PLASTIC SURGERY
Fat, Face, and Facebook: The Latest Trends in Plastic Surgery
Surgeons say fat infusion and facial surgery are two of the more popular procedures. Social media is driving some of the demand.Plastic surgery doesn’t seem to be losing in popularity.New data from the American Society of Plastic Surgeons (ASPS) reveals that Americans are seeking out cosmetic surgeries and augmentations at a growing rateIn 2016, the ASPS reports plastic surgeons performed 17 million surgical operations and minimally invasive
procedures, such as laser hair removal and chemical peels.With more than 290,000 procedures, breast augmentation claimed the top spot for the second year in a row.The newly released information also reveals the number of cosmetic surgeries that focus on the face is growing.In addition, a new type of plastic surgery popped up on the popular list for the first time.Read more: Risks vs. results for plastic surgery »Though the phrase “plastic surgery” may stir up connotations of chemical fillers, silicone breast implants, and injectable artificial ingredients, the ASPS research suggests that patients prefer a more “natural” ingredient in their “plastic” surgery: fat.Minimally invasive cosmetic fat injections increased 13 percent in 2016.In addition, fat grafts in the buttocks also became more popular last year with a 26 percent increase.But it was breast augmentations that used fat injections that saw the biggest increase, with a 72 percent jump in one year.
“Plastic surgeons harvest a patient’s unwanted fat from their abdomen using liposuction and then inject it to lift and rejuvenate other areas such as the face, buttock, and even the breast,” said Dr. Debra Johnson, president of ASPS, and a private practice plastic surgeon at The Plastic Surgery Center in Sacramento, Calif., in a statement.Newer procedures focus on removing fat in less invasive ways, and many of these are more affordable. That may account for the increased popularity in 2016.Fat “freezing” increased 5 percent. Noninvasive skin tightening procedures that target fat pockets and seek to tighten sagging skin increased 5 percent, too.Fat-targeting injections, which are usually used to reduce pockets of fats in areas like the chin, increased 18 percent.While some people may be looking to move fat from one part of their body to another, others are just looking to remove fat altogether.Liposuction took the second spot on the list of most common plastic surgeries in 2016 with 235,237 procedures.Read more: Can plastic surgery help with migraines? »Spots three, four, and five on the list of most popular cosmetic surgical procedures in 2016 have a common theme: changes to the face.Nose reshaping and eyelid surgery were both up 2 percent year over year.Face-lifts, which had fallen off the list in recent years, climbed back onto the list at the fifth spot with a 4 percent increase since 2015.Likewise, many of the top noninvasive or minimally invasive procedures followed the same theme.The number of these procedures topped 15 million in 2016.Botulinum toxin type A (Botox) injections earned the top spot with 7 million procedures. That’s up 4 percent from 2015.
Rounding out the list were soft tissue fillers (2.6 million procedures), chemical peels (1.36 million procedures), laser hair removal (1.1 million procedures), and microdermabrasion (775,000 procedures).What do these minimally invasive procedures have in common?Fast results with little downtime.Johnson also thinks it points to people being more proactive about their skin’s appearance.“I think this represents both a younger demographic trying to take better care of their skin early on, and older patients who are not interested in surgery but want to do something to help them tread water longer,” she told Healthline.Read more: Lil’ Kim’s body modifications highlight the importance of self-love »The return of the face-lift, as well as the increased emphasis on face procedures in general, points to a suspected common source point: social media.If the popularity of selfies and disappearing photo apps like Snapchat reveal anything, it’s that Americans are becoming more obsessed with how they look — and how people respond to their looks.Filters and apps offer airbrushed effects that were once reserved for high-dollar photo editing software, so if a filter can make a person feel proud of their appearance for a short period of time, plastic surgery may offer that boost for a longer time.
That’s the reasoning for Johnson, who said in the same ASPS statement, “Patients are captivated by instant improvements to the face. It’s evident in the popularity of apps and filters that change how we shape and shade our faces. While there are more options than ever to rejuvenate the face, a face-lift done by a board-certified plastic surgeon can have a dramatic, longer-lasting result which is why I am not surprised to see face-lifts back in the top five most popular cosmetic surgical procedures.”In an interview with Healthline, she added, “I think social media is playing a huge role in increasing awareness of these issues and provides personal experiences with various treatments and surgeries. I think it’s positive that patients can see that others share their same concerns, which can be very validating.”That’s not quite how Elaine Ducharme, PhD, a licensed clinical psychologist in independent practice in Glastonbury, Conn., sees the social media influence.“Social media plays a huge role in impacting self-esteem and drive to alter our bodies. Everyone is so connected to the ‘perfect’ images of celebrities on their phones, iPads, computers, etc. Mixed in with all the friend information on websites such as Facebook, are all kinds of images and ads on how to look more beautiful,” she told Healthline.If social media and the pressure to match or meet a self-imposed expectation is the impetus for some of these surgical procedures, Johnson said people aren’t necessarily trying to replicate someone else’s looks for themselves.“It is rare that patients come wanting to look like someone else, a celebrity or some beautiful person. Instead they will say, ‘I’d like full cheekbones like Kim Kardashian,’ or ‘I’d like lips like Angelina Jolie.’”
