This was published 2 years ago
‘Please don’t kill me’: Elite soldier feared for his life after cosmetic surgeon cut him open
Shocking revelations about botched cosmetic surgery are the tip of the iceberg in a lucrative growth industry that is out of control.
It’s the stuff of nightmares. A 24-year-old woman, screaming in agony as a cosmetic surgeon uses scissors to cut a hole into her swollen, infected buttock after a Brazilian Butt Lift went horribly wrong.
As the cries of pain get louder, the room fills with a foul smell of something like vomit and faeces from the open wound.
The cosmetic surgeon, Dr Adam Najem, gives the patient gauze to bite on to stifle her screams “as there are other patients in the waiting room”.
Her condition deteriorates over the next few days but Najem advises her against going to hospital, saying, “No, it was all part of the procedure”.
Dr Adam Najem says he offers “a high level of care”.Credit: Janie Barrett
On June 4, 2018, the woman’s cousin calls an ambulance, and she is admitted to the intensive care unit of Sydney’s Liverpool Hospital in septic shock – a life-threatening condition.
Najem runs a cosmetic clinic in Baulkham Hills, Sydney. On his website he describes himself as a reputable cosmetic surgeon who offers his patients “a high level of care”.
But documents obtained as part of a joint investigation by The Sydney Morning Herald, The Age and 60 Minutes into the $1.4 billion cosmetic surgery industry expose doctors like Najem. They reveal multiple serious failings in a poorly regulated sector that allows doctors with basic medical degrees and weekend courses to call themselves cosmetic surgeons.
When things go wrong, it is left to public hospitals to pick up the pieces. The regulators are slow to act and, when they do, it is often not nearly enough.
Like most cosmetic surgeons, Najem has a basic medical degree and limited surgical training. He boasts as his credentials a certificate from the European College of Aesthetic Medicine & Surgery. But a quick look reveals this is an organisation that offers short courses in cosmetic surgery, including facelifts, which take 15 hours; or liposuction, which can be learnt in a four-hour online course followed by a hands-on training session.
‘Is it wrong that all I can think about during my inflight entertainment is how much I’d love to give Lady Gaga neck lipo?’
Dr Daniel Aronov
Over the past 10 months this masthead has received hundreds of emails and calls from patients of cosmetic surgeons living with disfigurement and pain.
These include penis enlargements gone wrong, patients left in excruciating pain, two women who had facelifts by a Melbourne-based cosmetic surgeon who were left disfigured, with one saying, “I look like a monster – and when I texted him for help, he said he is on leave”.
This flood of cases follows an expose into the Daniel Lanzer Clinics last October which uncovered a litany of safety and hygiene issues; and then in June we revealed questionable conduct at the country’s biggest cosmetic procedure network, Cosmos Clinic.
Ten months on, the casualties continue.
Their injuries come from big and small operators, who have been able to exploit gaping holes in the regulatory system to create a new kind of doctor-cum-entrepreneur, driven by profits and brand, not patients’ interests.
Some of the more shocking practices exposed in the latest investigation include nurses performing liposuction on patients (which is illegal), cosmetic surgeries being performed during lockdown (which is a criminal offence), nurses forging doctors’ signatures on scripts or filling pre-signed scripts, doctors performing major surgeries in unregistered facilities (which is potentially illegal) and doctors doing major surgeries in non-dedicated spaces such as side rooms and offices.
The investigation has trawled through thousands of leaked WhatsApp messages between doctors and nurses at the Daniel Lanzer network from 2019 to the end of 2021 and found evidence of damning behaviour.
Prescriptions supposedly signed by Daniel Lanzer showing a range of different signatures.
Lanzer surrendered his medical registration last December and some of the other doctors exposed by this masthead have had conditions imposed on them, but other doctors and nurses about whom we have received multiple complaints are still freely practising on patients.
