Comments on “10 Cosmetic Procedures You Should Avoid”

June 25, 2012
English: Facial Plastic Surgeon Amir Karam, MD...

English: Facial Plastic Surgeon Amir Karam, MD harvesting fat fr

English: Facial Plastic Surgeon Amir Karam, MD...

English: Facial Plastic Surgeon Amir Karam, MD harvesting fat from patient’s abdomen for facial fat transfer procedure. (Photo credit: Wikipedia)

ABC ran a quality piece on certain cosmetic procedures to avoid, listing 10 problematic cosmetic procedures.   Most of their discussion is right on target, but there are a few of these that may not be as bad as described.  Here is the complete list with three underlined procedures and a discussion of each and why they may not be as bad as portrayed.

1  Fat dissolving injections

2 Cosmetic foot surgery

3 Permanent filler injections

Injection for breast augmentation 

Cosmetic leg lengthening surgery

6  Buttock implants

7  Tatooed makeup

8  Extreme facial procedures

Combination mastopexy/breast implant

10 Any procedure by untrained hands

Injection for breast augmentation

The concern here is that augmenting the breasts with fat will somehow disguise the diagnosis of breast cancer.  The reality is that nobody really knows this.  It is very possible that calcifications from fat necrosis – possible after transferring fat to the breasts – will look different from the microcalcifications radiologists seek on mammograms.  In selected people with proper anatomy (relatively non-droopy breasts, and enough fat for transfer), fat transfer could be a great alternative for a natural look and feel without the problems associated with implants.  More research is needed.  Due to the risk of lawsuits, most American surgeons will follow the lead from foreign surgeons once they get better at this procedure.

Cosmetic leg lengthening surgery

Admittedly, saying this procedure should not be avoided is a stretch (pun intended).  Major complications, such as amputation and death, are possible.  Though orthopedic surgery is not a cosmetic field, the principles of bone-distraction developed from orthopedics can be applied for cosmetic use.  Few surgeons do this procedure, but one is right here in South Florida.  Dr. Dror Paley was highlighted on ABC’s 20/20 several months ago, and he does hundreds of these procedures per year, some for cosmetic indications.   That being said, anyone considering this should do deep research since it is one of the most major cosmetic procedures there is.

Combination mastopexy/breast implant

The article correctly notes that these two operations somewhat counteract one another.  But that is not a sufficient reason to rule it out entirely.  Surgeons in competitive markets are at a disadvantage if they are not able or willing to do a mastopexy/augmentation.  Many patients do not want to stage the procedure, and will go to other surgeons who can do it in a single stage.

Admittedly, if the breasts are very large or very droopy and the patient wants a large augmentation, staging is preferred

and sometimes necessary.  But for more moderate requests, this procedure can be done safely and effectively in the right patient and by the right surgeon.