Plastic Surgery: You Can't Fool Mother Nature

Perception and aging have always traveled together, hand in hand. But aging isn’t only about crow’s-feet around the eyes, gray hair, comfortable shoes, and flannel pants.

Aging is about the experiences that time brings. It’s about coming full circle. I think it’s a beautiful thing. There is nothing more elegant than seeing people appreciate their age and adapting their behavior to make the best of their life.

Many of us, however, are strongly motivated by perception—by how we want others to see us. The phrase “Keeping up with the Joneses” comes to mind. And it’s not just about who has a greener lawn, or a bigger garage, or a fancier grill. Sometimes people treat their worldly possessions better than their health. I’ve seen grown men cry over a scratch on the hood of their car, yet they don’t hesitate to light up a cigarette as they inspect the damage. The same holds true for some women; they can find time to shop, but God forbid they make time to get a mammogram.

I think many of us have lost sight of what is really important in life. It starts with those numbers we put on our age; then one day we get a kind of cosmic message: “Look at yourself…you’re 50!”

That number may be a major kick in the gut for some, and so what do people do? Many reach for a quick fix: plastic surgery. Bigger breasts, defined calves, smaller thighs, Angelina Jolie–like lips, Nicole Kidman–like nose, hair plugs…you name it.

But surgery is no small thing. Anything that involves going under the knife should not be taken lightly.

Plastic Surgery Myths

Do breast implants interfere with breast-feeding?

Do breast implants interfere with screening for breast cancer?

Do breast implants fix saggy breasts?

Is liposuction always better than a tummy tuck?

Is laser hair removal painless and permanent?

Can lasers remove stretch marks and cellulite?

No, no, no, no, no, no.

Of course, no one would argue the necessity of plastic surgery when women have reconstructive surgery after breast cancer; when individuals have rhinoplasty, a nose job, because the anatomy of their nose interferes with normal breathing; or when women who suffer severe back pain because of very large breasts get a breast reduction. These are all very good examples of reconstructive plastic surgery.

But typically when we talk about plastic surgery, we’re talking about cosmetic surgery, which is done to improve a person’s appearance and self-esteem.

There is no doubt that these are boom times for cosmetic surgery. Inspired by all the body-overhaul programs on television these days, more and more people are flocking to plastic surgeons for a little nip here, a little tuck there, to get rid of all those nagging “imperfections.”

Most of the increase in visits to plastic surgeons today involve minimally invasive procedures like Botox treatments to remove wrinkles and frown lines, collagen injections to enlarge lips and “erase” wrinkles, chemical peels to improve the appearance of the skin, and laser treatments to remove hair.

But no one is ignoring the old standbys either: breast augmentations, eyelid surgeries, face-lifts, liposuctions, nose reshapings. And don’t think for a minute that cosmetic surgery applies only to women, even though women tend to be the bigger users. Clearly men nowadays are also using cosmetic surgery to improve their looks and feel younger.

For example, hair transplants, which involve transplanting hair from one part of the body to another, have been very popular with men who have premature baldness.


Liposuction is a technique that has benefited both men and women looking to remove excess fat from specific areas of their bodies. Liposuction reduces the number of fat cells in areas that are resistant to weight loss, but it is not an answer to obesity. It is not a cure-all for poor dietary habits and inactivity, and, in fact, when you remove large amounts of excess fat, significant metabolic changes occur in the body that could have serious effects on your health.

The latest modification of liposuction is body sculpturing, in which fat is removed from one part of the body and injected into another part that you want to reshape, such as the chest and pectoral muscles, for instance.

Breast Augmentation

Breast implants are the third most commonly performed type of cosmetic surgery in the United States. Though some women are concerned about silicone breast implants leading to breast cancer, no link has been established between the two. Nonetheless, the use of silicone has been discouraged in favor of saline breast implants. The implant is usually inserted directly into the breast itself, although it’s also possible to place the implant on top of the chest muscle.

Another approach is inserting the implant through the belly button, but it takes a great deal of skill to move the implant through the incision and all the way to the breast without creating a permanent tract of its passage through the body.

Tummy Tuck

Also popular with many women is the belly tuck, or tummy tuck, formally known as abdominoplasty. This is frequently done on women who, as a result of giving birth, have very lax abdominal muscles and very lax skin. Again, this is a major operation, in which all the excess skin and fat is removed and literally “tucked in.”

Face Lifts

The most popular type of plastic surgery is cosmetic surgery of the face. Face-lifts come in a variety of flavors, but all of them seek to pick up the slack in facial skin and reduce fine lines and wrinkling. Nowadays there are “drive-through” face-lifts, which are just mild cosmetic alterations done by placing and securing a thread in different parts of the face to hold the skin in a more rigid position.

These fast, drive-through technologies have a temporary life span and do not yield the results that you would expect from face-lifts involving major surgery. Partial facial procedures include a blepharoplasty, which can remove the excess skin from the eyelids. This is quite commonly done because the skin of the eyelid is the thinnest skin on the face and is usually the first facial feature to show signs of aging.

Suspension surgery of the neck and chin is done either by removing the excess skin or by placing sutures underneath the skin, in order to keep it tight. All these procedures are usually performed on an outpatient basis, and the typical complications involve blood loss, infection, and nerve damage, which are very rare, but the more detailed the facial reconstruction, the greater the chances of nerve damage.

If you are considering major plastic surgery for yourself, be sure to do it for the right reasons. What those right reasons are, I’ll leave up to you, but think about it carefully. If you decide to go ahead with the surgery, be prepared to deal with the recovery phase, which can be quite an emotional roller coaster.

The recovery, of course, is going to vary depending upon what kind of surgery you have. If you have a total face-lift, you’re going to be swollen and be black and blue, and the healing process will take months. You have to plan out how you’re going to deal with your recovery. Will you be able to take some time off from work? Does the doctor operating on you have the resources to give you the follow-up care that you’ll need?

What Happened to You?

Everyone has heard stories about plastic surgery. You want to avoid being one of those horror stories. Here are some tips to keep in mind when picking a plastic surgeon:

--Be sure the surgeon is board certified.

--Compare surgeons.

--Look at his or her credentials.

--Look at his or her previous work.

--Compare complication rates.

--Make sure the surgeon specializes in the part of the body that interests you.

--Make sure he or she operates in a well-accredited center.

More than 90 percent of individuals undergoing plastic surgery feel an overwhelming sense of improvement and a positive attitude toward their surgery. But 10 percent express regret afterward: “Why did I do this,” they ask themselves?

Some of these people will go through depression, which can be either transitory or quite damaging if not identified and treated effectively. But, thankfully, for the most part, plastic surgeries make those who go under the knife for the sake of appearance quite happy, even if only for a while.

Click here to check out Dr. Manny's book The Check List (Harper Collins, 2007), from which this article was excerpted.

Dr. Manny Alvarez is the managing editor of health news at, and is a regular medical contributor on the FOX News Channel. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.