In today’s world of internet and TV shows, plastic surgery is a frequent topic of great interest to the public. While I have seen very few of such shows, I do hear of them from time to time as patients ask me specific questions on procedures that they have been presented on them. Today one of my patients asked me about a show on Dr. Oz that appeared last week. She stated it was about the ‘three plastic surgery procedures you should not have’. These included buttock implants, silicone lip augmentation and facial threadlifts.
One of the two established ways to increase buttock size is either the placement of an implant or by fat injections. The popularity of buttock augmentation today is primarily due to the use of fat injections. Known as a Brazilian Butt Lift, it offers the simultaneous benefit of unwanted fat reduction elsewhere since donor fat is needed. But before fat injections, buttock implants were the only option. The use of such implants is actually very successful and it offers permanent volume retention. But it was never widely popular because the recovery is significant due to the submuscular placement of the implant. On the Dr. Oz show it was stated that you shouldn’t have this procedure because you can not sit for weeks after surgery. This is not true. The buttock implant is actually not placed on where you sit, the lower buttocks or ischium. It actually sits higher in the upper half of the buttocks region so you never actually sit on the implants.
Lip augmentation has become both possible and very popular due to injectable fillers. Largely done through the use of hyaluronic acid-based fillers, the increase in lip size is both immediate and very visible. Its only downside is that the results are not permanent and lasts only as long as the material’s properties permit. (between four and eight months) Silicone oil is a permanent injectable soft tissue filler but it is not FDA-approved. It also has a long history of known soft tissue problems that date back from the late 1960s. It is true that the material today (Silikon 1000) is a medical-grade material which is FDA-approved for eye fluid replacement. Some injectors use it employing a micro-droplet technique that purportedly eliminates the soft tissue problems of the past. I would have no doubt that a better material and injection technique is much more likely to be successful. But when the successful use of any permanent implantable material is highly technique-dependent, a significant rate of complications will ensue. Stay with the more temporary injectable fillers which have a proven track record of safety.
Threadlifts were very popular in the mid-1990s as a minimally invasive facial rejuvenation procedure for lifting of the brow, cheeks and neck. It has faded in use because it was realized that it could only produce a limited lifting effect and the results were not long-lasting. More traditional soft tissue excision and lifting procedures (e.g., Lifestyle lift, Quicklift etc) are more effective and offer a much better value. As one ages, it is possible that the subcutaneous linear location of these threads could become obvious due to fat atrophy and tissue thinning. Apparently the show stated that the removal of these implanted threads, if needed, was very difficult. I have removed numerous of these threads over the years and have not found their removal difficult or a particular problem. The reason to avoid threadlifts is because they do not work well. Because these facial threads are no longer manufactured, avoiding this procedure is no longer a concern.
Dr. Barry Eppley
Indianapolis, Indiana