Sarah Duckett tried to keep herself calm as she held her right breast and walked through the doors of a Florida hospital and into the emergency department.
About six weeks had passed since the Army veteran, then 33, had flown from the Tampa area to Columbus for a breast augmentation and in that time, everything had come undone — literally.
Duckett had already fought off a post-operation skin infection. Now the stitching and glue holding her breast implant in place was coming apart, and she feared it was in jeopardy of falling out.
"I was just thinking: 'I asked a doctor to do this to me. My God, maybe I should just chop them off,'" Sarah said. "It was just terrifying. I was scared to death."
Worried, Sarah couldn't help but wonder if her plastic surgeon, Dr. Katharine Roxanne Grawe, had botched something during her operation. Unlike most who go under the knife, Sarah had footage of her operation because Dr Roxy" — as her surgeon was more commonly known — had posted video of her procedure on Snapchat and possibly other social media platforms.
As she watched video from her surgery, Sarah noticed Grawe looking at the camera instead of what she was doing during the one-hour operation.
With Grawe more focused on filming the breast augmentation than the surgery itself, Sarah said it made sense that she was suffering from something called wound dehiscence — the separation of wound edges due to improper healing.
Just before heading to the hospital, Sarah said she was changing the dressing on her surgical wounds when the incision on her right breast opened and began spitting fluid.
Read More:Former Dr. Roxy patients say she hurt them years before she was TikTok famous
It stunned both Sarah and her husband, Kerby Duckett, who are both former Army medics. Knowing something was terribly wrong, Kerby insisted he take his wife immediately to the hospital.
"(When) the locals got injured overseas or something, we would give medical aid," Kerby said. "I've seen a lot of crazy stuff ... and when I saw that, I'm like ... that reminds me of this dude's leg that was sewn together with fishing line."
Luckily, Sarah's breast implant didn't fall out before she got to the hospital. Doctors gave her antibiotics and wraps for her wound and she and her husband went home.
Sarah's breast augmentation was one of an estimated 1,100 procedures Grawe performed in 2021, according to records from the State Medical Board of Ohio. On average, a plastic surgeon performs around 320 procedures a year, according to The American Society for Aesthetic Plastic Surgery.
Sarah had no way of knowing due to confidentiality laws, but her suspicions about Grawe were correct.
The doctor had already been warned at least twice by the state medical board. The first time was in October 2018 over concerns about patient privacy due to her use of social media. The second time was in September 2021, for her social media use and surgeries requiring revisions due to "avoidable complications."
Fourteen months after Sarah's September 2021 surgery, the state medical board suspended Grawe's license to practice in Ohio in November 2022. Grawe's medical license was permanently revoked July 12.
When reached by phone Thursday, Grawe immediately ended the call. Neither she nor her attorney responded to multiple requests to comment for this story.
In the July medical board meeting, Grawe pleaded with the board not to take her medical license for good. The punishment she received was harsher than anything she thought she could have faced, and it took a toll on her marriage and her kids, she told board members.
"This has been the most humbling experience of my entire life," Grawe said. "And just like you would give a chance to somebody who's a recovering addict, to have one more chance to prove that they can change ... I can do that too."
Dr. Roxy filmed surgeries as far back as 2014
By the time Sarah had her breast augmentation in September 2021, she said she'd been watching Grawe's videos on social media for roughly two years.
But Grawe, who had achieved internet fame with hundreds of thousands of followers by the time Sarah found her, had used social media to promote her work since 2010, according to medical board records. Grawe told the medical board she'd been taking videos of procedures since around 2014.
Although most of Grawe's social media has since been scrubbed or made private, a Dispatch review of her still-public Instagram account uncovered videos from the operating room as far back as 2016.
The earliest Instagram video from the operating room in April 2016 shows the doctor conducting a hair transplant. In another video from November 2016 Grawe lifted an undistinguishable portion of a patient's body on the operating table to better show viewers as she spoke about performing liposuction.
"This is what it looks like on the inside when you do liposuction. There's all this fibrous tissue in between, but all the fat cells are gone," Grawe said while motioning to a patient in the November 2016 video.
