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Buttock Implants
While many people hit the gym and suffer through crash diets to attain a smaller behind, there are others who actually seek out surgical solutions for a larger, rounder butt.
For these people, cosmetic surgery can offer buttock implants. Unlike breast implants, which are filled with either silicone gel or saline, buttock implants are solid slabs of silicone, positioned beneath the fibrous lining of the buttock muscles.
The result is a rounder, more voluminous rear end. But this result comes at a price for many patients.
"We don't really have the same demand for buttock implants in our part of the world as you see elsewhere," Roth noted. "And that may be a good thing. There is a high rate of problems with these implants."
Among these problems is an increased risk of infection. This is because in order to hide the incision from plain view, surgeons will often place it between the buttocks, perilously close to the anus and the germs that reside there.
And even after the incisions have healed, the implants are situated in an area of the body that endures its share of daily abuse.
"Just logically, if you think about what you're doing -- putting an implant into an area that you sit on -- it stands to reason that there is a very significant rate of problems with these devices," Roth said.
Made Up for Life: Tattooed Makeup
While many women may dream of skipping their makeup routine in the morning, for those who opt for permanently tattooed makeup, the reality can be more like a nightmare than anything else.
"I have had more than my share of patients who ask me to remove the permanent makeup tattoo that someone else gave them, and I will tell you that they're difficult to take away," Roth said.
Much of this difficulty in removing these tattoos is owed to the fact that the areas that are tattooed are some of the most delicate tissues of the face -- namely, the inner folds of the eyelids and the lips. And even with today's complement of high-tech tattoo removal lasers, there is never a guarantee that the tattoos will disappear completely.
This is especially bad news for those who have received botched jobs from untrained practitioners. But even for those who get what they want in the short term, their long-term satisfaction with the job may still be in question.
"If you don't like the results, you may still be stuck with them. And even though you might like the result in the short term, fashions change."
Extreme Facial Procedures
As the images of more than a few celebrities can attest, extreme facial procedures can have a dramatic impact on one's appearance -- and not always in a good way.
Dr. Gregory H. Branham, associate professor and chief of facial plastic and reconstructive surgery at Washington University in Saint Louis, said he treats a number of patients who want a revision of previous work done on their faces. Sometimes, he said, this previous work involved facial liposuction in which the natural fat pads of the face are sucked out. While these patients likely hoped for a sexier, more angular appearance, what they usually got was a hollow, "Cruella deVille" kind of look.
Another procedure he sees regularly is the skin lift -- a relic of 1970s-era cosmetic surgery in which the skin was pulled taut to eliminate wrinkles.
"While I do not perform these procedures I have seen patients come into my practice with broken or failed sutures that are extruding and need to be retrieved," Branham said. "I have not seen good long-term results with these, and they are generally quite expensive when you compare them to a conventional face-lift or even a mini-lift that is a surgical procedure with more promise of a longer lasting result."
But the ravages of bad facial procedures are not confined to surgery alone. Another extreme facial procedure, the CO2 laser peel, leaves patients with a scabby, red face that takes weeks to heal. While these patients eventually enjoy a smoother complexion once the healing is over, there are a number of alternative procedures available today that can give much the same result -- without the intense pain and downtime.
Combination Mastopexy/Breast Implant
What do you get when you combine two tried-and-true plastic surgery techniques in a single operation?
If the procedures in question are a breast lift, or mastopexy, and a breast augmentation, the chances are decent that you could get more complications than you bargained for.
"A mastopexy, or breast lift, with simultaneous breast augmentation [has] one of the highest sources of malpractice suits," said Dr. Henry Kawamoto, clinical professor of plastic surgery at UCLA and director of the UCLA Craniofacial Clinic.
The reason for all the problems is clear when the aim of each procedure is considered. While mastopexy is often aimed at breast reduction -- essentially tightening up the tissues of the breast to eliminate a flabby, loose appearance -- the aim of breast augmentation is the exact opposite.
So while surgeons performing both procedures may start by removing the excess skin on the breasts during the mastopexy operation, they may find themselves stretching the remaining skin in order to accommodate the breast implants that they put in later.
Aside from the complications that arise due to the combination of the two procedures, patients also face the normal risks that go with each individual surgery -- risks that include the possibility of infection, implant exposure, asymmetry of the breasts, loss of nipple sensation, the inability to breast-feed, healing problems and other complications.
Any Procedure by Untrained Hands
With the explosion in the popularity of cosmetic surgery in the past two decades has come another explosion in the number of people who are willing to perform these operations.
But not every doctor has the training necessary to perform these procedures. Indeed, many of the proprietors for whom cosmetic procedures represent a lucrative part of their business do not even hold a medical degree.
"Probably everyone has heard of the itinerant practitioner who performs procedures in a hotel room for bargain basement prices and then is nowhere to be found when complications arise," Branham said.
So what is the key to avoiding such practitioners? Do your homework, said Branham -- and don't rush into surgery before you know everything you need to about your surgeon.
"You should see the doctor ahead of time and not the day of the procedure except in unusual circumstances," Branham said. "This allows you the time and opportunity to check out the doctor and his or her credentials and see the facility for yourself without the stress of an imminent procedure."
And when in doubt, don't go through with the procedure.
"We have a saying," Roth said. "You never regret the operation you don't do."
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