Audio recordings confirm what people only find out when it is too late – that surgery is trivialised and recovery time is underplayed by doctors to improve their chances of getting more business.
A private recording sent by Lanzer to staff encourages them to lie to patients about the time it takes to recover from major cosmetic surgeries.
“As everyone knows we underplay recovery because people get scared,” Lanzer tells staff.
The recordings give an insight into a “whatever it takes” attitude in the quest for more patients.
Dr Daniel Aronov was hugely popular on TikTok before his videos were removed.Credit: TikTok
In one internal message, Dr Daniel Aronov posts an image of Lady Gaga to a WhatsApp group of up to 65 nurses and doctors and says, “Is it wrong that all I can think about during my inflight entertainment is how much I’d love to give Lady Gaga neck lipo?”
Lanzer replies, “Write to her. Free.”
Aronov fires back, “How do I word it so it’s not outrageously offensive? Hey Lady Gaga. Big fan. Can I call you lady? Just wanted to talk to you about your double chin…”
Other disturbing behaviour includes a video taken of anaesthetist Terrence Palmer using an operating theatre as a performance space, not wearing a mask as he sings opera beside an unconscious patient undergoing liposuction by two Lanzer doctors. Professional standards require masks to be worn during surgery. The video was recorded during COVID-19 lockdown in August 2020, which makes the cavalier attitude even worse.
The same doctor dances and laughs in an internal video as two cosmetic surgeons jig and sing to Dolly Parton’s Jolene as they thrust long stainless-steel cannulas into an unconscious male patient.
Palmer is not a specialist anaesthetist, which requires an extra five years’ training. He has a basic medical degree from the UK but administered general anaesthetics to patients.
When the NSW regulator, the Medical Council, launched an investigation shortly after being contacted by this masthead about his credentials, he surrendered his medical registration, which stopped the regulatory investigation in its tracks. It said should he return to practising “it is highly likely he would be the subject of further council proceedings related to the above circumstances”.
Palmer told this masthead: “I have provided non-specialist anaesthetic services in both public and private institutions since 1986. I do not hold myself out as a specialist anaesthetist, nor do I market my services.”
Cosmetic surgery is a massive growth industry. Facelifts, tummy tucks, BBLs, liposuction and breast implants are estimated to be worth $1.4 billion a year. If you add laser surgery, injectables and non-surgical fat reduction, Australians are forking out more than $6 billion a year, with forecasts that will hit $7.8 billion by 2024.
The sector has been dogged by scandals for decades and has triggered a series of inquiries. Hefty profit margins, low barriers to entry and deficient regulatory oversight have created a lucrative juggernaut, with estimates the sector has doubled in size in the past five years to reach 500,000 cosmetic procedures a year. Australia has become one of the biggest consumers of cosmetic surgery in the world, on a per capita basis.
Nurses, dermal therapists and beauticians are signing up for weekend injector courses for a few thousand dollars. They pay an annual membership fee to get access to GPs who prescribe the drugs remotely. In untrained hands, Botox and cheek filler injections can cause blindness.
As one plastic surgeon said, “No one is stopping nurses from doing this in unsupervised, unhygienic premises.” He cited a necrotic calf wound caused by an unsupervised nurse in a salon doing sclerosant injections into leg veins.
“This is a very dangerous chemical usually used in selective areas by vascular surgeons.”
It took six months to heal and required multiple hospital admissions and left permanent scarring, he said.
Cosmetic cowboys operate with little oversight
- Cosmetic surgery industry is worth $1.4b a year in Australia
- An estimated 500,000 cosmetic surgery procedures a year. There is a lack of official data.
- If you include laser surgery, injectables and non surgical fat reduction, Australians spend more than $6 billion a year
- Hundreds, and possibly thousands, of patients have been maimed, scarred and permanently damaged by botched surgeries. Again, there is no official data.
