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Cosmetic Surgery

Cosmetic Surgery

woman contemplating cosmetic surgery According to The American Society of Plastic Surgeons (ASPS), minimally invasive cosmetic procedures grew 66% from 2000-2006, and there is a growing market among men and younger patients, especially in metropolitan areas.

In a recent survey of dermatologists in the Epocrates network, the majority of participants reported an increase in patients’ requests for cosmetic procedures in the past 5 years, and 3 in 4 expect to see more patients for cosmetic enhancements.

Forget the Facelift by Dr. Doris Day Epocrates member Doris Day, MD, a New York-based dermatologist and author of “Forget the Facelift,” says that in 2008 “the cosmetic/aesthetic market will grow at an exponential rate thanks to newer, better, less invasive treatments. The patient dialogue is changing to not just lifting and tightening, but also to rejuvenating, enhancing and maintaining.”

We’d like to hear your opinions of and experiences with cosmetic procedures, such as:

  • Would you undergo surgery to change your appearance?
  • How do you advise patients who are unhappy with their looks?
  • Do you think teenagers should be getting cosmetic surgery?
  • Are we aging gracefully?

Please share your unique insights with the Epocrates community below.

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32 Responses

  1. Dalton Gay


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  2. Andre Price


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  3. Sherry Hoover ARNP

    Plastic surgery to inhance one’s looks and make a women more competitive in the workforce are a personal choice. I feel our society does not respect mature people in the workplace and the fact that someone would consider drastic alterations of appearance to make one more competitive is a sad commentary of our society as a whole. I do alot of breast exams on female who have had saline implants and I wonder what could possibly be sexy to have hard “icecream cone “shaped objects on your chest.

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  4. Michelle Maust

    I thought I would age gracefully, and undergoing surgery still seems too risky. I would consider enhancements, maybe around my smile lines, and between my eyebrows. My niece who is 15 years younger than me has has that done with good results. Now that I am turning 50, “aging gracefully” has a new definintion.
    If I were to advise a patient, I would tell them to carefully weigh the risks and benefits. After watching “Extreme Makeover”, I don’t think I would do it. I wonder what they look like without the makeup?

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  5. kim thorpe

    I would consider cosmetic surgery for myself but would be mopre hesitant to recommend it to someone elase. Cost vs benefit not worth surgery risks & better to improve self image through other realms than the body

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  6. tom giovanni

    check out this site gives great infomation
    all about cosmetic surgery.

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  7. Deborah Nelson

    In the comments I’m reading there seems to be come confusion between cosmetic procedures and plastic surgery for medical reasons. I think these are two distinct issues and the point of the Epocrates survey. And yeah Anne - nursing student at 64! You go girl!!

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  8. Anglo Germanic, MD

    Would you undergo surgery to change your appearance? Yes
    How do you advise patients who are unhappy with their looks? Lookup on Wikipedia, consider all the negatives and whether you would like to have the procedure, get on a makeover TV show OR a substantial numbers of dinners out with your partner.
    Do you think teenagers should be getting cosmetic surgery? If they have a good relationship with parents and their personal primary physician they could consider surgery. Please do not let GW sign it in as a ‘freedom’ of being an American.
    Are we aging gracefully? Each is different, most look good, if they would change clothes and wear a tie without gravy on it.

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  9. Bill Buckton

    No, personaly I won’t consider cosmetic surgery but i am a male and 65 years old
    But I have had female patients become less depressed after a face lift, so I do admit there is a need.

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  10. Maria PA

    Interesting, and sad, to read. Plastics is an amazing and wonderful field when repairing cleft palates, reconstructing breasts ravaged by cancer…but “I want to look young enough to get hired in my field”? “It’s always been with me even when I was anorexic”? Does anyone see anything distressing in these statements? They suggest that America’s obsession with youth is correct not only in terms of beauty but in our worth as health-care providers, and that if one has tried an eating disorder and it hasn’t worked, let’s try going under the knife. Let’s throw out our medical journals and resubscribe to Vogue.

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  11. Chrissy

    I had breast augmentation 4 years ago and I couldn’t be more happier. But I did it for my self, not for my husband or anyone else for that matter. I have always been very athletic and very tone. I am 5′9″ and weigh 132lbs. I tried everything including bust increasing exercises before making my decision. I remained “flat chested” despite my efforts. Since I had the procedure I have felt so much better about myself. I am a mother of three and have extra skin around the abdomen. I am now considering having a tummy tuck because no matter haw much I work out, I can’t loose the look of having belly fat because of the skin. I would highly recommend anyone who has issues with there body to consider plastic surgery to help with their self esteem. However, I would not recommend it to teenagers because their body is still developing and the results they get from surgery will not be the same if they wait until they are in their 20’s. I would also be against anyone to have sugery to impress others or the please someone else.

