Plastic Surgery: Is It Worth The Risk?

by Jennifer Wider, MD

(Washington DC, 2/5/04):  Want to look young, thin and attractive? Who wouldn't? Cosmetic plastic surgery offers a world of possibilities for the young, old and those unhappy with their appearance. But the surgery is not without risk. Magazines, movies and advertisements are filled with images of a youthful and trim America, but are these images realistic?

In the movie, " The First Wives Club," mega-lipped Goldie Hawn gets nipped, lifted and tucked to avenge her husband who has left her for a younger woman. The film portrays a discarded generation of women who need to appear young and fit to keep their husbands' attention. "It's the 90's," Goldie Hawn's character said, "plastic surgery is like good grooming."

Good grooming? Maybe for some. But these high cost procedures can be dangerous. In a recent, tragic twist, Olivia Goldsmith, the author of the book "First Wives Club," died of complications from anesthesia during plastic surgery. Despite the glamorization of cosmetic surgery in the movie, surgery of any kind comes along with risks. And even though the end result of cosmetic procedures may be alluring, people need to consider the hazards.

There are risks or complications associated with any surgical procedure including bleeding, infection, ugly scarring and anesthesia-related risks. "Each plastic surgery procedure carries it's own risk," Todd M. Wider, M.D., a plastic surgeon at St. Luke's/Roosevelt Hospital in New York City, said. "It is essential that the patient understands these risks fully before he/she proceeds with the surgery."

One of the most popular procedures is breast augmentation, which received significant bad publicity years ago with the silicone implant scare. The procedure has seen a resurgence in popularity using implants filled with saline or salt-water. Currently, silicone implants, which were continuously used in the rest of the world, are staged to make a comeback in the United States as the Food and Drug Administration considers allowing their return to the American market. Breasts implants have been linked with changes in nipple and breast sensation, the possible inability to breast-feed, hardening of the breast and asymmetry. Recent studies have suggested that implants may interfere with mammography, possibly hindering early detection of breast cancer.

Another common procedure is liposuction. Although most patients walk away satisfied, serious complications can occur. The most feared is fat embolism syndrome, when fat gets loosened during the procedure and pieces lodge in the lungs, potentially causing death. Other complications include: numbness, burns, waviness, and accidental organ puncture. "When considering liposuction, it is important to find a plastic surgeon who has significant experience with the procedure because most of the complications can be avoided in experienced hands," explains Wider.

Since FDA approval in 2002, Botox injections have become increasingly popular. Botox stands for botulinum toxin, the same offender of food poisoning outbreaks. When used cosmetically, it can stop muscle contraction and eliminate frown lines. There are risks associated with the use of Botox including: headache, flu-like symptoms, redness at the injection site and muscle weakness. If the wrong facial area is injected, a patient can walk away with drooping eyelid muscles that could persist for several weeks. The results of Botox aren't permanent, and people need to get injected every six months to avoid frown lines.

Despite the risk, plastic surgery is as popular as ever and women are the largest consumers. Approximately 6.6 million people had cosmetic plastic surgery in the United States in 2002 and almost 85 percent of them were women, according to the American Society of Plastic Surgeons.

For women, the leading surgical procedures in order of popularity are: breast enlargement, liposuction, nose reshaping, eyelid surgery and facelift. In the non-surgical category, Botox injection, chemical peel, micodermabrasion (used to reduce fine lines, scars and age spots), sclerotherapy (used to treat varicose and spider veins) and laser hair removal topped the list.

By contrast, the most popular surgical procedures for men were nose reshaping, liposuction, eyelid surgery, hair transplantation and ear surgery.

"Plastic surgery has the potential to significantly improve a person's life, but it is vital to be an educated consumer and know what you are getting into before going ahead," Wider cautioned.

The Society for Women's Health Research is the nation's only not-for-profit organization whose sole mission is to improve the health of women through research. Founded in 1990, the Society brought to national attention the need for the appropriate inclusion of women in major medical research studies and the resulting need for more information about conditions affecting women. The Society advocates increased funding for research on women's health, encourages the study of sex differences that may affect the prevention, diagnosis and treatment of disease, and promotes the inclusion of women in medical research studies. Dr. Donnica Moore has been a member of the Society since 1990 and is a past member of its Board of Directors.

Created: 2/5/2004  -  Jennifer Wider, M.D.
Reviewed: 2/6/2004  -  Donnica Moore, M.D.