It's not all that uncommon for doctors and other medical professionals to use social media to promote their practices, said Dr. Smita Ramanadham, a New Jersey-based plastic surgeon.
Ramanadham said she uses social media to try to educate her patients about procedures.
But she described her use of social media as more conservative than Grawe's. Ramanadham had seen videos from Grawe in the past and said filming in the operating room wasn't something she'd consider doing herself.
"It's important for ... my patient to have 100% of my attention, my focus," she said. "I also don't want to prolong the procedure. ... So the longer you keep on stopping and taking video ... that's more time the patient's under anesthesia."
Read More:Timeline: How Dr. Roxy's career imploded after she became a TikTok star
Appropriate use of social media is something Dr. Mark Morocco warns his students about at the University of California in Los Angeles.
Morocco, a professor of emergency medicine, has consulted on reality TV shows and hit dramas such as "ER." He also studies the intersection of medicine and popular culture, he said.
While Grawe may be the latest doctor to get in trouble for the way she used social media, she wasn't the first and won't be the last, he said. If Grawe had fully understood what she was doing with her social media, Morocco said she probably could have avoided her own downfall.
"Dr. Roxy kind of tripped over it," Morocco said. " But I think there were places where she could have ... made it on an off-ramp. ... if she had been a little bit more aware of the power of this thing."
Attorney: If mother of 3 didn't call 911, 'she'd be dead today'
The medical board cited the outcomes of three patients in making its case against Grawe.
One was a patient who underwent a breast augmentation by Grawe in December 2021 and developed an infection that required her breast implants to be removed, according to medical board records.
Another patient the board cited suffered from a perforated bowel while her procedure was being broadcast on social media in March 2022. In a letter to Grawe, the board noted the social media broadcast may have led to the complication by distracting the doctor as she performed liposuction.
A third patient suffered from multiple punctures to her bowel and had to have part of her bowel removed after undergoing liposuction, a Brazilian butt lift, hernia repair and a Renuvion J-plasma procedure (which tightens loose skin without the need for surgery) in December 2020, according to the board. The woman, Chasidy DeSantis, filed a malpractice lawsuit in Franklin County Common Pleas Court in December 2021, said her attorney, Jim Arnold.
After her procedures at Roxy Plastic Surgery, DeSantis, then-age 36, was taken to the so-called "Roxy house" — a suburban home in Powell that Grawe used as a place where patients could recover. While there, DeSantis began experiencing massive amounts of abdominal pain, according to medical board records.
DeSantis called 911 from the Roxy house and was taken to OhioHealth Dublin Methodist Hospital, where they found the seven punctures in her bowel and made repairs, Arnold said.
"Had she not had the wherewithal to refuse to accept the nonsense that it was normal, she'd be dead today," leaving behind three young children and a husband, Arnold told The Dispatch.
DeSantis and her family were friends of Arnold, which is how he came to represent her in the malpractice lawsuit filed a year after her operation.
Read More:Dr. Roxy: The Dispatch's coverage of the rise and fall of the TikTok doc
As of early December, there were 14 active lawsuits against Grawe in Franklin County Common Pleas Court, and at least four closed cases. One lawsuit against Grawe in Delaware County, where her practice was located, has also been closed, court records show.
As of 2022, about 31% of physicians reported they had been sued at one point or another during their medical careers, according to the American Medical Association.
DeSantis' court case remains active, and despite some complications, Arnold said she's made nearly a full recovery. Still, Arnold said she now has noticeable abdominal scars from a bowel procedure that she wouldn't have had she not gone to see Grawe.
"The irony is she went to a cosmetic surgeon to improve her appearance and she ended up looking worse off because of what happened," Arnold said.
How Dr. Roxy branded herself a 'girl boss'
While Grawe became known for livestreaming from the operating room, she also used her social media to educate patients and to show herself and her staff dancing around the office.
In her videos, Grawe encouraged followers not too feel bad about wanting to have some work done. She sometimes wore a T-shirt with the words "girl boss" on it.
In disciplinary hearings, she told the medical board that she was passionate about empowering women through plastic surgery. Grawe's brand of feminism was part of what made Sarah want to travel all the way from Florida to Ohio for her breast augmentation.
