She Went In For a Mommy Makeover And Never Came Home

Dr. Chang (00:04):
You are listening to Secret Services where we discuss the procedures nobody admits to, but everyone's curious about. I'm your host, Dr. Christopher Chang. Okay. We're back with another episode of Secret Services. I'm Dr. Chang.

Jackie (00:20):
And I'm Jackie. Welcome.

Dr. Chang (00:21):
Welcome back. So a lot been going on in plastic surgery lately, Jackie.

Jackie (00:27):
A lot.

Dr. Chang (00:28):
So I was hearing one of the things that was blowing up lately in terms of the news was an incident where someone had a bad outcome, unfortunately, in Ohio. So we don't usually open like this with bad news, but we're going to start with a name. And her name is Rachel Tussey. She was a 47-year-old mother of three from Ohio and she spent weeks leading up to her surgery on TikTok and we've talked a lot about influencers on the show and in our practice. But she was sort of talking about her upcoming surgery. She was excited preparing and asking for advice from other women who had done it. And she went in on February 25th and unfortunately never came home.

Jackie (01:14):
On February 25th, 2026, she had been documenting her journey online in the weeks leading up to the operation.

Dr. Chang (01:22):
So Jackie, have you heard this story?

Jackie (01:24):
So interestingly enough, I'm on TikTok a lot, but the first time I heard about this story was from a patient. I call all of our patients before their surgeries and one of our patients brought it up and asked about what safety measures we have here and started telling me about the story. And I was like, hold on, this is nuts. So then obviously I got on TikTok and started looking it up. My first thought I guess was just we need to know everything. We need to know all these details. But my biggest question was her medical history. I was curious, did she have anything going on or was she just a completely healthy young woman?

Dr. Chang (02:11):
Yeah. What she was asking for is pretty common.

Jackie (02:15):
Very common.

Dr. Chang (02:16):
Right. Mommy makeover.

Jackie (02:16):
47.

Dr. Chang (02:18):
Right?

Jackie (02:19):
I mean-

Dr. Chang (02:19):
Probably pretty healthy, at least in that age group. Yeah. I think patients actually are usually the first ones to bring up some of these things that come up because they're already searching for things and their algorithm starts pushing these stories toward them. And certainly patients that have surgery coming up are really tuned into what's happening. They're asking a lot of questions.

Jackie (02:39):
I think that her first initial question was, is the surgeon, is he going to leave as soon as the surgery's over? So I think that was one of the-

Dr. Chang (02:50):
The answer to that question is no in our practice.

Jackie (02:52):
Yeah, correct. We always stay in the building. So I think that was a thing. I think that this surgeon had left the facility from what I understand. And again, we don't know every single detail. So were things seemingly fin when he left? I don't know. But as soon as the patient asked that, I was like, "Well, I can assure you 100% that he will not be leaving the building. So if anything were to happen, he would be around." But yeah, my initial thought was just like, was there anything else going on in her medical history or anything that maybe was missed? I don't know.

Dr. Chang (03:32):
Yeah. When we have elective surgery, healthy patients, things that are in our control, we usually think that they're going to go very smoothly perfectly. We don't expect anything to alter the outcome or to have adverse events. That's why when it does happen, it's so unusual and so startling. If this were a gunshot situation or a trauma and you'd say, "Well, yeah, they had devastating injuries. We did our best, but the outcome is not favorable." I think that's a little bit more anticipated given the circumstances, but when somebody goes in for surgery and they're well to start, it is very, very troubling when the outcome is not good and something like that happens. So you're right. So as we dig into the details, on February 25th, Rachel had been documenting her journey for weeks and she was very excited about it. And on February 25th, she went in for the procedure at the Journey Light Surgery Center in Cincinnati with Dr. Tork. Her husband, Jeremy, waited in the parking lot and came back in at 5:45 when the surgery was done and minutes after the doctor left, Rachel became unresponsive. CPR was started. She was transported to Bethesda North where doctors told Jeremy that she had been without oxygen for six minutes and she suffered permanent anoxic brain injury and died on March 17th.