While others may be quick to blame the Instafamous or the celebrities who use their social media to promote themselves in ways stars never did, celebs may not bear the real blame.“A lot of people have become truly preoccupied with themselves,” Ducharme said. “People judge each other by how they look and then put pressure on themselves to look perfect. People constantly are posting pictures of themselves and watching for comments and compliments. I see teens becoming more preoccupied with their looks and wanting to make changes with Botox.”Read more: Social media feeding obsession of celebrity look-alikes »While the top procedures focus on the face and the highly visible parts of the body, another less obvious cosmetic procedure is gaining popularity.The ASPS started tracking the number of labiaplasty procedures in 2015 and 2016. Doctors performed more than 12,000 of those procedures. That’s a 39 percent increase in one year.This procedure reshapes the labia by lifting skin or filling out areas of the vagina and labia with injectable fillers. Here, too, Ducharme points to the influence of social media.
“When social media, sexting, and especially pornography began to show female genitalia, women suddenly start comparing, and often feel that if they are different in any way, they must be abnormal,” she said. “There is actually quite a bit of variation in size and shape of labia and the vagina. Social media has just given women one more thing to worry about and feel insecure about.”Johnson, however, sees another way social media is influencing and accounting for the increase in vaginal cosmetic changes.“The fashion of removing pubic hair with waxing, laser hair removal, or shaving has made the labia more ‘visible,’ and women thus see themselves more critically. Social media has made labiaplasty less scary to many women,” she said, “Knowing that other women share the same concerns has allowed women to seek consultation with issues they might have otherwise been embarrassed about.”As with any type of invasive surgical procedure, cosmetic or otherwise, labiaplasty carries with it risks and possible side effects. These include bleeding, infection, and loss of sensation in the genitalia.
It might seem, based on outdated stereotypes, that the plastic surgery clientele is almost entirely female, but that’s changing quickly as plastic surgery among men is becoming more common eachyear.Between 1997 and 2015, the number of plastic surgeries for men increased more than 325 percent. In 2015, men accounted for more than 1.2 million plastic surgery procedures.
The top five surgical procedures were:
“Men are becoming more open to plastic surgery. The ‘metrosexual’ movement has made caring about your appearance more acceptable to men,” Johnson said. “Men often seek less invasive procedures, including Botox, fillers, laser treatments. They have minimal downtime and no scars.”Here again, Ducharme sees the increase in plastic surgery for men in a different light.“Overall, I think social media has had a greater impact on women, since they have traditionally struggled more with body image. On the other hand, I have seen more young men becoming more preoccupied with their bodies and spending inordinate amounts of time at the gym,” she said. “Instead of starving themselves, as do women with eating disorders, they work out in a very unhealthy way. They use nutritional supplements and sometimes drugs to get that perfect body.”
If social media is to blame for the increase in cosmetic procedures, it’s social media that may turn the boat in the other direction.Social media campaigns like Project HEAL’s #WhatMakesMeBeautiful encourage people of all shapes and sizes to embrace their bodies and be openly proud.The United Kingdom’s Body Gossip uses art and creativity to encourage self-esteem and self-acceptance.Sport England’s This Girl Can campaign aims to encourage women of all shapes and sizes to get moving to make themselves healthier.And it’s in England where the powerful self-love movement may be gaining some traction. Last year, the number of surgical procedures done there fell 40 percent. That’s a near-decade low after hitting their highest numbers in 2015.“So many seek plastic surgery to fix imperfections, thinking that somehow their lives will miraculously change for the better. If they don’t really like or accept who they are, the surgery will do nothing to increase their happiness,” Ducharme said.
If you’re considering plastic surgery, Johnson reminds you to be careful with your choice of doctor.“Plastic surgery is one of the only specialties in which nonplastic surgeons seek to provide care. It is important for patients to do their homework and assure that the surgeon they choose to perform their cosmetic procedure is truly a ‘plastic surgeon,’” she said.You can start by visiting the ASPS’s website where they maintain a list of board-certified plastic surgeons who are ASPS members.When you make an appointment, be sure to ask questions of the doctor and staff. Find out how long they’ve been in practice, what certifications and licenses they have, and what their specialty is, if they have one.Don’t be afraid to seek second and third opinions to find a doctor that is both licensed and makes you comfortable with your choices and options.
Death Raises Concerns About the Risks of Plastic Surgery
After the death of a West Virginia woman, experts remind people considering cosmetic surgery that the procedures are still a serious medical operation.If you’re thinking about having plastic surgery, you might want to do a little pre-op preparation.The risks of cosmetic surgery have come under a spotlight after two serious incidents were reported this month.A 29-year-old West Virginia woman and mother of two, Heather Meadows, died in early May after undergoing a Brazilian butt lift procedure at a South Florida clinic.According to the medical examiner’s report, Meadows died from a fat embolism. That’s when fat enters the bloodstream, causing a blood vessel to clog.A heart defect also contributed to Meadows’ death, according to the examiner.Also in Florida, a mother this week spoke publically about the dangers. Mariela Diaz said her daughter suffered permanent brain damage three years ago while undergoing breast augmentation surgery.The injury was caused by a lack of oxygen to the brain, state officials said.The Miami Herald reported there were 46 office surgery deaths in Florida between 2000 and 2010.“I tell the daughters and mothers to think it over before going to those clinics because they never know how they are going to come out,” Diaz told The Herald. “They should accept what they have naturally.”