- 540 patients have joined a class action against Daniel Lanzer cosmetic surgery clinics
- 65 patients have contacted lawyers regarding a class action against Cosmos Clinics
- There is a confusing maze of regulators, state and federal
- Different states have different rules about what is safe
More and more medical graduates are swarming into the space, enrolling in short courses and calling themselves cosmetic surgeons, body sculptors or liposuction specialists.
Social media expert Michael Fraser thinks the problem is far bigger than the regulator realises. “We’re seeing cosmetic surgery centres popping up everywhere. They’re offering cosmetic medicine or cosmetic surgery. They’re going into shopping centres down the strip.”
Companies are popping up offering personalised reports for as little as $100 to tell you what’s wrong with your face and how to get it fixed using artificial intelligence software. It is the latest way to warm up candidates for cosmetic surgery.
“Want to see a different version of yourself? Our experience of faces, Photoshop and A.I. allow us to produce morphs that minimize cosmetic flaws and produce attractive faces,” says online operator Qoves on its website. Qoves has 159,000 TikTok followers and 43,000 Instagram followers.
Lack of data hides extent of problem
The extent of botched surgeries is hard to quantify. There is no national data collection on cosmetic medical and surgical procedures, nor is there a central depository for botched surgeries or deaths.
But botched surgeries and maimed patients aren’t new. They have been happening for decades.
Cynthia Weinstein was a cosmetic surgeon who was reported to the then Medical Practitioners Board of Victoria in 2000 after a series of complaints, including a patient who developed a permanent palsy after surgery and a failure to warn a patient she would be left with a flap of skin that would hang between her thighs.
Weinstein agreed to stop doing liposuction and facelifts after the board found her guilty of serious professional misconduct. In 2003, she pleaded guilty to defrauding Medicare and in 2010 she agreed to surrender her medical licence and stop practising in Australia.
In 2015 the media reported that she was at it again, prompting an investigation by the national regulator AHPRA. In 2016 she was sentenced without a conviction and the business was fined $15,000.
In 2016, in an unrelated incident, a 35-year-old woman died after cosmetic surgery went horribly wrong.
And in 2018, hundreds of women joined a class action against The Cosmetic Institute, alleging botched breast augmentations that left them with health issues. At least one went into cardiac arrest.
Professor of surgery at Melbourne University Mark Ashton says he has a constant stream of people coming to see him for revision surgery.
“Every single week, I see three or four or five patients who have been maimed and harmed by people with limited or basic surgical training,” he said. “These people are seemingly just not interested in looking after the patient.”
Class action launched
Kathryn Emeny, a lawyer at Maddens Lawyers, is spearheading a class action into the Daniel Lanzer cosmetic surgery clinics. It was filed in the Victorian Supreme Court in March and so far 540 patients have signed up, alleging Lanzer and some of his other doctors including Ryan Wells, Daniel Aronov, Daniel Darbyshire and Ali Fallahi, engaged in negligence.
Victorian lawyer Kathryn Emeny and law firm Maddens are leading a class action on behalf of victims. Credit: Nicole Cleary
It also alleges cosmetic surgeries were not undertaken with an appropriate level of care and skill. The doctors are defending the claim. In previous statements, Lanzer has said he had thousands of happy patients and he denied any wrongdoing.
Emeny says it is unprecedented to have such a high level of interest in a class action at a relatively early stage. The action came on the back of the “Cosmetic Cowboys” joint investigation by this masthead and Four Corners 10 months ago.
Since that story aired, hundreds of emails and phone calls have poured in from patients sharing harrowing stories of surgery gone wrong. This masthead has seen multiple photos, videos and medical records of botched abdomens, nipples missing, serious infections and lopsided faces.
Maddens has also received photos, some of which patients shared with us. Many look like the walking wounded, with their lives upended by pain or disfigurement or psychological issues – in some cases permanent.
These include photos of a man who had complications after staples were used on a mini facelift in November 2019. Photos of belly buttons put back in the wrong place, infected abdomens, infected legs, lumps, scarring, burns, and lopsided tummy tucks.