(04:59):
An investigation is ongoing. So he husband was told the surgery went great and the doctor left and a few minutes later she was calling for him and then she wasn't. So naturally people wonder what happened there. The surgeon came out, things went great during the surgery. She's responsive in speaking to her husband, maybe in a little bit of distress or uncomfortable, hard to know why she was calling for her husband and then all of a sudden was nonresponsive.

Jackie (05:30):
So then my brain is going, "Okay, well, what was the recovery room nurse doing? Was he or she at the bedside the whole time? It just seems very shocking to be without oxygen for six minutes, especially six minutes is nuts.

Dr. Chang (05:50):
It's interesting that they would tell the family that from the ER or the trauma, the people receiving at the hospital to say that. That's a very specific thing. Very specific number. And how would they know? It's hard to know. Maybe somewhere in the monitoring and the documentation they note when she had arrested or heart stopped beating or whatever or stopped breathing and then they back calculated it. But it's hard to know, especially because there is a recovery room nurse or personnel with them presumably throughout, like literally at the bedside with them the whole time. When I hear, I assume the family say that, that makes me think that that is a conversation that's been pieced together. That makes me think that when the hospital staff is telling the family, your loved on has devastating brain injury because they have not been receiving oxygen, they're kind of explaining to them the reality of the situation that they have brain injury and they're not going to recover. So I think that statement may have been taken in context of, okay, now we've seen her over the course of several weeks.

(07:05):
She's not showing signs of brain activity. You have to be prepared that this is not a recoverable incident because she did not receive oxygen for a period of time.

Jackie (07:15):
Right, right. That does make sense.

Dr. Chang (07:17):
That statement may have been true, but may have also come at a different time in the counseling of what's happening.

Jackie (07:25):
Yeah. And also from what I read, the surgery center staff is saying that they acted in the appropriate standards of care. But you do wonder, I mean, maybe as soon as they realized she was unresponsive, they immediately started CPR, but right, did the nurse walk away to go get something? Were the alarms turned down on the machines? You have to wonder, did something occur a little unusually for this to happen? Or was it just a freak thing that just occurs?

Dr. Chang (07:57):
Yeah. Certainly surgery, anesthesia, procedures don't have zero risk. So I don't think from the circumstances that I understand, if the surgeon had been there, he could have done anything. It doesn't sound like a surgical problem that, oh, if the surgeon was standing right there at that moment, that would've prevented all of this from happening.

Jackie (08:19):
Right. Also, I think it's important to note too that not only do we have the surgeon in the same building, but we also have the anesthesia provider in the building as well. So that's another detail that I don't know. So the surgeon may have left, but was the anesthesia provider there because in the surgery world, when something goes south, usually the anesthesia provider is the person who's manning the code, kind of running the drill, which I think people outside of this world may not know you default to the anesthesia provider more so than the surgeon itself in those moments.

Dr. Chang (08:58):
I mean, this is super good point. And it's funny to me that people that we talk to are always so scared of anesthesia.

Jackie (09:06):
They are.

Dr. Chang (09:07):
But anesthesia is the greatest. Anesthesia, I mean, they are super duper good. I think the reliability of being able to control the situation, control your breathing, control your heart rate, control your blood pressure allows them to really keep you safe, control your pain so you're not uncomfortable. I mean, it's really the most important and the best part of having a surgical procedure is that you want that control and somebody that's expert and just focusing on that.

Jackie (09:38):
Right. Yeah. That's their only goal. Anesthesia is great. That one patient, you are constantly being monitored. So yeah, things like that, I do wonder, did a monitor come off or something. It's hard to even fathom something like this happening.

Dr. Chang (09:57):
Well, I will tell you, I saw somebody comment that there was a little bit of a question whether they had given some pain medication because she was uncomfortable and maybe there was a little overdose on the pain medication. So that's certainly possible depending on whether it is a narcotic pain medication or I don't know, lidocaine or something, but there is possibility of getting some toxicity from overdosing of medicine or a medicine that goes in that's supposed to be given in a certain route, either orally or intravenously or whatever gets absorbed too quickly. If there's a big mommy makeover type of a thing, there's always a possibility of having just a large volume of the medicine. They're trying to make you comfortable, but then your body could absorb it or it metabolizes differently in your skin versus in your fat versus in your circulation.

