Exploitation of cosmetic surgery industry for Botox, facelifts revealed

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The consequences can be devastating. For Janine Kepert, it was a decision that changed her life. “He was amputated. I cut everything,” she said.

In 2018, Kepert underwent breast reduction surgery and labiaplasty after consulting NorthEast Plastic Surgery in Melbourne for breast reduction surgery due to neck and back pain.

During the consultation, she was asked if there was “anything else” she was interested in.

“I had lip inflammation and asked them to take a look at it. They also tried to convince me to do a tummy tuck. I think the term they used was ‘mom makeover’,” said the single mother of two children.

“It’s the cosmetics industry… You go into one thing and they tell you there are other problems that don’t exist. But you walk away from there thinking, “I need this mummy makeover.”

She said she was told that the more procedures she had, the more discount she would get.

She agreed to breast reduction and labiaplasty, saying labiaplasty was described as a “minor procedure” to remove a small amount of tissue from the labia.

She ended up with almost all of her external genitalia removed. This left her suffering from incontinence and loss of sexual function, making sex difficult.

She realized that something was seriously wrong immediately after the operation. “I remember going back to another consultation and just sobbing. I was in such distress because of my injury. I was crying in the consulting room and remember they kicked me out so as not to disturb any of the other patients or potential clients in the room.

Kepert sought a second opinion and was told it was one of the worst such injuries he had ever seen. “Everyone who examined me was all horrified,” she said.

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She filed a lawsuit through the law firm Maurice Blackburn and Dr Sugitha Seneviratne was the plastic surgeon named in the proceedings.

As part of the legal process, Kepert was evaluated by a number of independent medical examiners (IMEs), including one who identified incorrect Medicare billing regarding her labiaplasty.

A letter written and filed in the legal proceeding stated that the item number was “intended to address the surgical repair of female genital mutilation or major birth defect…not covered by circumcision of ‘MBS items’.

It said: ‘I doubt Mrs Kepert suffered from any of these conditions.’

Faux reviewed Kepert’s Medicare records and agreed that there had been improper Medicare billing.

“It was especially awful for Janine because her surgery ended up inflicting this precise mutilation on her,” she said.

The legal action included evaluation by an independent medical committee. During this process, Seneviratne vehemently denied any negligence.

In March of this year, the medical panel determined that Kepert suffered a significant permanent injury.

She reached a settlement in August, but wanted to speak out and warn others of the risks.

“This insidious practice takes place under a veil of secrecy (because) injured women are unlikely to come forward due to the intimate and sensitive nature of the injury,” she said. “Female genital surgery should only ever be for medical reasons.”

A spokeswoman for Seneviratne denied that he had engaged in “wrongdoing”.

Questionable cosmetic surgery billing is the latest scandal to hit the industry after an exposure at Dr. Daniel Lanzer’s clinics revealed safety and hygiene concerns and doctors dancing and laughing while shoving long stainless steel cannulas in an unconscious male patient.

Registered nurse Justin Nixon, who once worked in the cosmetic surgery industry, said the industry routinely drains money from Medicare — sometimes illegally.

While working at Lanzer clinics, he said he saw blood work and pathology billed wholesale for cosmetic surgery patients.

“I understand these types of practices are pervasive in the cosmetics space,” Nixon said.

Audio messages obtained from WhatsApp sent to 60 employees across the country and in the Philippines in 2019 discuss Medicare.

In one, in May 2019, Lanzer explains to staff how Medicare is billed and how to use doctors who have worked at the clinic for referrals.

“Medicare is when I claim directly from the government…we do it at the reception and we get the money directly. Medicare is a direct way to claim from the government.

In another staff audio from the same year, he explains how to claim a tummy tuck. “The main thing is that in addition to losing a lot of weight, they must have had resistant rashes on their lower abdomen. If the doctor writes these conditions, I can give the article number. They recover about $700.

Nixon said it was part of the “routine or shtick” of doctors prompting patients to say they had certain conditions, even if they didn’t, so they could claim Medicare.

Faux reviewed the health insurance records of a series of patients at Lanzer clinics and found questionable health insurance billing in nearly all of them. “Most had about $100 pathology, preoperative pathology, some had radiology,” she said.

A comment has been requested from Lanzer.

One patient, a Victorian policewoman, had a tummy tuck in late 2020 purely for cosmetic reasons, but her health insurance records included $600 for a tummy tuck.

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In March 2021, the Medicare watchdog reprimanded a doctor for improperly using Medicare for cosmetic services that he said were not reimbursable under Medicare. He said the practitioner “initiated pathology for screening purposes and did not always follow PBS (pharmaceutical benefit plan) restrictions when prescribing certain antibiotics.”

The practitioner agreed to reimburse Medicare $65,000.

Watch the ABC 7:30 a.m. program on Wednesday, October 19 to find out more.

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