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On March 15, 2005, 42-year-old Kathleen Cregan told her husband and two young sons that she would be taking a business course in Dublin for a few days. She kissed them goodbye, left their home in rural Ireland, and boarded a plane to New York City. There, she would have a full-facelift performed by Dr. Michael E. Sachs in his offices on Central Park South.

Months before, after reading about Dr. Sachs' prowess in physical transformation in The Sunday Independent of Ireland, she contacted his office, took out a loan, and set the date. It was to be a surprise for her husband. Mrs. Cregan left her home at 6am and was in surgery by 6pm that evening. Soon after the procedure she went into cardiac arrest and was rushed to the hospital. Two days later she died from complications associated with her surgery.

Three years earlier, the morning after my senior prom, my mother took me for a consultation with Dr. Sachs. I'd hated my nose since I was a child. It resembled a parrot's beak, one that warranted ornithological study. Because I came from a long line of people with avian features, my cousins, aunts, uncles, and even my mother had gone under the knife for everything from rhinoplasty to ear pinning and eye lifts. It seemed fair that I be next in line. After a long conversation with my parents, they agreed to get me rhinoplasty for graduation.

Dr. Sachs seemed like the ideal plastic surgeon. My mother had heard about him through friends. He specialized in young patients, many of who lived abroad and traveled to New York for his services. We were living in London at the time. My mother contacted his office, and we were sent packets of literature and a promotional video, highlighting Dr. Sachs' appearances on "The Today Show" and "Good Morning America." In the video, he was all smiles and seemingly hard facts. Alternately kind and cocksure, he acted like a detective from "Law and Order", comforting worried patients as they drifted to sleep with noses like mine and then again when they awoke, fully transformed, with only a bandage covering their newfound perfection. He had articles published on him in all of the top magazines, including Elle, Harpers Bazaar, W, and Vogue. Apparently, the rhinoplasty that Dr.Sachs performed was less painful and dangerous than the rhinoplasty that my mother experienced. There would be no bone cracking, just a simple incision inside the nose, and a shaving down of the cartilage.

"It's nice to meet you Alee. Now, let's see what we've got here," he said at our initial consultation, which was in a posh London hotel suite. He'd flown there to hold appointments with several other young adults. Although the setting felt somewhat unorthodox, I was relaxed. I sat on the couch next to my mother and he sat on the coffee table in front of us. Turning my face to the side, he had me hold up a hand mirror. Then, with a piece of paper, he covered the bump on my nose. "The front view of your nose is perfect," he said. "It's just the bump that has to go. It can be shaved down in under fifteen minutes." I smiled at the reflection of my future profile. Dr. Sachs crossed the room, sat in an arm-chair and told me what I could expect after the surgery. He talked about increased confidence and new motivation. He pulled out a portfolio of cards he'd received from elated patients, thanking him for changing their lives. Finally, someone was looking at me and being honest about what they saw: something that needed to and could be fixed. With my mother's approval, I scheduled an appointment in New York, where the surgery would take place three months from the day of my consultation.

The morning of my surgery, I was a mess of nerves and excitement. Dr. Sachs' Central Park office was clinical but relaxed. The building's lobby was made of a subdued marble, and the elevator was sterile, smelling faintly of cleaning supplies. As we walked through the door of the office I was greeted by a receptionist who sat behind a long white counter; couches lined the room and a coffee table held scrap books filled with thank you cards like the ones he had shown me in London. The staff roamed the floor in blue scrubs; there were three nurses and an anesthesiologist. Dr.Sachs stood in a crisp white jacket at the door holding a clipboard. "Alee!" He smiled. "Let's get you started."

First I was taken into a consultation room where I spoke with the anesthesiologist. He gave me a bunch of pills, and I drifted into a glorious haze. In my mind, it was a short and simple procedure. After the pills I went directly into the operating room, they gave me a shot, I went to sleep, and woke up soon after with the bandaged button nose of my dreams.

In actuality, my experience was very different. According to my mother, who clutched my hand through the entire ordeal, after I was given the oral anesthetic my surgery was pushed back for a total of five hours. When it was finally over, I was rolled out the door in a wheel chair wearing a bandage that looked like a piece of a gymnastics mat on my face. There was no recovery time in the office, no monitoring of meds, no waiting for the anesthesia to wear off. I was simply lifted off of the table, wheeled out to a car and sent home to our new house in Connecticut. Although a nurse escorted my mother and me outside, there was little post-operative direction other than to keep the bandage dry and drink grapefruit juice to stave off bruising. My mother kept asking the nurses if I should stay at the office longer, but they assured her that it was safe for me to leave. My mother told me later that she was worried because blood trickled from my bandaged nostril and I kept talking about my trip to Bermuda -I've never been. To her it felt as though, since we'd already gone through with and paid for the surgery, it didn't matter how they treated me.

The bandage was removed a week later in the same office where the surgery took place. The swelling was still so bad that I could barely recognize myself in the mirror. Still, I was happy to be rid of my beak. Within five months my nose had healed perfectly. I was happy. I felt lucky. It wasn't until three years later that I realized just how lucky I was.

Following the death of Mrs.Cregan, a New York Times article revealed that Dr. Sachs is among the most sued doctors in New York State, having settled 33 malpractice suits since 1995. In 2004, the State Health Department banned Dr. Sachs - an ear, nose and throat specialist - from performing complex nasal surgeries without the supervision of another surgeon. The operating room in his office was not accredited. And while he stated on his Web site that he has been affiliated with the New York Eye and Ear Infirmary "for the last 23 years," he was not affiliated with that hospital or any other.

Like me, Mrs. Cregan was swayed into surgery by glowing media accounts of Dr. Sachs' work. Like me, she'd met him only once before surgery, also in a hotel room. My surgery, like Kathleen's, therefore had taken place in a non-accredited office. After learning this, I called Dr. Sachs' office over a dozen times, leaving messages and hoping for some sort of explanation. I never received a call back. My father was upset, and my mother swore that looking back on it, she wasn't surprised. Against her better judgment, she'd bitten her tongue.

Although I'm still angry with Dr. Sachs for placing me in an unnecessarily life threatening situation, it was ignorant of my parents and me not to have completed a background check on him. We'd never considered the possibility that someone who'd been on the "Today Show" could be less than credible. His presentation of before and after pictures, seemingly endless array of thank you notes and press coverage, as well as his list of celebrity clients gave us a false sense of security that we now deeply regret.

When planning to undergo plastic surgery, you should take extensive measures to check a doctor's references, no matter how much excellent or ample the word of mouth references. There are great online resources including www.plasticsurgeryportal.com, a website designed to help you locate and research surgeons before you make a decision. As futile as it may sound, it's also never a bad idea to check Google for other tidbits. Simply type in your prospective surgeon's name along with "death or malpractice." Make sure that the surgeon is board certified, and if the doctor is performing surgeries in an office suite, instead of a hospital, be sure that the office is accredited.


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