The death of a Canadian woman during liposuction will make many think twice before having such a procedure.
The Toronto woman's tragic and unnecessary death highlights how dangerous some cosmetic procedures can be and the need for more restrictions on who is allowed to perform them.
Krista Stryland's death is now under investigation; she died after having fat removed from her abdomen at a cosmetic clinic which was performed by a family doctor and not a certified plastic surgeon.
It is unclear at present if actions by the family doctor performing the liposuction contributed to her death.
Currently there are no rules prohibiting general practitioners declaring themselves to be cosmetic surgeons and carrying out operations, such as liposuction.
Though they may be trained doctors they have not been subjected to the rigorous licensing, training and regulatory supervision that governs plastic surgeons.
Liposuction is an invasive procedure which should not be regarded as a trivial operation; it involves vacuuming fat cells from the body through a tube inserted under the skin and serious complications which are sometimes fatal do occur.
These include infection, clots that travel to the lung or brain, punctured organs, nerve damage and the destruction of skin through necrosis.
Experts estimate risk of death from liposuction to be 20 in every 100,000 cases which is higher than the U.S. death rate from motor vehicle crashes.
However those risks only apply to certified specialists and the actual death rate could be much higher.
Many doctors and medical associations are calling for more regulations to control the growing number of family doctors who are leaving the profession in favour of the more lucrative cosmetic-surgery industry.
British Columbia and Alberta recently passed laws placing restrictions on private surgery clinics and now all surgeons and their surgical facilities must be licensed for each procedure they perform.
Family doctors in Ontario who switch to cosmetic surgery are encouraged to notify the CPSO, but are not obliged to do so and the CPSO does not keep track of how many doctors practise cosmetic surgery in the province.
The number of doctors practising cosmetic surgery in Ontario has reportedly increased by 150 per cent over the last four years, while the number of fully certified plastic surgeons graduating from medical schools in Canada has dropped and there are in fact only about 350 in the entire country.
According to a 2001 study published in the Aesthetics Surgery Journal, about one in 46,000 people in the United States who had liposuctions died from complications.