been killed have usually been having plastic surgery."

Vain Drain
Dr Robert Rey, the famous Beverly Hills surgeon who stars in the reality TV series Dr. 90210, says rich Australian women are flying to Los Angeles for their cosmetic surgery. "It's become kind of a luxury item," he claims. "You know, 'I drive a Mercedes, I wear Gucci and I had my work done by Dr Rey.'"

If you're considering plastic surgery, the Australian Society of Plastic Surgeons (ASPS) suggests asking your GP to recommend a surgeon. Also, ASPS spokesperson Pam Garcia says, "You can reduce the risk by consulting a surgeon who is certified by the Royal Australasian College of Surgeons." Call 1300 367 446

1 in 3 Australian women would undergo cosmetic surgery to improve their looks, making us one of the most image-obsessed nations in the world, according to an ACNielsen study released in 2006, while 41 per cent of 18 to 20-year-olds say they'd have a nip/tuck when they are older.

14 is the age of the youngest patient to consult Gold Coast plastic surgeon Dr Terrence Scamp about breast enlargement (he sent her away). NSW and Victoria are considering new measures - including a one-month cooling-off period - to make it more difficult for people under 18 to have purely cosmetic procedures.

21 is how many makeover shows were shown on Australian TV last year, from Ambush Makeover to Extreme Makeover: After The Storm. More than 600,000 viewers tuned in weekly to watch the original Extreme Makeover.

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