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FARAI CHIDEYA, host:

Plastic surgery has skyrocketed among African-American women, among all women. And it may have helped cause the death of Donda West, the mother of rap star Kanye West. On Friday, the 58-year-old reportedly had cosmetic surgery. She died only hours after being released from the care of her surgeon, Dr. Jan Adams. The Los Angeles County Coroner's Office is looking into the cause of her death. Could this be a cautionary tale about the rising popularity of cosmetic surgery or is this an isolated case?

For more, we've got Dr. Brian Evans. He had a team of surgeons at Cosmetic Physicians of Beverly Hills. Dr. Evans, welcome.

Dr. BRIAN EVANS (Plastic Surgeon, Cosmetic Physicians of Beverly Hills): Welcome. Good morning.

CHIDEYA: So at this point, we don't know for sure what caused Donda West's death, and I'm not going to ask you to try to figure out that case. But we do know she was in surgery for at least five and a half hours. Is that typical?

Dr. EVANS: You know, every surgery has a different approach and the surgeon has a different plan. So it's really not fair to comment on this particular case whether or not this was typical or atypical without actually knowing all of the details surrounding the case and what the pre-operative plan was for the surgery.

CHIDEYA: There has been a lot of discussion of whether or not she, in fact, ignored a conversation with another doctor about resolving some health issues before she went into surgery. How big of an issue was this? How sure should you be that you're in top physical shape or, at least, as much as you can be, before you go ahead with cosmetic surgery?

Dr. EVANS: I think any surgery in general and in particular an elective surgery, it is absolutely imperative that, you know, a complete workup is performed. And, you know, at that time, you know, once the necessary lab values - EKG, chest x-ray, et cetera - are reviewed and then you and the patient can make an intelligent decision. You know, often as plastic surgeons, we are, at times, faced with a patient that may not tell you all of the information. So again, it's extremely critical that you spend a lot of face-to-face, one-on-one time and discuss in depth what the goals are and get a good feel for what the patient is interested in.

CHIDEYA: Now, according to the American Society of Plastic Surgeons, African-Americans had more than 783,000 cosmetic procedures last year. That's just seven percent of the total. But in the last three years, the number of African-Americans having plastic surgery went up more than 60 percent. Why do you think that there has been this movement towards African-Americans who haven't always been totally whole hot for cosmetic surgery, getting on the bandwagon?

Dr. EVANS: Well, I think in general, there's been an increase in awareness for plastic surgery. Some of that, we can thank for for the TV shows. I mean, that has really brought plastic surgery to the forefront. And I think a lot of the fears have been addressed with that. And there's also a growing trend, especially in Southern California that people want to look their best and sometimes, they feel that some of these, you know, these goals can be achieved through plastic surgery.

CHIDEYA: Just to be real, do people take this too lightly? A lot of people like, oh, you know, maybe I'll go ahead with this done and that done and then I'll be up and about in a couple of days. If you're talking about something like, say, a tummy tuck, that's not just like going and getting a pedicure, is it?

Dr. EVANS: Absolutely. Plastic surgery is definitely something not to be taken lightly. It's a serious operation. It requires anesthesia. It requires a recovery period. And those are things that need to be discussed with your physician at the time during your initial consultation.

CHIDEYA: If you go for a fairly major procedure or, you know, an invasive procedure like a tummy tuck, what can you expect afterwards in terms of your recovery?

Dr. EVANS: Well, with any surgery, there's going to be some discomfort. And there is pain involved. And it's going to take a few days until you're back on your feet.

CHIDEYA: Now, you actually provided us with a list of questions that a potential patient should ask when considering a cosmetic surgery. We posted the full list on our Web site, nprnewsandnotes.org. But I want to get you to elaborate on a few of these suggestions. Number one, is the doctor board-certified by the American Board of Plastic Surgery. Why is that important?

Dr. EVANS: Being board-certified by the American Board of Plastic Surgery requires that physicians go through a rigorous training and meets all of the criteria, so that they're at least, recognized in their specialty that they have received an adequate amount of training.

CHIDEYA: Now, you had another one: What are the risks of the procedure? Asking that - it seems pretty obvious to ask, but do you trust that you'll get accurate answer? I mean, what makes you sure that you're going to get a good answer for the kind of procedure that you're having? And does the risk depend to a certain degree on your specific health issues?

Dr. EVANS: Absolutely. There's several factors. I mean, clearly, if you have a lot of pre-existing conditions, that can impact your ultimate result with your surgery. So those things need to be discussed in detail. And it is the physician's obligation, you know, to really go over in detail as to whatever, what the risks are, what the benefits are and all of the potential complications. I personally feel that the more educated the patient is, the better decision that can be made with, you know, with whatever procedure they're interested in.

CHIDEYA: You also have here, does the doctor have before and after pictures and any examples of complications that can occur. So you go in, you ask someone, well, what could be the downside. Is that important?

Dr. EVANS: Absolutely. Reviewing before and after photos, both the good and the bad, or we, as plastic surgeons, we try to show, you know, the glamorous side of plastic surgery. And, you know, it is a surgical specialty and risk and complications and things can occur. Unfortunately, that is part of the practice.

You know, we try to minimize that as much as possible, but, you know, I believe that it is important to share both the good and the bad so that we have a very realistic expectation. I think that it gives way to a much better doctor-patient relationship in the long run, when they clearly understand that this potentially, you know, adverse outcome may occur.

CHIDEYA: Very briefly, you're on of few black plastic surgeons well known, do you worry about your own practice in light of this death?

Dr. EVANS: I think in general, I think any time there's an unfortunate incident and it can affect the plastic surgery community as a whole. I don't think it affects one person individually anymore than the community as a whole. And I think it's important that we all try to practice safe medicine as we can. In whatever field, there are, you know, unfortunate incidents.

CHIDEYA: Doctor Evans, thanks.

Dr. EVANS: Thank you.

CHIDEYA: Dr. Brian Evans leads the teams of surgeons at Cosmetic Physicians of Beverly Hills.

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