"What I loved about Dr. Roxy was she was very much your cheerleader," Sarah said. "She was always: 'Go team' and 'check the guilt at the door.'"
Grawe's "girl power" persona was so appealing, that even Melinda Snyder, an assistant attorney general making the case against the doctor for the medical board admitted she wanted to buy into it.
By most accounts, Grawe appeared to be a well-trained plastic surgeon, Snyder said during May hearings on Grawe's medical license. Snyder said she hoped that she'd hear Grawe take responsibility for the patients she had hurt in the medical board hearings.
Instead, Snyder said Grawe's response was to say, "It wasn't me" and to point the finger at other physicians who treated her patients once they developed complications.
"I came into this hearing wanting to believe that Dr. Roxy was every bit as girl power as she markets herself to be, and I wanted to get behind this smart and determined woman who grew her practice from four employees to 20 in 10 years," Snyder said in a May hearing. "I wanted to believe that what I saw in those 4,000 Instagram posts was real. And I wanted her to own her mistakes, and I wanted her to apologize to her patients. ... But that's not what we heard."
On Instagram, one of Grawe's few remaining public social media accounts, she posted something the day her medical license was revoked by the state in July.
She shared an image of someone walking alone on what appear to be sand dunes. Over the image are the words: "You don't always have to tell your story. Time will."
In the comments of the Instagram post, Grawe talked with followers.
She told some that she was spending more time with her kids before she decided what to do next with her career. When she was asked by followers what happened, she replied with just a few words propping up her "girl boss" persona she'd built.
"Witch hunt" and "boys club."
Going from a Dr. Roxy defender to a critic
After Sarah's breast augmentation in September 2021, she traveled from the Tampa area to Columbus twice more to see Grawe.
She saw Grawe for a follow-up appointment in December 2021, during which the doctor told her that her augmentation had healed well.
But Sarah wasn't happy with the results. In July 2022, she underwent a revision surgery by Grawe to fix mistakes and scarring she said she suffered after the first procedure.
After her second procedure, Sarah said she still had one-inch-thick purple scars near her armpits. She called Roxy Plastic Surgery in December 2022 to talk to Grawe about having more work done to fix the scarring.
Sarah said she was told to call back in 2023. When she called in February of this year, she was shocked to hear that Grawe hadn't been practicing for months.
"When this first came out, I actually tried to defend her. I was like: 'We love you, Dr. Roxy,'" Sarah said. "I thought it was just maybe four or five (people). I didn't realize this was as bad as it was."
The more Sarah read the details of the medical board's case against Grawe, the more she came to believe the doctor's mistakes weren't one-offs or simply the everyday risks of having plastic surgery.
For one, Roxy Plastic Surgery didn't have a $300 certificate it needed from the Ohio Department of Health to operate as an ambulatory surgical facility.
Grawe told the medical board that she didn't know she needed the certificate. Failing to get one can result in fines of up to $250,000, according to the state health department.
Eventually Sarah stumbled upon a Facebook support group with more than 2,500 members. She joined it and began reading about stories from several other women who accused Grawe of causing life-altering complications.
Finally, Sarah said she realized there was "one common denominator — Dr. Roxy."
Nearly 18 months after her revision surgery, Sarah said she's still trying to figure out what to do to fix the scarring and other issues she's suffered.
She recently met with a Florida surgeon who specializes in breast reconstruction and was stunned to hear that she may need to have her breast implants removed for several months before the issues can be corrected.
Sarah had originally budgeted $10,000 for her breast augmentation. But when all is said and done, she may end up spending around $30,000 or more for the original surgery and the work she'll have done to fix what she said are Grawe's errors.
Spending money they weren't planning to has meant sacrifices for Sarah and her husband. They didn't go on vacation last year and they probably won't be going on one anytime soon, she said.
While Sarah wishes she could get back the money paid for what she described as two botched procedures by Grawe, she also said she's just ready to move on.
"Look, I don't even want any money from her ... just have her refund the remainder of like what I owe to the finance company, and just call it even," Sarah said. "I don't want her house; I don't want her car. I don't want anything from her. I just want to be done."
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