Maddens has also launched an investigation into another big operator, Cosmos Clinics, following the investigation by this masthead and 60 Minutes in June. So far, they have received 65 registrations of interest.
Our June investigation was delayed by three weeks as the Cosmos founder Dr Joseph Ajaka rushed to court after receiving a series of questions before publication. The story was held up for three weeks, in which time two patients ended up in hospital in Sydney after serious infections post-surgery.
After the Court of Appeal threw out Ajaka’s claim and the story appeared, he threatened to sue for defamation but did not go through with the threat.
At the time Cosmos said in a statement that “patient safety informs everything that we do.”
Emeny believes the Lanzer class action and the investigation into a Cosmos class action have unleashed a groundswell of suffering.
“People are coming out of the woodwork. We’re receiving inquiries from patients who have concerns about other cosmetic surgeries, and they’re both big and small operators, they’re located across Australia.”
A retired soldier had a horrendous experience when he underwent cosmetic surgery.Credit: 60 Minutes
‘I was thinking I was going to die’
An elite retired soldier, who asked for his identity to be protected for security reasons, has joined the Lanzer class action after undergoing gynecomastia, or the reduction of man boobs, and liposuction of the abdomen in Brisbane by Dr Ryan Wells.
The military man said after the first surgery his right nipple fell off. He says he was told nipples grow back – but it didn’t.
Several months went by and in March 2021, Wells suggested revision surgery of the patient’s abdomen. This time a nurse without supervision performed liposuction for up to 15 minutes, the soldier says, which is illegal. When Wells took over he performed an abdominoplasty, or tummy tuck, cutting a 30 centimetre line from one side to the other.
‘I could feel myself losing thoughts and consciousness through the day with the amount of blood I’d lost .... but they weren’t letting on how bad it was.’
Former elite soldier
“Instead of using the liposuction on my abdomen, he actually cut me to the groin,” the soldier said. “I didn’t know that was going to happen.”
He went home and started to bleed. When he went back the next morning Wells told him he would need to open him up again. “He said, ‘I’m sorry but there might be some blood vessels that we need to cauterise that I’ve missed’.”
The patient spent more than 10 hours in the clinic before he was operated on.
“I could feel myself losing thoughts and consciousness through the day with the amount of blood I’d lost,” he says. “But they weren’t letting on how bad it was.
“I was thinking I was going to die. I actually said before he cut me open that second time, ‘Please don’t kill me’.
“I remember Wells telling me that he was concerned about the level of blood loss but wouldn’t call an ambulance because he didn’t want other doctors ‘messing up his work’.”
The elite soldier had to be cut open again and was given a green whistle to manage the pain. A green whistle is an analgesic used to relieve pain, and its associated website says it is used by sports clubs, lifesavers and ambulance paramedics for situations where “fast-acting and uncomplicated relief is needed”. An abdominoplasty does not fit that description.
After the surgery, Wells moved the soldier in a wheelchair to a nearby motor inn, where he stayed overnight. “I couldn’t stand or urinate, it was a nightmare,” he says.
Emeny describes this level of aftercare as astounding. “An ambulance isn’t called. He’s checked in at a motor inn down the road and Wells books the room next door to stay overnight. It is the script of a horror movie.
“This is a patient who came in otherwise fit and healthy, and he left wheelchair bound and on orders to remain on bed rest for an indefinite period.”
The elite soldier is still recovering from the ordeal. “You think the defence force treats you bad but, I tell you what, this is the next level,” he says.
Wells was suspended in June this year, five weeks after 60 Minutes uncovered some shocking practices including doing major surgeries such as gynecomastia at an unregistered facility, which is potentially illegal, nurses backdating audits by up to a year, hygiene and safety issues and the removal of 12 litres of fat and fluids from a liposuction patient in one procedure, twice the amount considered safe.