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  12. MC

    Realistic expectations up front and doing research beforehand are vital before making a decision of whether to proceed with any cosmetic surgery. I find that many Plastic Surgeons are not “up front” with potential patients of a realistic outcome.
    I recommend anyone considering PS to head to where many PS also answer questions in regard to expectations and complications as well as real patient experiences to help.
    Dr Balhuizen’s comment suggests an outdated outlook and I appreciate the balance Alanna Smiths comment brings.
    I have researched and helped support literally thousands of men and women on their quest of whether to have PS or not and then helped guide them to useful resources before making these decisions.
    A teenagers body is still changing and developing and in 99% of cases it is best to hold off until their 20’s before having any PS.

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  13. Mary Huff, MD

    I started doing laser hair removal, vein treatments and tattoo removals 3 1/2 years ago. I also do botox and fillers. I have had all the procedures before I perform them on my patients and feel that I was appropriately trained before starting to do them. I personally do all my procedures, not office staff or estheticians. I do have some patients with unrealisyic expectations and try to be clear on what my procedures can and can’t do. These minimally invasive treatments are enhancements like make-up or hair color. I have done a few facial vein treatments on children and some hair removal on teenagers, however overall I would balk at more than this. I get a great opportunity to discuss sun exposure, diet and exercise, hormone replacement, and tobacco abuse with my patients and try to help them make healthier lifestyle changes.

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  14. Sherry

    Beauty is in the eye of the beholder. Today, we are fortunate to have many options be it surgical or non-surgical to choose from that will enhance or reconstruct the features we were born with, or have neglected. Self esteem and ones mental health are additional ‘parts’ of a whole being. I feel that as a plastic surgeon you have to consider the ‘whole’ person before committing to a procedure. As an adult, if having a procedure makes someone feel better about themselves then a conscious decision between the provider and the patient should be made. I do feel children should not have any enhancements until over age 18.

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  15. Kim Anne

    As a women’s health provider, I see many breast implants, liposuction and minor work results. Sometimes patients ask my opinion before. I think it is fine if someone wants to have something done to enhance their appearance. However, especially with breast implants, the results may not be natural looking and the psychological need may have been more for poor self esteem or a desire to look like an unrealistic ideal. I think we should especially be cautious with teens. My 15 y.o. asks about liposuction! The emphasis should be on health and good personal choices and not just on appearance.

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  16. Elora

    I think Plastic Surgery/Cosmetic surgery is a wonderful thing. I believe everyone has their own definition of beauty and the right to look by what they define. For some people that may be something simple like fuller lips, others want body contouring … its all relevant to each person’s opinion. I myself would love to get work done someday. Maybe make the nose a little more defined, remove a lil’ fat from certain areas where the gym doesn’t help. But that’s because to me that is what I think would make myself beautiful, not to say I think I am ugly now, but if I believe I can correct what I believe are my little errors then why not. Plastic surgery is actually the field I want to go into one day, and I am beyond excited to my plastic surgery elective this summer.

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  17. Scott K

    I personally approve something that makes you feel better physically or mentally or spiritually if it doesn’t take money away from basic needs and doesn’t impinge negatively on others.
    I’m also glad that I live in a country where we can have discussions like this and everybody is right.

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  18. Tanya

    Do what makes you happy! It’s your money and if you want to get cosmetic procedures done, why not? There is a minimal risk, but the benefits of increased confidence, are well worth it.

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  19. Regina

    As a female physician I have lived with excessive stress, poor diet, and lack of consistent exercise for most of my life starting with medical school. Tanned skin was an almost universal requirement in my age group to be considered beautiful so I sunbathed and used tanning beds for about 35 years. All this damaged my skin, so in my early 40’s I could see clear signs of aging. “Not fair!” I said. “I just now reached a point in my life where I can relax and enjoy myself. I do not want to look too old to be doing the things I postponed all those early years in school and starting a practice.” I researched all the available options and found skin rejuvination and tightening with laser to be safe, effective for early signs of aging, and with minimal discomfort and recovery time. I got alittle braver and tried botox to smooth lines between my brows and smile lines around my eyes. Worked well with the added bonus of relieving my frequent tension headaches! I do not use botox in areas that would interfere with my usual expressions my friends and family consider part of my “character.” Most recently I used alittle juvederm to define the edges of my lips where tiny lipstick lines were starting to pop up. No regrets there, either. All this seems about the same as coloring or perming my hair. People have been enhancing their appearance for thousands of years. We just happen to have better stuff in the last 8 years.

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  20. KESO MD

    Health is physical, mental, spiritual well being. As a doctor i do not encourage the patient in his/her mental or spiritual misperception when there is no gross deformity. Instead, I work to heal them within so that the outward perception is corrected- in their minds. This not only corrects their deformity but their other somatic , social, and personal problems.

