Plastic Surgery: Fact and Fiction

With the success of reality TV plastic surgery programs, cosmetic surgery is more popular than ever. According to the American Society for Aesthetic Plastic Surgery (ASAPS), the total number of cosmetic procedures performed annually has increased 293 percent since 1997. With that exposure comes more awareness about this previously veiled experience.

"Twenty years ago, there was no information about plastic surgery except from plastic surgeons," says Alan M. Engler, M.D., a board certified plastic surgeon in private practice in New York City and author of BodySculpture. "Now, because of reality shows, patients are coming into my office and saying, 'I want the following four procedures done.'"

The danger lies in developing unrealistic expectations. After all, the "before" and "after" shots of patients on TV shows are usually dramatic. But that's not necessarily how it will be for the average person.

"If you're considering having plastic surgery or any cosmetic procedure, it's important to come in with realistic expectations by doing your research," says Dr. Engler.

Surgery has risks

Fiction: Since it's cosmetic, it's not risky.

Fact: "Cosmetic surgery may be cosmetic, but it's still surgery," says Dr. Engler. "With any surgery, there are risks associated with anesthesia, poor wound healing and infections, not to mention the uncertainty associated with the procedure itself, including the potential for long-term medical complications. Any of these risks could be life-threatening, although it's unlikely."

Still, it's important to know what could go wrong before you sign on the dotted line. You also should learn the risks for cosmetic procedures you're considering that aren't surgery, but fall within the spectrum of a "procedure." Possible complications from any injectable filler, such as collagen, for example, include bleeding, swelling, lumpiness, pain, infection and scarring.

Fiction: Plastic surgery is expensive, but you get what you pay for.

Fact: A physician with a good track record and a solid following will charge more than one who's less established or less well-known, but don't let a high price tag alone -- or a low one, for that matter -- be your deciding factor.

"See several surgeons to determine if there are variations on what each recommends," says Dr. Engler. "Compare the doctor's approach and the support staff, since they'll also be working with you. You should feel comfortable and have a clear idea of how the procedures you're considering will look."

Subtle improvements

Fiction: Not only will your appearance change, but so will your life.

Fact: "In most cases, plastic surgery can provide subtle improvements in your overall quality of life," says Dr. Engler. "But it won't save your marriage, erase 20 years of hard living or put your career on the fast track. If the rest of your life isn't going so well and you think plastic surgery is the answer, you're likely to be disappointed."

It's reasonable to expect, though, that cosmetic procedures can provide a boost in confidence and help you look younger than your age by seven to 10 years, depending on what you're having done, Dr. Engler says.

Fiction: The earlier you start with plastic surgery, the better.

Fact: "You can start too early," says Dr. Engler. "If a 20-year-old came in for a face-lift, I'd worry."

Likewise, according to ASAPS and the American Society for Plastic Surgeons, getting breast implants isn't recommended for women younger than 18 in light of the potential long-term ramifications.

Among adults, those ages 35 to 50 are having the most cosmetic procedures done, according to ASAPS. If you'd rather not let nature take its course, there's a benefit to starting early.

"If you're considering plastic surgery, and you do it -- say in your 50s -- rather than holding off until you're 63, the procedure typically will be less extensive," says Dr. Engler. "The results also will be less obvious and the surgery easier to recover from."