Jackie (10:53):
Right. And of course our goal is always to make the patient comfortable, but I do find it very important, especially with these conversations I have with patients beforehand, at the end of the day, you are still having surgery. So to have zero out of 10 pain is an unreasonable goal. There will still, no matter what, be pain associated with having a surgery. So yeah, maybe they push too much and it's too short of an amount of time possibly.

Dr. Chang (11:30):
Other people may say things like, "Well, what if she was in a hospital?" I mean, more and more plastic surgery and cosmetic surgery is done in an office-based setting or an outpatient surgical center. So what do you think about that?

Jackie (11:44):
So I think the only difference, I think there may be more hands around in a hospital of course. However, in a recovery room, whether you're in a surgery center or a hospital, you're one-on-one, you have one nurse with the patient, you have the anesthesia provider around, everyone is ACLS certified, you have an AED, you have all of the lifesaving medications. So I think regardless, you have the same tools at hand in the moment. I think in a situation like that, quick responsiveness from the team is really important and I think that you can get that in an outpatient setting just as much as you can in a hospital.

Dr. Chang (12:37):
Yeah. I think that it's a double-edged sword. There's certainly a lot of benefits to having a smaller center that's more intimate and focused on patient care and more focused on individual ... Like you go to sleep and you wake up with the same person instead of being like, "Who's this stranger taking care of me? " Or there's less handoffs because there's less shift work. So your story, your care is consistent. Somebody who's been following your heart rate, your blood pressure, your pain level, your medicine, they followed you consistently instead of having to have, "Oh, so- and-so said they gave this medicine at 12, and then I noticed there's less interpreting of the data and the history. They were there for you. " Usually in a smaller setting when the staff and the rosters is a smaller team, they know how things go, they know the routine, there's more nonverbal communication, it just operates smoother.

(13:36):
However, I think that now what I love to operate at the hospital, I did for many, many years, but just the trend of medicine and surgery in America now is pushing all outpatient surgery, not just plastic surgery, to smaller outpatient centers.

Jackie (13:54):
I mean, even total joint replacements now, you used to spend the night in the hospital and then COVID happened and all of a sudden now they're all at outpatient surgery centers going home an hour afterwards.

Dr. Chang (14:06):
I mean, these are huge things where there's a huge amount of sterility, giant space suits, taking out your hip or your joint and popping into prosthetics, big, big surgeries that the whole trend is cost to get patients out quicker and also based on reimbursement. So I think there is a big trend to move everybody outpatient for those reasons and there's benefits for sure, but I think it's just sort of the way that medicine's going that we have to be anticipating. But I agree with you. I don't think from a safety standpoint it would've been necessarily a total game changer. I don't think that's the reason why she had something bad happen.

Jackie (14:49):
Yeah, I would agree.

Dr. Chang (14:50):
The other thing that comes across when I hear this story, a sudden change in the person's consciousness is a clot or an embolism.

Jackie (15:00):
And that's quick and can happen in any setting.

Dr. Chang (15:05):
Yeah. So who's at risk for a collateral embolism in your mind?

Jackie (15:09):
Well, I would say especially in surgeries like this, a mommy makeover, those longer surgeries definitely put you at a higher clotting risk. People who aren't very active if you've had a clot in the past, a lot of medications can also increase your instance of clots. One being hormones, hormone replacement therapy, birth controls. This patient, she was around 47, so we don't know what medications she was on. And of course, each surgery center or surgeon has different protocols of when they ask each person to stop taking these medications before the surgery. So maybe it was something like that. We don't really know.

Dr. Chang (15:54):
For sure. So definitely those risk factors or things that we all compile in terms of compiling an overall risk score. If patients have a history of a clotting disorder, some genetic things-

Jackie (16:07):
Smoking.

Dr. Chang (16:07):
Predispositions, right? Smoking.

Jackie (16:09):
Vaping. We see a lot of vaping recently.

