PLASTIC SURGERY GIMMICKS AND TRENDS: WHAT REALLY WORKS?

I am frequently asked this question:  "I read about this on the internet, do you do this procedure?"  Unfortunately, information on the internet can't always be believed.  Numerous marketing techniques present new cosmetic procedures with misleading claims.  The latest and hottest techniques can be dangerous and have permanent complications.  Procedures should be properly evaluated and researched prior to presentation to the public. 

The overall trend in plastic surgery is directed towards less invasive procedures that are safer and have shorter downtime.  Some new procedures are better; some are not.  So, what works in plastic surgery?

Laser versus traditional liposuction - Laser assisted liposuction devices were designed to remove fat and tighten the skin simultaneously.  Unfortunately, numerous studies have failed to find any benefits to this technique.  In addition, higher levels of free fatty acids are released with laser assisted liposuction and investigators are evaluating whether these fatty acids may result in liver or kidney damage.   Ultrasound assisted liposuction has not been found to be of improved benefit.

Lunchtime facelifts, Lifestyle Lift, Quicklift- Short scar facelifts have been used by plastic surgeons for many years.  These procedures all utilize internal suture tightening with less tissue dissection to tighten the deep facial tissues.  Patients must be properly chosen for this procedure.  "Quick and Lunchtime" are two misleading terms and should never be used in conjunction with facelifting procedures.  Would you want a plastic surgeon to do a 'quick facelift' on you?  I dont think that anyone would.

Thermage - Thermage has been associated with subcutaneous tissue destruction and its benefits are controversial.

Periumbilical breast enlargement "TUBA" -   This procedure, also called belly button breast augmentation is also controversial.  Breast implants are inserted through an incision above the belly button.  The results are inconsistent and higher reoperation rates are reported.

Stem Cell Grafting - Fat cells taken from the abdomen have been found to have a small number of stem cells that will repair and heal tissue where it is injected.  When injected into the face, early studies have revealed an improvement of the aging process.  Stem Cell Grafting works.  It is safe and effective.

Breast enlargement wit fat graft or stem cell grafting -   This is an extremely controversial subject in plastic surgery.  The primary controversy relates to the ability to detect breast cancer on a mammogram after the breasts have been injected with abdominal fat.  There have been two conflicting studies in the medical literature and long term mammogram changes are not known.

Mesotherapy - Mesotherapy is the technique in which substances are injected into fat to dissolve or destroy the fatty tissue.  This procedure continues to be controversial with no proven benefits.

Awake breast augmentation - This procedure is usually performed in an office setting instead of in an operating room.  Instead of an anesthesiologist performing general anesthesia with the proper monitoring equipment, the procedure is done with numbing medicine alone or with oral medications.  I have heard of people choosing their size while someone holds a mirror in front of their chest!  The breasts go through so many changes after surgery so not only does this increase infection rates, the size is distorted with the numbing medicine, intraoperative draping and patients possibly being under the influence of medications. 

Plastic surgeons know how delicately the pocket needs to be made for placement of the implant.  This procedure is extremely precise.  An uncomfortable, moving patient will lead to asymmetry, increased bleeding, and possibly severe risks such as a collapsed lung since the lung cavity is millimeters away from the implant pocket.

Some cosmetic procedures are quite foolish:  dimple implants, toe shortening and buccal (facial) fat pad removal.  Some procedures have unacceptable results and high complication rates.

Patients should always choose a board certified plastic surgeon for their cosmetic surgery.  Would you rather have someone doing surgery on your body that has been trained and tested for years or would you like to have someone from a nonsurgical specialty that has taken a weekend course do your procedure?  Safety is always the primary concern for any cosmetic procedure.