People have many misconceptions and oversimplified ideas about plastic surgery. While many associate the field with the material plastic, the word actually comes from the Greek word meaning “to mold”. Almost all plastic surgeries have some cosmetic element, but many procedures focus on reconstruction. In 2011, the most common reconstructive surgeries were tumor removal and laceration repair, according to the American Society of Plastic Surgeons.
“Reconstructive surgery restores the normal and cosmetic surgery improves on the normal,” said Dr. Rod Rohrich, professor and chairman of plastic and reconstructive surgery at the University of Texas Southwestern Medical Center in Dallas.
But plastic surgery is only part of the equation. Following reconstructive surgery, a patient typically requires rehabilitation. Exercise needs to be done after liposuction. And while cosmetic surgery can tighten skin, a patient may have to apply post-cosmetic surgery creams to minimize lines. Surgical and nonsurgical procedures “can complement and enhance each other, but they don’t replace each other,” said Dr. Alan Matarasso, a plastic surgeon practicing in Manhattan, and a spokesman for ASPS.
Regardless of the type of surgery someone ultimately has, prospective patients need to understand the risks and benefits of each and have realistic expectations about what it can do. Here, seven common misconceptions are laid to rest:
False. While liposuction involves removing fat from the body, it’s designed to remove fat from trouble spots. For a healthy person with excess fat in a specific area, liposuction may work well. However, it removes 10 to 12 pounds, tops.
That’s why, Matarasso said, the procedure may be most helpful in someone who is healthy and prefers a slightly different body shape.
“You can’t go to the gym and say I want to get rid of my love handles,” he said. Liposuction allows that targeting.
“When you lose weight, you lose it overall,” Matarasso said. “Weight loss through liposuction is site specific.”
Because plastic surgery entails a repair or enhancement, almost any procedure has a cosmetic element. But the names are not equivalent.
“Cosmetic surgery is a very generic term,” Rohrich said.
The terms go beyond semantics, however. Board certification in plastic surgery from the American Board of Plastic Surgeons means a physician has completed five years in surgical training at an accredited hospital, with at least two years dedicated to plastic surgery.
Physicians in other disciplines may have some training in plastic surgery; for example, an ophthalmologist may be trained to perform cosmetic procedures around the eyes. However, a medical degree and some form of certification in cosmetic surgery does not equal that level of training. That’s why prospective patients need to ask about a physician’s training.
“Any time you pick up a knife and cut the skin, a scar results,” Matarasso said. What plastic surgeons do, however, is minimize the appearance of scars.
How visible a scar might be is determined by how the surgical incision is closed; how it is cared for after the operation; and where the incision is made. Typically, a plastic surgeon will make an incision in an area where there are natural creases in the skin, which helps hide the scar. But some physical evidence of the procedure will always be present.
“We operate with scalpels, not wands,” Rohrich said.
Breast augmentation is one of three standard plastic surgery procedures that are performed on breasts. The others are breast reduction and breast lift, known as mastopexy. Augmentation and mastopexy may be done at the same time. However, neither is permanent.
Like other procedures, such as facelifts, Rohrich said, maintaining the appearance of the breasts will require another surgery as time passes and environment and genetics take their toll.
And breast implants — just like other artificial implants — have a limited shelf life; in the case of breast implants around 10 to 15 years.
But an implant’s projected life span is not an expiration date, and how long an implant lasts depends upon the individual. “Patients have to be followed and examined,” Matarasso said. “There’s not a set time when implants have to be taken out.”
If fat reappears after someone undergoes liposuction, it is not because of the procedure.
During liposuction, fat cells are removed from the body — which typically stops producing them during the early teenage years. But the cells that are left behind can still grow.
“If you really gain a lot of weight, fat can reappear in other places,” Rohrich said. Continuing to exercise and eat healthfully to prevent weight gain are the key to better results.
In other cases, the issue of increased fat in other places post-liposuction may be perception, said Matarasso. After undergoing liposuction, people’s perceptions of their body are out of proportion. A woman who has had liposuction on her thighs, for example, may feel as though her arms are fatter, he explained.
Ask your doctor about the exact post-surgical procedures to follow, but avoiding the sun is typically not necessary. It is a good idea to limit sun exposure after surgery since it can delay healing and cause scars to redden. (What’s more, sun exposure raises the risk of skin cancer.)
“You always should limit sun exposure,” Rohrich said. “The bottom line is that the sun is not your friend. You always want to use sunscreen to prevent sun damage and skin cancers.”
Cosmetic surgery is often elective and therefore is paid for out-of-pocket. In other words, don’t expect your health insurer to cover it. But whether or not you can afford the procedure is not the only issue you’ll need to consider.
While declining prices have helped make middle-income earners the primary consumers for cosmetic surgery, pre-surgical counseling is necessary before someone alters his or her appearance.
“I need people to understand it’s not going to be perfect,” Rohrich said. “You’re not going to look exactly the same. We’re surgeons, not magicians.” In addition to discussing what the surgery can accomplish, the surgeon will often attempt to gauge a patient’s expectations; whether she is emotionally stable; and whether she really wants the operation or is being coerced, Matarasso said. For example, is a woman considering a breast augmentation because her husband wants it or is a teenager getting a nose job at the urging of her mother? “You need to be properly screened so that your expectations are met,” he said.
Even in cases where the procedure is reconstructive, patients need to be counseled about the cost of the surgery, what rehabilitation will involve and what the likelihood of success is.