Liposuction in Maryland set for tighter regulation

Maryland is moving to strengthen laws on the fast-growing medspa industry — a shift developed to narrow a “loophole” and stop fatalities including one last year following a liposuction treatment at a Timonium, Md facility.

Laws being discussed by state officials might bar plastic surgeons from performing liposuction and other procedures in medspas and health-related offices unless the services are inspected by the authorities or third – party accrediting bodies, Maryland Secretary of Health Joshua Sharfstein stated.

Greater scrutiny would be brought by the changes to an industry where liposuction clients generally pay out of pocket for procedures – – – making the customer the primary oversight authority, instead of private or government insurers who demand safeguards, Sharfstein said.

“The objective would be to be sure the riskier procedures are happening in the safer places,” he said.

Maryland is among a growing number of states wanting to regulate where liposuction and other procedures can be performed. Twenty-seven states have passed regulations or added guidelines regarding where liposuction operations can take place, based on the American Association for Accreditation of Ambulatory Surgery Facilities

A law was passed by Florida, for example, last year requiring yearly review of any center that eliminates more than 1000 cubic centimeters of fat during liposuction. In New York, certification is required for any office-based surgery that eliminates more than 500 cubic centimeters of fat during liposuction or uses anything more than minimal anesthesia.

“A lot of states are working out these problems with medspas,” said Dr. Doug Forman, a cosmetic surgeon in North Bethesda who serves on the American Society of Plastic Surgeons’ government affairs board. “Nationally, medspas are slipping in to this grey area.”

There are almost 5, 000 now listed using the International Medical Spa Association, while there were about 800 medspas across the US five years ago, said director Allan Share.

But there is no classification for what qualifies as a medspa, and they include facilities that offer a variety of solutions from Botox to complex surgeries, Share said. The industry continues to grow as centres seek to benefit from the demand from demand from cash paying customers, he said.

“Minimally invasive” processes such as laser skin treatments and Botox injections have increased by 6 percent since 2000, according to the plastic surgeons society. Surgical procedures, meanwhile, have dropped 16 per cent on the same period. Health authorities encourage individuals to verify that licensed physicians are conducting their cosmetic surgery procedures and that the procedures are taking place in certified facilities that are either equipped to manage problems or have associations with neighborhood hospitals.

Physicians and other health care workers have been charged with a range of infractions in the past few years, occasionally with serious results, Md Board of Physicians records show. Maryland lawmakers were pressed into motion a year ago after a Lochearn woman died of an illness developed during liposuction at Monarch Medspa in Timonium.

But similar risks are shown by earlier cases. A doctor at another Timonium plastic surgery center lost his medical licence in 2011 after two of his patients died of complications associated with complex aesthetic surgeries. Officials reprimanded that doctor for executing procedures in improper settings.

Others have been disciplined for offering services including laser hair removal without a medical licence at all. Their state Dept of Health and Mental Hygiene elevated plastic surgery regulation to a best legislative priority in the days after regulators close down Monarch Medspa in Sept over “likely deviations from common infection control methods.” Three aggressive infections were contracted by patients after undergoing liposuction; one of them, 59 – year – old Eula Witherspoon, died less than a week after the process. Monarch officials had pledged to assist authorities and extended their sympathies when the infections came to light. They could not be reached for further comment.

At the time, Sharfstein noted “an unevenness” in regulation over liposuction and additional aesthetic procedures.

The 2013 Basic Assemblage approved a bill permitting the health department to create laws that tackle the loophole. Health authorities anticipate Gov. Martin O’Malley to sign the bill next month, though Raquel Guillory, a spokeswoman for the governor, stated it is not clear when that will be.

Regulators intend to begin by seeking community input on processes which should be protected by the requirements, Sharfstein said. That can include liposuction and other surgical procedures that require anesthesia, he said.

Cosmetic surgeons who run out of workplaces which are currently accredited welcomed the new regulations as a godsend to patient security. For example, Dr. Adam Summers of the Maryland Cosmetic Surgery Center in Glen Burnie mentioned that service would not be affected by the regulations because, even though the center bills itself as a “medical spa,” it is already certified by the state as an ambulatory surgical center.

Health officials and plastic surgeons informed that any aesthetic procedure involving a scalpel or a laser involves danger, though. Board of Doctors records show a variety of disciplinary steps in recent years involving plastic surgeons and aesthetic procedures.

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