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Plastic surgery myths debunked

Robin Wulffson MD's picture
plastic surgery, cosmetic surgery, myths, breast surgery, teens

A number of myths are in circulation regarding plastic surgery. Examples are: an airline flight will cause breast implants to pop; and the sun will melt the implant in your nose after rhinoplasty. Also, a recent trend in plastic surgery is the number of teens undergoing cosmetic procedures. To obtain the straight scoop regarding plastic surgery, I consulted Tracy M. Pfeiffer, MD, MS. She is a New York City plastic surgeon with a special interest in breast surgery. In addition to noting that the foregoing myths are untrue. Dr. Pfeiffer made the following points.

Plastic surgery is a luxury only the wealthy can afford:
This is simply another myth associated with plastic surgery. I would say that plastic surgery is a lifestyle choice. Like with any other lifestyle choice, the average person may have to save and budget for it, but it’s within reach. Most of my patients are not the extremely wealthy. Rather, they are everyday Americans such as teachers, lawyers, real estate agents, retired persons, etc. that come from every social strata and ethnic background. What these people all have in common is not their wealth, but that they want to feel good about their appearance and understand that treatments are available to address their concerns. Plastic surgery has also come a long way and become much more common in the lives of everyday people. Recognizing this, many plastic surgeons offer payment options for patients such as plans, financing, partial pre-payment, etc. This helps make plastic surgery much more mainstream, and not only reserved for the super wealthy.

Plastic surgery is unsafe:
This notion is completely untrue. I think that the perception that plastic surgery is unsafe is partially due to the media reports. This is because it is so rare for a person undergoing plastic surgery to have a complication that when it does happen, it often makes the news. The truth is that since patients having plastic surgery are having a purely elective procedure, reputable plastic surgeons will usually insist that the patient have a full medical clearance to insure the patient is medically cleared for surgery. Additionally, many patients are worried about anesthesia and possible complications, but anesthesia is very safe. This is even true for patients who have significant medical problems.

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However, since plastic surgery is a fee for the service medical field, there are physicians, unfortunately, who are trying to cash in. This is why patients need to protect themselves by seeking a plastic surgeon who is board certified by the American Board of Plastic Surgery. This should not be confused with The American Board of Cosmetic Surgery, which does not have the same significance in terms of rigorous training. Patients must check their surgeon’s credentials and not just assume they are qualified. They can do this by checking with their state’s department of health to see if any complaints have been filed and researching common red flags that patients should be aware of. Additionally, patients can see if their surgeon is ASPS board certified by logging onto www.plasticsurgery.org.

All plastic surgeons will provide the same results:
This is entirely untrue. First, one must separate plastic surgeons board certified by the American Board of Plastic Surgery and the American Board of Otolaryngology from those board certified by organizations such as the American Board of Cosmetic Surgery. This is because there is simply no comparison between the training and qualifications between them. Surgeons board certified by ABPS and ABO have extensive training and therefore intimate knowledge of the anatomy involved in plastic surgery procedures. ABPS surgeons are trained in all areas of the body and face whereas ABO are trained in only head and neck, not the body. Next, even if the surgeon is board certified by ABPS or ABO, it is important to look for someone who specializes in aesthetic/cosmetic procedures. If a surgeon in interested in this area, he/she is more likely to be very up to date on the latest techniques, products, etc. Also, it is important to look for someone who specializes in the part of the body you are interested in improving, because there is no substitute for experience.

Teens undergoing plastic surgery:

Plastic surgeons are sometimes consulted by teenagers and their parents for a variety of concerns. The most common reasons are breast reduction, breast asymmetry (breasts of dissimilar sizes), breast augmentation, rhinoplasty and for the treatment of acne. The main concern on the part of the plastic surgeon is making sure that this young person can understand the possible ramifications of the surgery and that they are emotionally mature enough. Warning signs are teenagers who “just want it" but have no good reason for the procedure. This is most commonly seen with breast augmentation and least commonly with acne treatments. This is why I tend to separate out the breast augmentation and acne groups from the others.

Acne treatment does not require surgery and the treatments are non-invasive although some of the medications have side effects. For this reason, the treatment of acne in teenagers is not problematic and is very much justified. Teenagers seeking breast augmentation tend to have a different set of concerns and different attitude. In my experience, they often cannot fully absorb the potential complications and necessary management of breast implants. Teenagers in this group can sometimes be more self-absorbed, less thoughtful about the downsides of surgery and implants, cannot accept adverse advents and, in my opinion, are sometimes not really able to sign a truly informed patient consent. These patients must be carefully screened to insure they are mature enough for the breast augmentation surgery. I find it is a good sign if the patient is accompanied by the parent. This usually signals to me that the parent has spent some time discussing the procedure and the pros and cons with their teenager. Additionally, although rare, parents who "give" their teenagers plastic surgery as a gift, such as augmentation or rhinoplasty, are a red flag and the plastic surgeon is wise to carefully assess these patients for their motivation and goals.

On the other hand, teenagers seeking breast reduction, correction of breast asymmetry and correction of nasal deformity, in my experience, have thought about these issues for some time, often years. They typically are thoughtful and mature and have excellent reasons for seeking these treatments, and they understand and accept the potential complications. Their parents are usually concerned but at the same time supportive. These teenagers often suffer from social embarrassment, inability to engage in sports, have difficulty finding clothes to wear and are extremely self-conscious about their appearance. Because of this, they are quite motivated to have the procedure. I find these teenagers are very, very happy with their surgical results and it is not uncommon for them to state that their lives have been really transformed in a positive way.

Tracy M. Pfeiffer, MD, MS
American Society of Plastic Surgeons

See also: Life coach offers healthy alternatives to teen cosmetic surgery