Shocking $66M malpractice after 'mommy makeover' complications led to woman's death
Industry Buzz
For procedures like a ‘mommy makeover,’ safety improves when surgeons limit total operative time, use risk-stratified DVT prophylaxis, carefully select appropriate surgical candidates, and stage procedures when necessary.
—Lucas Boehm, MD
One of the most common risks overall in combined cosmetic procedures in general is wounds. While wounds are not necessarily preventable, the risk of getting one can be decreased by certain things… the more procedures that are done in one case, the higher the risk for a wound.
—Sheina Bawa, MD
A 39-year-old woman died after combined abdominoplasty and liposuction when internal bleeding went unrecognized for hours postoperatively. A Cook County jury later found the surgeon liable and awarded $66 million in damages.[]
The case has renewed scrutiny on high-risk cosmetic surgery combinations. Complication risk increases with longer operative time and with combined cosmetic procedures.
Frank Agullo, MD, a board-certified plastic surgeon with Southwest Plastic Surgery, states that “99% of plastic surgery complications are due to poor judgment by surgeons rather than their surgical technique. The biggest challenge plastic surgeons face when combining multiple surgical procedures into one is performing too many procedures too quickly.”
Catherine Hannan, MD, a board-certified plastic surgeon from Washington, DC, said, “The most common complications we see in these patients are areas of wound breakdown. Many have lost 50 to 100 pounds, often rapidly, resulting in significant skin laxity throughout the abdomen, breasts, arms, and thighs. These patients frequently require several extensive procedures due to the speed and volume of their weight loss. Statistically, I believe the greater the total incision length, the higher the likelihood of minor wound breakdown in some areas.”
She further adds, “Bleeding and infection can also occur, as with most surgeries, and we use meticulous technique and antibiotic prophylaxis to minimize those risks. The most serious complication associated with abdominoplasty and body contouring surgery is an approximately 1% risk of deep vein thrombosis (DVT) or pulmonary embolism (PE).”
She further adds, “Bleeding and infection can also occur, as with most surgeries, and we use meticulous technique and antibiotic prophylaxis to minimize those risks. The most serious complication associated with abdominoplasty and body contouring surgery is an approximately 1% risk of deep vein thrombosis (DVT) or pulmonary embolism (PE).”
Safety reports in the literature
Safety studies on abdominal cosmetic surgeries have reported the following:
A large analysis of abdominoplasty found complication risk increased with longer operative time, with morbidity rising significantly for procedures lasting 4 hours or more and increasing further beyond 5 and 7 hours.[]
A 2024 review[] and a large database analysis[] confirmed higher complication rates with concurrent cosmetic procedures.
The CosmetAssure analysis done in 2015, involving a dataset of 25,478 abdominoplasties, found a rising complication risk depending on the type of combination: from 3.1% for abdominoplasty alone, to 3.8% when combined with liposuction, 4.3% with a breast procedure, 4.6% with liposuction plus a breast procedure, 6.8% with a body-contouring procedure, and 10.4% with liposuction plus a body-contouring procedure.[]
Venous thromboembolism and pulmonary embolism remain leading causes of mortality in abdominoplasty patients. The risk of these complications increases from 0.5% to 1.1% when abdominoplasty is combined with liposuction.[]
Consensus across the plastic surgery literature supports careful patient selection and caution with combined procedures, given their higher complication risk.[]
What the surgeons say
The experts MDLinx interviewed also underscore surgical judgment and case selection as key drivers for preventing complications.
Lucas Boehm, MD, FACS, plastic surgeon and Medical Director at Consona Plastic Surgery, said, “For procedures like a ‘mommy makeover,’ safety improves when surgeons limit total operative time, use risk-stratified DVT prophylaxis, carefully select appropriate surgical candidates, and stage procedures when necessary.”
Dr. Agullo adds, “I generally cap my surgical time at 6 hours.”
Wound complications are among the most common issues in post–weight loss patients undergoing body contouring. Dr. Hannan adds, “With abdominoplasty and extensive body contouring, patients undergo a lengthy procedure under general anesthesia or sedation, and due to the extent of their incisions, they are immobilized to some degree postoperatively. I therefore assess each patient’s thrombotic risk using the Caprini scale and provide most patients with enoxaparin postoperatively.”
As Sheina Bawa, MD, general/cosmetic surgeon and founder of MetamorphMD, puts it, “One of the most common risks overall in combined cosmetic procedures in general is wounds. While wounds are not necessarily preventable, the risk of getting one can be decreased by certain things. For example, the more procedures that are done in one case, the higher the risk for a wound. Therefore, decreasing the number of combined procedures at once can help this tremendously. Additionally, the risk of wounds can be decreased by making sure the patient is eating high protein the weeks leading up to the surgery and for at least 6 weeks after the surgery.”
The broader pattern is consistent across the literature. Complications in abdominoplasty can often be mitigated by incorporating preventative strategies, such as limiting prolonged operative time, avoiding combined procedures, and ensuring prompt recognition of postoperative deterioration.