10 Misconceptions About Plastic Surgery

October 21, 2013

Robert T. Grant, MD, MSc, FACS, debunks 10 common myths about plastic surgery, such as the safety of Botox injections and breast augmentation.

Waiting until a woman is postmenopausal can dramatically — and negatively — change the nature of the surgical result. Too often, older patients wind up with “overdone” looks where the skin needs to be pulled extremely tight in order to achieve contour improvements that could have been maintained more easily if the procedure had been performed at a younger age. Undertaking less-drastic procedures in perimenopause allows results to be maintained longer and, in many circumstances, to appear more natural and in line with a woman’s overall appearance.

#2. Plastic surgery is only for the rich

Statistics from the American Society of Plastic Surgery (ASPS) show that the vast majority of patients undergoing plastic surgery are middle-class individuals who use their own disposable income. In fact, the median income for patients who undergo plastic surgery is approximately $80,000. Many plastic surgeons offer a variety of flexible financing options. Additionally, non-surgical procedures such as the injection of Botox (onabotulinumtoxinA) and the use of fillers like Juvéderm (cross-linked hyaluronic acid) is surprisingly cost-effective; in many cases, those procedures cost little more than what a woman can expect to pay for her hair coloring or salon treatment.

#3. Plastic surgery is only for women

Men currently represent 15 percent of the total number of patients undergoing cosmetic surgery — a number that has been steadily increasing over the past decade. That statistic isn’t surprising, because men need to look their best in a competitive job market. As a result, more men entering their 40s and 50s are seeking access to non-surgical procedures like the use of Botox, neurotoxin, or fillers to rejuvenate their appearance. Men are also growing more comfortable with other surgical procedures, including liposuction to address “love handles,” rhinoplasty, and gynecomastia, which is the treatment of enlarged congenital breasts.

#4. Plastic surgery is only for the vain

Many patient satisfaction surveys and quality of life outcome studies have shown that patients enjoy genuine improvements in body image and a greater satisfaction with their position in life after cosmetic surgery. It’s a cliché, but I often say that plastic surgery won’t add years to your life, but it can add life to your years. Quality of life, not vanity, is the main decision-making factor for the vast majority of plastic surgery patients.

#5. It takes a long time to recover from plastic surgery

Advances in surgical technique, anesthesia methods, and pain control mean that, in many cases, patients no longer have the downtime associated with recovering from general anesthesia. The incidence of nausea and vomiting after surgery is markedly decreased, and patients are often able to get back into their daily routines more quickly. While surgical healing takes time, most patients can expect to return to normal activities in just a few weeks.

#6. Breast augmentation is dangerous

Breast implants have probably been the most thoroughly studied device in the history of American medicine. While no operation comes without risks, the risks and potential complications of breast augmentation surgery have been very clearly defined. Patients are also getting the message, as breast augmentation surgery has been the most common cosmetic operation in the United States since 2008.

#7. Botox is a dangerous toxin

Botox is derived from a toxin secreted by particular bacteria. While massive doses of this toxin can cause disease to develop, the dose level of Botox treatments is minimal, and the onset of disease has never been seen after administration. Indeed, Botox has one of the best safety profiles of any medicine that has ever been developed.

#8. All esthetic or cosmetic surgeons are plastic surgeons

Many specialties offer plastic or cosmetic surgery services, but not all of these surgeons have undergone the same level of training as board-certified plastic surgeons. Patients are always advised to check the credentials and qualifications of their surgeon and should check to see (a) whether that surgeon is board-certified by the American Board of Plastic Surgery (ABPS), and (b) whether the surgeon has privileges to perform cosmetic surgical procedures in a hospital setting. Having hospital privileges subjects the plastic surgeon to peer review, ongoing credentialing, medical education, and other monitoring that doesn’t exist if the plastic surgeon operates in a non-hospital facility.

#9. Having plastic surgery in a private residence or ambulatory surgery center is better than in an accredited hospital

Statistics from the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) show that when an accredited facility is used — whether it’s an ambulatory surgery center or a certified accredited office — patient outcomes are the same as if the procedure were performed in an accredited hospital. However, certain conveniences and amenities exist in private ambulatory centers and offices that hospitals can’t replicate. On the other hand, hospitals have access to a broad range of specialists should complications develop. Patients who are considering surgery in an accredited office or facility should ask whether the facility has an agreement with a nearby hospital for immediate transport in case any complications arise.

#10. Hard work and improving one’s nutrition can deliver surgical-type results

Attention to diet, exercise, sun avoidance, and nutrition are all important areas to have integrated into one’s personal lifestyle before elective cosmetic surgery is considered. However, there will be times when, despite a patient’s best efforts to remain true to the highest ideals of nutrition and exercise, areas of contour deformity will develop that can only be addressed with plastic surgery. Even so, it should be pointed out that patients are often better served by working with a nutritionist and personal trainer prior to undergoing plastic surgery, rather than having the plastic surgery first and then reaching out to a trainer or nutritionist afterwards.

Robert T. Grant, MD, MSc, FACS, is Chief of the combined Divisions of Plastic Surgery at New York-Presbyterian Hospital-Columbia University Medical Center and New York-Presbyterian Hospital-Weill Cornell Medical Center. He is also Associate Clinical Professor of Surgery in the College of Physicians and Surgeons at Columbia University and Adjunct Associate Professor of Clinical Surgery at Weill Cornell Medical College. For more information about Dr. Grant or to contact him, visit his website at www.robertgrantmd.com.