After his suspension, Wells told his patients: “The board has chosen to suspend me from practice whilst the investigation is ongoing. This will also allow me the time to put forward my response.”
The elite soldier is shocked the regulator took so long to act. “I couldn’t believe that he was still practising months after Daniel Lanzer retired,” he says. “Shocking that all the clinics weren’t just shut down and looked into in one big hit, rather than in dribs and drabs.“
Margaret Faux, a health regulation expert who has worked in the industry for 40 years, says Wells’ suspension should have happened the day after the 60 Minutes aired in June.
“It took five weeks for AHPRA to say, ’Oh actually, we’re going to suspend his registration because we’ve decided five weeks later, he’s a danger to the public. After that episode, they should have been making decisions the next day.”
Registered nurse Justin Nixon, who worked at the Lanzer clinics and blew the whistle 10 months ago on the dark side of cosmetic surgery, isn’t surprised at the lack of action.
“I’ve had to organise for the nurses to get in contact with the regulators. It seems they don’t want to pick up the phone,” he says.
Spying on a patient
For patients of poor cosmetic surgery, it is hard to find a suitable avenue when things go wrong. The facts are often buried by heavy-handed legal tactics such as sending unhappy patients threatening legal letters, writs or gag orders in return for refunds.
Or, in the case of one of Adam Najem’s patients, Belinda, which isn’t her real name, a private detective was hired to spy on her, her family, friends and workplace.
Belinda had liposuction and a BBL that she says left her in pain and scarred. She wrote to the regulators, who did little, then posted a negative review online, which sparked legal threats – and then the offer of $10,000 to remove the review.
A file was compiled of her movements over a three-week period in 2019, including photos of her mother in nightwear, her partner, references to where she eats, photos taken in an underground car park near her work and a visit to the supermarket. This surveillance was apparently to try to disprove her injury claim.
“I was left traumatised, depressed. It was the worst experience of my life,” she says. “I still don’t know why he had me followed, maybe trying to get dirt or something? I don’t know.”
Another patient, 19-year-old Kate, who asked for her identity to be protected for privacy reasons, underwent liposuction with Najem in October 2020 and says she was left with major burn marks on her abdomen.
“I just felt like my skin was ripping. He was burning me. I was screaming, and he did not do anything,” she says of the procedure.
“I felt like a piece of meat. “He just did not care at all. He just wanted to get it done and that’s it.”
When she reported Najem to the regulator, he was informed of the complaint and refused to complete her aftercare.
“He received the complaint, and he basically kicked me out. He was like, ‘I’m not taking care of you anymore. How dare you write a complaint about me’.”
Najem has a history of patient complaints. Liverpool Hospital reported him to the Health Care Complaints Commission and the Medical Council of NSW after a 24-year-old patient arrived in septic shock in June 2018.
The hospital’s internal interview notes with the patient and internal correspondence include an email outlining key concerns. One of the worrying issues expressed in a June 14, 2018, email between senior staff, “is that the patient was allegedly advised by Najem not to present to a hospital, but was in septic shock on arrival at Liverpool Hospital.”
In 2019 Najem had conditions placed on his medical registration, including that he couldn’t do fat transfers except for 50 millilitres or less.
Najem was contacted for comment but did not respond.
In February 2022, the regulator issued a new set of restrictions which included banning him from doing BBLs. It said he could not undertake procedures as the primary surgeon except liposuction procedures and procedures that can be done in an outpatient setting under local anaesthetic in consulting rooms.
For at least three patients, including Kate, Belinda who was spied on, and the 24-year-old who almost died from septic shock, and others, the regulator’s sanctions aren’t enough.
“I was only meant to get lipo, but he convinced me to get a BBL as he said my body would be out of proportion… My body is still disproportionate, and I am in pain,” one says. “Where’s the justice?”
With Klaus Toft
Part 2 on Tuesday: How the regulator is failing
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