Dr. Chang (16:12):
Absolutely. Activity and BMI and also the type of surgery. Some surgeries are a little bit higher risk. As we're talking about orthopedics, a lot of joint surgeries and people with immobility, they're very, very careful about protecting the patients for clotting risks because that ... And of course, what's the solution if you get a blood clot or an embolism is to anticoagulate and that's essentially you're doing surgery and then you stop the body from clotting and the consequence of that is bleeding, right? So you're constantly weighing these risks and benefits and if you protect the patient by not allowing them to clot as robustly, you have the other side of, "Okay, I made an incision, but now this incision won't stop bleeding and the patient can hemorrhage." So it is a very fine line of how much do I ... Clotting is good in a lot of ideas, it stops you from bleeding out. It stops from ... So clotting is good, but in this instance, it could be a factor that contributed to this.

Jackie (17:29):
It's a delicate, delicate balance. I think just ensuring that you have adequate staff at all times is one of the biggest things that you can do to help prevent things like this. But unfortunately, I mean, the story's everywhere because it is so rare and so crazy to happen. So hopefully we don't see a lot of stories like this popping up, but like we said, a lot of things are moving to outpatient and we don't hear a lot of these stories, thank God. So I think for me, that would be the biggest thing, just proper staffing.

Dr. Chang (18:02):
Yeah. And he's, from what I understand, a very well qualified surgeon, been in practice for a while, well respected in the community and in the city and is board certified as well. And so it doesn't mean necessarily he did something wrong or something was malpractice. And that's why this case is going to be litigated or investigated. Of course it should be, but I think that it's one of those things where even what we do is risky, inherently risky. And even though you do the right things and you follow all the guidelines, you can have complications. So it's very important that you have people who are prepared for complications, people who understand the risks and do everything they can to anticipate and prevent ahead of time. That's my biggest thing with plastic surgery. I always say we are the specialty of problems, complications, and how to deal with them.

(19:00):
And I mean that for the listeners out there, when other surgeons have a problem and they need help, a lot of times a plastic surgical solution is the way to get the help. So if they have a problem where the wound that they've created doesn't heal, let's say they made an incision and whatever they did below the incision went well, but the skin really won't heal and they have an exposure and they need to make sure that it gets covered, they'll call the plastic surgeon to deal with it. They may think the skin would heal normally, but it didn't. So that became a complication that the plastic surgeons would have to reconstruct or something like that, or somebody who had some other adverse event and they needed some coverage to help the body continue to heal. So usually a plastic surgeon is dealing with complications.

(19:47):
And so the way that we think about things is how to anticipate what could happen down the line and how to prevent that or what's your solution going to be later on. And so hopefully all the surgeons out there are thinking that way about their patients, how to reduce the risk of a complication before it happens. I think that keeps a lot of people out of trouble if you have that foresight. Yeah, it's terrible. It's stressful for everybody. It's horrible. And as we said before, we all want it to go smoothly. We want everybody to heal well, have a great outcome, go home and celebrate how happy she should have been on her TikTok page and all that sort of stuff. So a downer of a story really, but hopefully one where everybody can look and we'll have to see what happens.

Jackie (20:35):
Yeah. We'll have to follow up because I believe the surgeon is suing the surgery center.

Dr. Chang (20:42):
Oh yeah, yeah, yeah. I saw something like that, right? So the surgeon now is also involved kind of blaming the surgery center for what happened. So there's going to be a little round robin of who was at fault and of course they would all be happier if everything had worked out. So we'll see what happens, whether something happened at the surgery center. So we'll have to update you.

Jackie (21:06):
Yeah, we'll follow up as soon as we find out.

Dr. Chang (21:08):
But for now we'll have to leave it there and get back to you next week.

Jackie (21:14):
Leave some comments what you guys think about this. I know it was shocking for everyone to watch on TikTok, so we'd love to hear your thoughts. So leave us a comment and then don't forget to like, follow, subscribe.

Dr. Chang (21:28):
All right.

Jackie (21:28):
Thank you guys.

Dr. Chang (21:29):
Take care. Thanks for listening to Secret Services, the podcast where we see everything and say nothing except right here. I'm Dr. Christopher Chang, double board certified plastic surgeon located in Tysons, Virginia. Follow us on TikTok @CongressionalPsurgery or on Instagram @congressionalplasticsurgery. To send us a classified message or to hear more episodes, go to secretservicespodcast.com. Links to everything we talked about on today's show are available in the show notes. Oops, patient's here. We got to go.