An investigation into cosmetic surgery chains by KFF Health News and NBC News has prompted consumer warnings from industry groups representing plastic surgeons and a call for more transparency around physician disciplinary actions in California.
The American Society of Plastic Surgeons, which represents 12,000 doctors, is now warning patients to “do their homework” before getting liposuction, a Brazilian butt lift, a “mommy makeover” or other cosmetic procedures.
“Plastic surgery is real surgery with real risks, and the risk of complications is never zero,” said Scott Hollenbeck, the immediate past president of the plastic surgeons group.
And in an exclusive interview, TJ Watkins, a member of California’s medical licensing board, called for greater transparency in the secretive process for disciplining physicians, saying the board should alert the public about doctors under investigation for alleged misconduct.
Hollenbeck and Watkins were reacting to the news outlets’ series, which examined allegations of disfiguring injuries or even deaths tied to cosmetic surgeries.
One story revealed that three patients of California plastic surgeon Heidi Regenass died within a few months after liposuction and fat transfer operations, according to medical malpractice lawsuits filed in California courts.
A complaint to the medical board from a patient’s daughter triggered an internal board review of the surgeon, but the public will hear nothing until the investigation is concluded, which can take years.
“If you were really protecting the patients, there would be a notice right now that says this doctor is being investigated,” said Watkins, one of seven nonphysicians appointed to the California medical board to represent consumers.
Regenass, a board-certified plastic surgeon, did not respond to numerous requests for comment on the patient deaths. In response to medical malpractice lawsuits filed by families of the three women, she has denied any negligence or that her actions caused any deaths. One case was settled in 2024, while the two others are pending in California courts.
On Feb. 9, the California medical board filed an administrative complaint against Regenass unrelated to the three patient deaths. The complaint accuses Regenass of “repeated negligent acts” in caring for a 49-year-old woman who had postsurgical concerns after liposuction on her abdomen and arms and a fat transfer to her buttocks in July 2022. The board alleged that the surgeon “failed to document an appropriate physical examination prior to surgery” and did not keep “adequate and accurate records” of the woman’s care after she was injured. The board requested an administrative hearing on the accusations, though no date has been set.
Lawyers for Regenass didn’t respond to a request for comment on the new complaint.
Some patient lawsuits have accused cosmetic surgery companies of hiring doctors who lacked adequate training or had troubled pasts, and of using high-pressure sales tactics and misleading advertising pitches that downplay safety risks, federal and state court records show. The companies dispute these allegations and have won dismissal of some suits. Other cases have been settled under confidential terms, although a Georgia judge late last year awarded $52 million to the family of a woman who died after liposuction and a Brazilian butt lift.
Christopher Nuland, an attorney and lobbyist for the Florida Society of Plastic Surgeons, said that the investigation “underscores the need for vigilance from all parties.”
“There is an opportunity for better legislation, such as regulating post-surgical recovery centers and better enforcement of existing laws,” he said in an email. “But patients need to take an active part by ensuring that they are seeing a board-certified plastic surgeon in an accredited facility and that neither has a history of bad outcomes.”
Nuland said his group supports a bill pending in the Florida Legislature that would require licenses and set quality standards for recovery houses where patients often stay to recuperate for a few days after cosmetic surgery. Florida officials have struggled for years to regulate unlicensed facilities that often charge patients hundreds of dollars per night, though they may lack adequate medical staffing.
Cosmetic surgery companies, some financed by private equity investors, are competing in a growing U.S. body-contouring market in which patients are charged up to $20,000 out of pocket, or on credit, for these procedures. Ads promise life-changing body reshaping techniques with minimal risk and quick recovery times.
As the cosmetic surgery companies have grown, there’s been little regulatory oversight. There’s no federal public database to assist patients in tracking these companies’ safety records, their staffing standards or how commonly patients suffer severe complications. And complaints to medical boards about surgeons or other doctors can remain under wraps for years.
Ste’Aira Ballard, whose mother, Tamala Smith, is one of the three Regenass patients who died, filed a complaint with the California Medical Board in early 2025. Smith died in 2023.