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  21. Alana Smithee

    re: Dr. Balhuizen:

    The study you’re referring to studied 24000 women who specifically had breast implants. The study went on for 15 years. “…A total of 480 women with breast implants died during this period. Compared with the control group, the scientists calculated the mortality rate was 26 percent lower in the women with breast implants. The discrepancy can be accounted for, they said, by the fewer deaths from cancer, notably breast cancer, and heart disease for the women with breast implants….”. If you calculate the mortality rate compared to the total number of women, it’s really not that high for any one cause.

    The study suggests that it wasn’t really able to quantify how many of the women in the study had major or minor depressive problems before or after the surgery. This would be a vital number in figuring anything valid about the study.

    Basically, some number of 480 women died of suicide; a number possible around 50 but possibly not. That’s not really not a statistically significant number. The lives were important, of course, but the stats are not.

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  22. Alana Smithee

    re: Dr. Franks:

    I had a mole removed on my shoulder last year, because it was getting abraded every time I put my bra on. If I went out with a sleeveless shirt in the summer, it looked like some bubo or other. =) Not all moles are equal, I guess.

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  23. John Balhuizen MD

    Since a significant % of people, who had plastic surgery, commit suicide later,
    I would strongly recommend that people who contemplate plastic surgery, undergo
    a psychiatric evaluation first, to make sure they do it for the right reasons.

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  24. Alana Smithee

    I’m forty-two years old now, and I have been told I look around 30. On, I got the same result. I agree that my face looks good (well, I would like my eyes to be slightly more almond shaped and tipped up, but that’s a detail, not something worth a whole procedure). My problem is my belly. My hips are slim, my legs are nice, my torso is huge. Ever since I was about 5, I’ve looked like I’m wearing some sort of Roman warrior plate armor on my stomach, with the traditional 2 roll belly. It has never left me, even when I’ve been very anorexic, very athletic, or really, very anything.

    I would get liposuction in an instant to repair this, but it’s so frightening… reviews on the internet are not only biased, but written by people in the heat of anger or happiness or whatever. You can look in the phone book and find organizations that oversee certain aspects of any surgical profession, ombudsmans, provincial/state boards, but we have all heard of doctors with a complaint sheet as long as your leg getting no public exposure as a bad doctor. I don’t want to have a smoother belly if it means putting it into a crematorium because of some mistake. =/

    I think everyone could come up with one thing to change… I think it’s just how much that thing changes the way one looks at oneself, and how others look at you.

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  25. ME Ciptak RN PsyD

    Plastics on large scale is still in it’s infancy… the trend will continue to what the market can bear. It is only really recently in history that common folk have a disposable income–something that in the past, only Kings, Presidents and Emperors had.

    In countries of Western culture/influence, machines do most of the physical work. People sit. Loss of tone, less exercise, less outdoor exposure, major changes in diet affect how we feel, look and age. Plastics is truly the ultimate indulgence in affluent societies.

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  26. Whiz

    Just shows that people can AFFORD the things they really want (but they’ll plead ‘poor’ when asked to contribute to something worthwhile)!

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  27. Anne

    I had a minor face lift at age 64. The only thing I regret is that the plastic surgeon used restylane to fill wrinkles around my mouth, instead of making the lift just a little tighter. When the restylane dissolved there was not that much difference for what I went through. I would do it again only with a different plastic surgeon.
    I am a full-time student going for my bachelors in nursing and I want to look young enough to still get hired after I graduate. Also, if I look good, I feel good, and I see nothing wrong with that.

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  28. Karen

    I believe to much emphasis is placed on retaining youthful appearances at any cost, including in some cases one’s life. Some of the most beautiful movie stars have ruined their appearances and it really is apparent. Moderation is key, and that should be the rule. I am not opposed to plastic surgery for adults, however I do have a problem with children having this type of surgery.

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  29. PA Fay

    I work with a Plastic Surgeon. Most procedures, even cosmetic ones can be thought of as reconstruction. Many women remard that their back pain is gone after tummy tucks. If the person is willing to undergo surgery and recovery, personal choice is still available in this country.

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  30. Claire Nunes-Vaz MD

    This terribly narcissistic trend is distressing. The risks involved can be horrific. I can appreciate the need to deal with disfiguring scars or gross abnormalities but where does one draw the line.
    Focusing on good health rather thana perfect appearance is ethically much more comfortable.
    Hollywood should not set the standard for appearance. It frightens me more that very young people are asking for the Perfect rather than the beautifully healthy look.

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  31. Dr. Franks

    I see quite a few teenagers in my pediatric practice, and I’ve definitely noticed a change in attitudes, not just with my patients, but also their parents! It’s no wonder teens are thinking about having surgery done when so many of their parents are doing it! Thankfully, most parents are still dead against their children having any major surgery, but more and more of them are asking about things like removing moles and even freckles!! It definitely concerns me that we are so becoming paranoid about such the things that make us unique.

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  32. Shannon

    As far as I’m concerned, if we have ways to look better, why wouldn’t we want to take advantage of that? When I look good, I feel good too. I haven’t had anything done yet except whitning my teeth, but if I start to see things heading south, I won’t hesitate!

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