Plastic Surgeons Report Effects of Post-Hurricane IV Fluid Shortage

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This year’s hurricane season has been one of the worst on record, causing up to $200 billion in damage and claiming more than 100 lives (so far). Hurricanes Harvey, Irma, Jose, and Maria have influenced tons of industries — including beauty, with brands and influencers stepping up to mobilize their fans to do something to help. But the hurricanes, especially Maria, are directly affecting the aesthetics industry in another way: They’ve led to a national shortage of IV fluid, which is needed for any cosmetic procedure that requires general anesthesia — from face-lifts to breast augmentation to liposuction.

Here’s what happened: When Hurricane Maria hit Puerto Rico last month and devastated the island, the storm also severely impacted facilities there, such as Baxter International, where critical medical supplies, including IV fluid, are produced, CBS News and others reported. As a result of the manufacturing disruptions, suppliers are reporting a deficit in fluid that’s driving up prices. “It’s sort of like an Uber surge pricing for IV fluids,” explains Darren Smith, a plastic surgeon based in New York City.

“We are in a critical shortage,” David Rapaport, a plastic surgeon and director of Coolspa in New York City, tells Allure. According to the FDA, the United States is currently experiencing a shortage of IV fluid (Sodium Chloride 0.9 percent injection bags, if you want to get technical) that’s likely to last through the beginning of 2018.

That shortage is impacting all kinds of medical procedures — not just cosmetic ones. While plastic surgery centers have much more scheduling flexibility, hospitals and other surgery centers often do not — and they are heavily dependent on IV fluid. The factory shutdowns are compromising other vital medical products, too. According to a statement by the FDA, the supply of over 40 “pharmaceutical and biological drug products” has been compromised by the hurricanes.

To be clear, this deficit isn’t a life-or-death situation — at least not yet. “Hospitals have IV fluid,” says Rapaport. “What’s happening is practices like us that do cosmetic things — we’re not hospitals, we work out of our accredited operating room — we can’t get IV fluid. We are scrambling.” Rapaport says a case of IV fluid, which contains 12 liters, usually retails for about $100, but in order to continue cosmetic procedures during the shortage, they’re paying up to $400 per case. Hospitals, meanwhile, are larger and higher on the list of priorities so, while The New York Times reports that even they are feeling the strain of the shortage, they often have more resources to scrap together the IV fluids needed to continue running smoothly.

IV fluid is vital, whether you’re going under the knife for a major procedure, like a face-lift, or a quick round of in-office liposuction. “Specifically, every procedure that requires or gets any form of IV anesthesia needs IV fluid,” explains Rapaport. In other words, any procedure you’re knocked out for relies on a healthy supply of IV fluid to deliver drugs.

Liposuction is particularly dependent on IV fluid, as many procedures use it to help flush out treatment areas (called the tumescent technique), he adds. “A typical liposuction might easily use four or five bags of IV fluid,” says Rapaport. “We absolutely could be looking at a situation where we’ll have to cancel liposuction surgeries or other surgeries if we don’t have IV fluid because that is literally the lifeline for delivering anesthesia.”

Of course, no surgeon is going to perform a procedure without the proper supplies, says Smith, and it is certainly not a “life or death” matter. However, the shortage has led to scheduling conflicts. “If this problem continues unabated, some facilities may start canceling patients,” says Rapaport. It’s also important to note that elective procedures don’t just include minor cosmetic services — they can also entail procedures like elective reconstructive surgery that, while it may not be deemed medically necessary, can dramatically improve someone’s life.

During our conversation, both Smith and Rapaport stressed just how many plastic surgeons are struggling to stay afloat during the shortage. “It’s not sustainable the way that it is right now,” says Smith. The surgeons explain they only have enough supply to last them a week — then it will be back to calling in favors and sharing amongst other practices. “We are dealing with the crisis really hour by hour in terms of trying to find IV fluid,” says Rapaport. “And that’s how thousands of plastic surgeons and other ambulatory surgical facilities are functioning all throughout the United States right now.”

The surgeons we spoke to said they have not be able to get any information from their suppliers on when they can expect IV fluid to start flowing again. We reached out to three major suppliers (Henry Schein Medical, B. Braun Medical Inc., and Baxter International) and have yet to hear back. According to the FDA and a statement made by the company, Baxter is reporting very limited quantities of a few types of IV bags right now. B. Braun estimates the shortage will end sometime in first quarter of 2018, per the FDA.

So, what should you do if you’re planning on getting a cosmetic procedure before then? “Nobody’s going to operate on someone and in the middle of surgery say, ‘Oh my God. We don’t have IV fluid,’” says Rapaport. But to prevent any last-minute snags, he suggests calling your doctor to double-check that they have enough IV fluid on hand the week of your procedure.

If you were hoping to schedule a non-elective procedure before the holiday season but don’t have anything on the books, you might want to hold off. As long as there’s a shortage, hospitals, and non-voluntary procedures will continue (rightly) getting first pick of the supplies. So for elective cosmetic procedures, talk to your surgeon to see if they anticipate having enough fluid through the end of the year.

To donate to Hurricane Maria recovery efforts, head over to hispanicfederation.org.


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