Ten women are in the process of suing a St. Louis-area plastic surgeon for posting pictures of their breasts on the internet.

Before-and-after pictures are a common way for plastic surgeons to show prospective clients the quality of their work. In Dr. Michelle Koo's case, the photos shown on the website were without names attached, before and after their breast augmentations. When pictures are uploaded using files with patients' names however, the pictures come up on search engines.

For some of these women, who were 21 to 58 years old at the time of the surgeries, the searches popped up when they searched for their own names. For other women, the discovery came to their attention when friends searched for their names.

The suits are all pending in federal courts.

Dr. Koo's site is managed by Long Island, NY-based MedNet Technologies, Inc. They also manage 2,500 other medical health care providers. MedNet says that Dr. Koo is responsible, as they are not culpable for what third-party providers post onto their site.

Dr. Koo says that the blame lies with MedNet.

Indeed, Neil Bruntrager, the lawyer for eight of the ten clients, says that he has been contacted by lawyers from four other states who were troubled about the practices of some of MedNet's competitors. He says that this is a much larger problem.

According to the St. Louis Post-Dispatch, a simple internet search for various doctors' websites pulled up pictures and names of clients who'd had nose jobs, liposuctions, face lifts, and breast augmentations and reductions. This search only took place earlier this month.

Einstein Medical, a MedNet competitor, said that, in 16 or 17 years, only one instance like Dr. Koo's has emerged. They deleted the photo immediately, before even informing the physician involved. But they also said that medical clients were warned against using names, and was shocked that problems like these even occur. In an age with strengthened algorithms for search engines, where almost anything is searchable, they said that removing the names would be common sense.

For most, if not all, patients whose pictures were searchable with their names, they had all signed agreements stating that physicians could use their pictures for their websites. (Some could not remember, or denied signing such a waiver) but all the people that the St. Louis Post-Dispatch contacted said that it was not okay that searching for their names could turn up those images.

Medical professionals' websites that are found to violate confidentiality agreements are supposed to contact the patients involved within 60 days. However, in none of the cases that the Post-Dispatch contacted, did that seem to be the case.

Dr. Koo's website has since removed the photos in question.