The cases have prompted some cautionary advice from experts.“Patients really need to do a lot of research in finding the right certified doctors before they undergo cosmetic surgery,” Dr. David H. Song, the president of the American Society of Plastic Surgeons, told Healthline.Song explained that although a fat embolism is a known potential problem in plastic surgery, it’s a rare complication.“That’s why it is extremely important that patients go to a board-certified plastic surgeon by the American Board of Plastic Surgery and who are members of the American Society of Plastic Surgeons because we’re trained to deal with these things and, more importantly, to prevent them,” said Song.He explained that many doctors are falsely claiming to be board-certified plastic surgeons.“There are many people out there that are calling themselves board-certified, but they’re not,” said Song.
To be board-certified by the American Board of Plastic Surgery, a doctor needs at least six years of training and has to pass two rigorous examinations.“It takes a good seven to eight years to become board-certified,” said Song.Song stressed that it’s not safe for a patient to undergo cosmetic surgery with a doctor that has certification in another area of medical expertise.“There are a lot of pseudo boards, someone can be board-certified in internal medicine and still call himself or herself a cosmetic surgeon and still say that they’re a board-certified cosmetic surgeon,” he said. “The training is vastly different and that’s the critical piece here that needs to be broadcasted.”Patients can seek board-certified plastic surgeons by using the Board-Certified Plastic Surgeon Finder at plasticsurgery.org, a directory of American Society of Plastic Surgeon members.
NBC Miami reported that the clinic where Meadows underwent surgery, Encore Plastic Surgery, is fully licensed.The clinic’s website states it has board-certified surgeons with experience in each of the procedures they perform.However, the doctors listed on the Encore Plastic Surgery website are not listed on the Board-Certified Plastic Surgeon Finder.A representative for the clinic ended an online conversation with Healthline when asked if the doctors at Encore Plastic Surgery are board-certified by the American Board of Plastic Surgeons.“Patients spend more time looking for a hairdresser or buying a car than they do doing research for a plastic surgeon and that’s really a shame and potentially can be very dangerous,” said Song.“It doesn’t mean that board-certified plastic surgeons don’t have complications, so patients do need to understand that this is real surgery with real potential complications,” he said.Even when performing a minor surgery, board-certified plastic surgeons have been trained to spend much of their time going through the patient’s history, medications, and physical exams to prevent complications.Song explained that there are many red flags when evaluating a patient before deciding whether or not they should undergo esthetic plastic surgery.“Respiratory, breathing problems, childhood development, family history, medication interactions, previous surgical histories, reactions to any anesthesia, recovery, their activity level, their home environment, who’s going to help take care of them, all of these things play into how someone’s going to recover successfully and quickly,” he said.
Song said he turns away at least 3 out of 10 patients due to these potential complications.He explained that when doing aesthetic surgery, everything has to be perfect.“They have to be healthy. They have to be in ideal shape. They have to be in great shape mentally and emotionally. Also, for non-medical reasons, if a patient comes in with expectations that are unrealistic or motives that are not aligned with well-being, these are things that are very critical,” Song said.He said that once a patient finds the right doctor, it’s important for them to be honest about their history, including drinking, smoking, drugs, medicines, and past medical procedures.“This is your health and surgery, as minor as it may seem and appear on TV, is real surgery and has real and potential complications,” Song emphasized.
Social media is buzzing about buccal fat removal. What is it, and why do doctors urge caution?
Across social media, many users, primarily younger women, are buzzing about a plastic surgery technique called buccal fat removal. While the procedure is simple and has been around for years, it's grown in popularity for those drawn to the look of a narrow, angled facial structure. The surgery, which is done under local anesthesia, involves incisions being made in the back of the mouth so some of the fat in the cheek area can be removed. It is nearly impossible to reverse, causing some concern among experts. Dr. Ira Savetsky, a plastic surgeon in New York City, told CBS News that he has seen an increase in patients requesting the "irreversible" procedure, which is called a bichetomy. "The interest in the buccal fat pad really just stems from people's sort of obsession with having a really defined and countered jaw line," Savetsky said. "And I think that's all driven from social media. In this era of selfies and just photos in general ... people really started to notice, more than ever, their jawline, and buccal fat is something that is very intriguing to people." The surgery is purely cosmetic and does not have any medical benefits, but some people are better candidates for it than others, said Dr. Rod Rohrich, a Dallas-based plastic surgeon."In about one in 10 patients that come to me for buccal fat removal is (the procedure) really indicated," Rohrich said. "Basically, it's fat in front of the jawline... If you bite down and pucker, if (your cheeks are still) full, then you are a candidate for buccal fat removal, but most people aren't."
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